KEVIN EAGAN, JUAN GARIBAY, MICHAEL SOH, SYLVIA HURTADO, MITCHELL CHANG

1. GUNNING FOR THE WIN! HOW COMPETITIVE CLASSROOM ENVIRONMENTS AND STUDENT EXPERIENCES PREDICT PRE-MEDS’ COMMITMENT TO HEALTH RESEARCH AND PRACTICE KEVIN EAGAN, JUAN GARIBAY, MICHAEL SOH, SYLVIA HURTADO, MITCHELL CHANG University of California, Los Angeles

2. BACKGROUND • Call for increasing the number of physicians, especially from URM groups • URM <10% of physician workforce • Greater diversity among medical professionals requires a better understanding of premedical student experience and context • Competitive and collaborative learning environments • Premedical students less likely to persist in STEM, despite entering college as more well-prepared

3. BACKGROUND • Introductory STEM classrooms present significant barriers for persistence in premedical studies • Competitive environment • Lack of engaging pedagogy • Premedical student experience • “Gunners” • Competition vs. journey of self discovery • Premedical culture vs. medical school objectives

4. BACKGROUND • Gatekeeper debate • Necessary to discourage ‘unfit’ students • Competitive nature of gatekeeper debate disadvantages students whose cultural backgrounds do not value competition • Differential effects of competitive classroom environments • By gender • By race

5. RESEARCH QUESTION Controlling for students’ prior academic preparation and co-curricular experiences, how do premedical students’ experiences in introductory STEM courses, the learning environments in these courses, and the pedagogies students encounter predict the development of their commitment to health research and practice?

6. THEORETICAL FRAMEWORK Social Cognitive Career Theory (SCCT) • Self-efficacy, outcome expectations, personal goals • Student interests and goals precede a student’s action to become a physician Students’ basic values embedded in outcome expectations • Anticipated outcomes of medical career (e.g. status, money, helping others) • Hyper-competitive undergraduate STEM learning environment Self-efficacy • Occupational interests reflect self-efficacy beliefs • Culturally determined competition-cooperation norms

7. METHOD: DATA AND SAMPLE • Introductory STEM course student surveys in spring 2010 • Pre and post • 3,205 respondents • Pre-college experiences and academic preparation, educational and career aspirations, introductory STEM course experiences, and perceptions of the professors teaching these courses • Introductory STEM faculty survey • Cross-sectional • 76 classrooms • Perceptions of and goals for undergraduate students, the instructional strategies used in their introductory STEM courses, and opinions about institutional priorities • Analytic sample: 1,218 premedical students in 65 classrooms

8. METHOD: VARIABLES • Dependent variable: Commitment to health research and practice • Making a theoretical contribution to science • Improving the health of all communities • Improving the health of minority communities • Working to find a cure for a health problem • Alpha = 0.75 • Direct Pretest: Commitment to health research and practice • Alpha= 0.72

9. METHOD: VARIABLES AND ANALYSIS • Independent variables • Background characteristics and pre-college preparation • Measures of self-efficacy (e.g., resiliency, competitiveness) • Classroom experiences (e.g., asked questions, sense of competition) • Classroom context (e.g., overall competition, collaboration, faculty encouraging questions) • Analysis • Missing data – expectation maximization • Hierarchical linear modeling (ICC = 3%)

10. METHOD: LIMITATIONS • Limited generalizability • Short timeframe (one academic term) • Not a full test of Social Cognitive Career Theory • Unobserved co-curricular variables

11. Premedical Student Characteristics • Compared to non-STEM/non-premed and to STEM, non-premed students, premedical students: • Are the most academically prepared (67% earned A/A- in HS) • Have the greatest commitment to their major • Have the greatest commitment to their career aspiration • Report the highest ratings of wanting to help those in difficulty (76%) • Report the highest level of involvement • Come from more affluent, most well-educated families

12. FINDINGS: CLASSROOM CONTEXT

13. FINDINGS: STUDENT-LEVEL VARIABLES

14. DISCUSSION • Premedical students, as a group, not affected by competitive classrooms as it relates to their commitment to health research and practice • Commitment to health research and practice reduced in classrooms where faculty include complex problem-solving • Importance of faculty ethic of care – welcoming questions

15. DISCUSSION • Early research exposure as a precursor to a stronger commitment to health research and practice • Student resiliency and its connection to collaboration • Intellectual stimulation and grading on a curve • Feeling respected and having opportunities to collaborate

16. CONCLUSION • Importance of implementing learning environments that: • Increase student interest in health professions AND • Are consistent with goals of medical field • Competitive learning environments can: • Impede development of interpersonal communication skills • Decrease development of empathy and altruism • More opportunities for collaboration • Importance of premedical students learning about teamwork • Creating a supportive network

17. CONTACT INFORMATION Administrative Staff: Dominique Harrison Faculty/Co-PIs: Sylvia Hurtado Mitchell Chang Postdoctoral Scholars: Kevin Eagan Josephine Gasiewski Graduate Research Assistants: Tanya Figueroa Gina Garcia Juan Garibay Felisha Herrera Bryce Hughes Cindy Mosqueda Michael Soh Papers and reports are available for download from project website: http://heri.ucla.edu/nih Project e-mail: herinih@ucla.edu This study was made possible by the support of the National Institute of General Medical Sciences, NIH Grant Numbers 1 R01 GMO71968-01 and R01 GMO71968-05, the National Science Foundation, NSF Grant Number 0757076, and the American Recovery and Reinvestment Act of 2009 through the National Institute of General Medical Sciences, NIH Grant 1RC1GM090776-01. This independent research and the views expressed here do not indicate endorsement by the sponsors.