c h a t h a m U N I V E R S I T Y Physician Assistant Program Enhancing Diversity in the Admissions Process Luis A. Ramos, PA-C, Susan Hawkins, PA-C, Mark Hertweck, PA-C

Objectives Describe how diversity in the classroom, including racial and ethnic diversity, enhances the educational experience of all students Identify the key legal and policy trends associated with access and diversity efforts in higher education

Objectives Identify program-specific, diversity- related policies that can advance the educational goals of PA programs Construct a program’s diversity self- assessment survey and action plan Develop and implement a holistic approach to admissions at PA programs

Why is diversity in the classroom important?

Introduction The following is a summary of the statement of the American Council on Education entitled "On the Importance of Diversity in Higher Education“ PAEA is not an endorsing organization

Background Diversity in higher education: Colleges and universities Public and private Large urban universities and small rural campuses Two-year community colleges, Graduate and professional programs Undergraduate education

Background This collective diversity is one of the great strengths of America's higher education system Everyone agrees that diversity in student bodies, faculties, and staff is important to fulfill their primary mission: providing a quality education

Statement The public is entitled to know why institutions believe so strongly that racial and ethnic diversity should be one factor among the many considered in admissions and hiring

Reason #1 Enriches the educational experience We learn from experiences, beliefs, and perspectives different from our own This is best taught in richly diverse intellectual and social environments

Reason #2 Promotes personal growth Challenges stereotyped preconceptions Encourages critical thinking Helps students learn to communicate effectively with people of varied backgrounds Strengthens communities and the workplace

Reason #3 Prepares students to become good citizens Fosters mutual respect and teamwork Helps build communities whose members are judged by the quality of their character and their contributions

Reason #4 Enhances economic competitiveness Sustaining the nation's prosperity require us to make effective use of the talents and abilities of all our citizens in work settings that bring together individuals from diverse backgrounds and cultures

Conclusion Achieving diversity does not require quotas or warrants admission of unqualified applicants It does require that we continue to be able to reach out and make a conscious effort to build healthy and diverse learning environments

Key Legal and Policy Trends

Rationale for a New Policy Minority health care providers deliver disproportionate care to minority populations Racial-ethnic concordance of patient and provider result in improved communication, trust, and patient satisfaction

Rationale for a New Policy Patients prefer providers who share their own cultural, linguistic, and racial backgrounds Institute of Medicine recommends increased provider diversity as an action aimed at minimizing or eliminating health disparities

Rationale for a New Policy Underrepresented student diversity: Can result in an improved educational experience for all students Could reduce or eliminate health care disparities

Supreme Court Decision Underrepresented student diversity: Is the only rationale for race conscious admissions policies that has been accepted by the supreme court Must be applied to each individual

Supreme Court Decision Admit a group of students who individually and collectively are among the most capable Substantial promise for success in school Strong likelihood of succeeding in practice Contributing to the wellbeing of others Mix of students who will respect and learn from each other

Supreme Court Decision Focus on academic ability coupled with a flexible assessment of applicants’: Talents Experiences Potential to contribute to the learning of those around them

Supreme Court Decision Evaluate each applicant based on all information available on file, including: Personal statement Letters of recommendations Essay describing the ways in which the applicant will contribute to life and diversity

Supreme Court Decision Even the highest possible scores do not guarantee admission nor does a low score automatically disqualify an applicant Policy requires admissions officials to look beyond grades and test scores to other criteria that are important to the institution’s educational objectives

Supreme Court Decision The policy does not restrict the types of diversity contributions eligible for “substantial weight” in the admissions process, but instead recognizes “many possible bases for diversity admissions”

Supreme Court Decision By enrolling a “critical mass” of [underrepresented] minority students, the institution seeks to ensure their ability to make unique contributions to the character of the institution

The Evidence in the US Population

Diversity Rates Source: U.S. Census Bureau, Current Population Survey, 2007 Annual Social and Economic Supplement With degrees US Population

The Evidence in PA Education

Diversity Rates Health professions diversity rates: 6-9% PA profession’s: 21-25% So is there a problem?

URMs-Overall Rates PAEA Annual Demographic Reports, AY through AY

When URM rates are factored in, the profession’s rate remains the highest of all other health professions.

Masters Overall-URMs ‘97-’07 PAEA Annual Demographic Reports, AY through AY

Call to Action: Can the Chatham University PA Program Impact the Diversity of Our Student Body?

Background Chatham PA Program started in 1995 Master of Physician Assistant Studies (MPAS) awarded Bachelor’s degree required prior to admission

Years reflect graduation dates

Diversity Rates Overall diversity rate: 3.4% 20.6 points below PA national average (24%) URM rate: 2.4% 5.6 points below PA national average (7.5%)

Possible Barriers Interviews (interviewer bias, language skill) Writing exercise (language skill, evaluator bias, inter-reader reliability) Cost of travel to the University Emphasis on GPA (overall and science) Number of prerequisite courses Absence of diversity as a prioritized mission of the program

Selection Process Class of 2009 Pre-requisite courses General Chemistry (2 semesters) General Biology (2 semesters) General Psychology (2 semesters) Anatomy/Physiology (1 semester each) or Anatomy and Physiology (2 semesters) Developmental Psychology (1 semester) Genetics (1 semester) Statistics

Selection Process Class of 2009 Admission Requirements Overall and science (3.0) GPAs CASPA application Baccalaureate degree Shadowing Form Written Essay (decisive factor) Interview (decisive factor) Applications received Class of ‘09: 365

Rationale for Changes No outcomes correlation to support continuation of the following barriers: Developmental Psychology Genetics Statistics GPA Interview Written exercise (not conclusive)

Phase One -Class of 2010 Eliminated all prerequisites which were deemed as barriers Collected data on those that were inconclusive – no positive predictive value, some negative predictive value Applications received for Class of ‘10: 525

Phase Two -Class of 2011 Written exercise assessment modified (remote option) No requirement to come on campus prior to selection Implemented Holistic Review Process Applications received Class of ‘11: 765

Holistic Review Process What qualities make an excellent physician assistant? How can the physician assistant class more closely represent the population at large? What type of student do we want to have in our classroom?

Holistic Review Process Selection based on total credits rather than any one criterion Minimum requirements must be met Pool of applicants considered for acceptance show substantial promise for success

Holistic Review Process Four Major areas evaluated Sustained Academic Performance Personal characteristics Personal attributes Personal Experiences

Sustained Academic Performance Overall GPA of 3.5 and above or induction into a national honor society Research, publications, or presentations Advanced degrees or training

Personal Characteristics Cultural background Ethnicity Race Gender Socioeconomic status Region of residence (rural or inner city)

Personal Attributes Leadership Enthusiasm Trustworthy Honesty Motivation Confidence Tolerance Altruism Goal oriented Team player

Personal Experiences Life adversities and struggles Multilingual ability Contact with other cultures or travel Work experience, especially in healthcare Military or government service Voluntary service Chatham student or alumni

Diversity Rates 2010: 6% (3 A and no URM out of 50) 2011: 17% (5 A and 7 URM out of 72) 21% economically disadvantaged (from NR) 22% male (from 6%) 18% students over 30 y/o (from <5%) 5.5% students with special needs (from 0%)

Phase Three Number of applicants for Class of 2012: Approximately 1,000 Written exercise eliminated Holistic Approach to Admissions

Conclusion Elimination of barriers a factor in increasing diversity Implementation of the holistic approach to admissions had a big impact

Conclusion Further research Applicants’ rates for previous years were not analyzed Retention rates need to be monitored

We still have some ways to go… goal is at least 25% diversity rate.

Questions?