Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schools

Objective To measure Differential Attainment (DA) among Scottish medical students and to explore whether attainment gaps increase or decrease during medical school.Design A retrospective analysis of undergraduate medical student performance on written assessment, measured at the start and end of med...

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Main Authors: David Hope, John Paul Leach, Alan Jaap, Avril Dewar, Eleanor J Hothersall, Isobel Cameron
Format: Article
Language:English
Published: BMJ Publishing Group 2021-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/9/e046056.full
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author David Hope
John Paul Leach
Alan Jaap
Avril Dewar
Eleanor J Hothersall
Isobel Cameron
author_facet David Hope
John Paul Leach
Alan Jaap
Avril Dewar
Eleanor J Hothersall
Isobel Cameron
author_sort David Hope
collection DOAJ
description Objective To measure Differential Attainment (DA) among Scottish medical students and to explore whether attainment gaps increase or decrease during medical school.Design A retrospective analysis of undergraduate medical student performance on written assessment, measured at the start and end of medical school.Setting Four Scottish medical schools (universities of Aberdeen, Dundee, Edinburgh and Glasgow).Participants 1512 medical students who attempted (but did not necessarily pass) final written assessment.Main outcome measures The study modelled the change in attainment gap during medical school for four student demographical categories (white/non-white, international/Scottish domiciled, male/female and with/without a known disability) to test whether the attainment gap grew, shrank or remained stable during medical school. Separately, the study modelled the expected versus actual frequency of different demographical groups in the top and bottom decile of the cohort.Results The attainment gap grew significantly for white versus non-white students (t(449.39)=7.37, p=0.001, d=0.49 and 95% CI 0.34 to 0.58), for internationally domiciled versus Scottish-domiciled students (t(205.8) = −7, p=0.01, d=0.61 and 95% CI –0.75 to −0.42) and for male versus female students (t(1336.68)=3.54, p=0.01, d=0.19 and 95% CI 0.08 to 0.27). International, non-white and male students received higher marks than their comparison group at the start of medical school but lower marks by final assessment. No significant differences were observed for disability status. Students with a known disability, Scottish students and non-white students were over-represented in the bottom decile and under-represented in the top decile.Conclusions The tendency for attainment gaps to grow during undergraduate medical education suggests that educational factors at medical schools may—however inadvertently—contribute to DA. It is of critical importance that medical schools investigate attainment gaps within their cohorts and explore potential underlying causes.
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spelling doaj-art-b6ed3ab5a431420d9cdabb87ef8644212025-08-20T02:18:35ZengBMJ Publishing GroupBMJ Open2044-60552021-09-0111910.1136/bmjopen-2020-046056Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schoolsDavid Hope0John Paul Leach1Alan Jaap2Avril Dewar3Eleanor J Hothersall4Isobel Cameron5NHS Lothian, Edinburgh, UKSchool of Medicine, University of Glasgow, Glasgow, UKThe University of Edinburgh, Royal Infirmary of Edinburgh1 Medical Education Unit, The University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK2 School of Medicine, University of Dundee, Dundee, UK4 School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UKObjective To measure Differential Attainment (DA) among Scottish medical students and to explore whether attainment gaps increase or decrease during medical school.Design A retrospective analysis of undergraduate medical student performance on written assessment, measured at the start and end of medical school.Setting Four Scottish medical schools (universities of Aberdeen, Dundee, Edinburgh and Glasgow).Participants 1512 medical students who attempted (but did not necessarily pass) final written assessment.Main outcome measures The study modelled the change in attainment gap during medical school for four student demographical categories (white/non-white, international/Scottish domiciled, male/female and with/without a known disability) to test whether the attainment gap grew, shrank or remained stable during medical school. Separately, the study modelled the expected versus actual frequency of different demographical groups in the top and bottom decile of the cohort.Results The attainment gap grew significantly for white versus non-white students (t(449.39)=7.37, p=0.001, d=0.49 and 95% CI 0.34 to 0.58), for internationally domiciled versus Scottish-domiciled students (t(205.8) = −7, p=0.01, d=0.61 and 95% CI –0.75 to −0.42) and for male versus female students (t(1336.68)=3.54, p=0.01, d=0.19 and 95% CI 0.08 to 0.27). International, non-white and male students received higher marks than their comparison group at the start of medical school but lower marks by final assessment. No significant differences were observed for disability status. Students with a known disability, Scottish students and non-white students were over-represented in the bottom decile and under-represented in the top decile.Conclusions The tendency for attainment gaps to grow during undergraduate medical education suggests that educational factors at medical schools may—however inadvertently—contribute to DA. It is of critical importance that medical schools investigate attainment gaps within their cohorts and explore potential underlying causes.https://bmjopen.bmj.com/content/11/9/e046056.full
spellingShingle David Hope
John Paul Leach
Alan Jaap
Avril Dewar
Eleanor J Hothersall
Isobel Cameron
Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schools
BMJ Open
title Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schools
title_full Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schools
title_fullStr Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schools
title_full_unstemmed Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schools
title_short Measuring differential attainment: a longitudinal analysis of assessment results for 1512 medical students at four Scottish medical schools
title_sort measuring differential attainment a longitudinal analysis of assessment results for 1512 medical students at four scottish medical schools
url https://bmjopen.bmj.com/content/11/9/e046056.full
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