Black students applying and admitted to medicine in the province of Quebec, Canada: what do we know so far?

To address the underrepresentation of Black students in medical schools in Canada and identify barriers in selection processes, we compare data from the latest Canadian census to that of an exit-survey conducted after a situational judgment test (Casper) among medical school applicants and from questionnaires done after selection interviews in Quebec, Canada. The proportion of Black people aged 15-34 years old in Quebec in 2016 was 5.3% province-wide and 8.2% in the Montreal metropolitan area. The proportion in the applicant pool for 2020 in Quebec was estimated to be 4.5% based on Casper exit-survey data. Comparatively, it is estimated that Black people represented 1.8% of applicants invited to admission interviews and 1.2% of admitted students in Quebec in 2019. Although data from different cohorts and data sources do not allow for direct comparisons, these numbers suggest that Black students applying to medical school are disproportionately rejected at the first step compared to non-Black students. Longitudinal data collection among medical school applicants will be necessary to monitor the situation. Further studies are required to pinpoint the factors contributing to this underrepresentation, to keep improving the equity of our selection processes.

Temporal typifications as an organizational resource: Experiential knowledge and patient processing at the emergency department

The connection between time and power has been studied extensively. A common strategy through which street-level bureaucrats exert power and dominance over their clients consists of imposing protracted waiting and maintaining uncertainty regarding the outcomes of waiting. In this study, I argue that another facet of power in organizations is related to the temporal typification of cases. By exploring the triage work in two emergency departments (EDs), I show that nurses and clerks identify patterns in the temporal distribution of visits and attach clinical and moral meanings to them. The temporal typifications are sense-making devices through which triage workers orient to patients. They form a stock of tacit experiential knowledge that delineates specific expectations about the legitimacy of cases and the worth of patients. These expectations impact the unfolding and structure of triage admission interviews and contribute to the prioritization of cases. The study brings into conversation the sociological literature on time and power with the study of the moral evaluation of patients to examine temporal typifications as an organizational resource in healthcare settings. It contributes to a better understanding of triage workers’ experiential knowledge and the practical accomplishment of moral evaluation in EDs.

Incoming Veterinary Students’ Perspectives on Animal Welfare: A Qualitative Study

Animal welfare is an increasingly important component of veterinary medicine. While the AVMA Model Animal Welfare Curriculum is not required, there is growing research that examines veterinary students’ understanding of animal welfare and moral and ethical responsibility to animals. However, there is limited research that investigates incoming veterinary students’ perspectives on animal welfare: a significant pedagogical gap, as successful curriculum interventions take into account students’ pre-existing experiences. This study investigates this gap in the literature through a qualitative, interview-based study of twenty incoming veterinary students at an accredited veterinary college. Four themes are identified in the data: formative childhood experiences; pre-professional experiences in the field; public conversations in the media/ social media; and academic definitions memorized for admission interviews. In conclusion, I draw on the field of narrative medicine to discuss how students’ stories are important to understanding the curriculum and pedagogy of animal welfare in veterinary education.

The therapeutic needs of psychiatric in-patients with psychosis: A qualitative exploration of patient and staff perspectives

Background Concerns are recurrently expressed that the therapeutic content of in-patient care is limited and lacking clear guidance. The perspectives of patients and staff regarding therapeutic priorities for psychiatric in-patient care have been little explored and compared. Aims The aim of this study was to examine patient and staff perspectives on the care priorities of psychiatric in-patients with psychosis. Method We recruited 12 in-patients with psychosis and 12 multidisciplinary team staff. All participants undertook a semi-structured interview examining their perspectives on the therapeutic needs of people with psychosis during admission. Interviews were transcribed verbatim and thematic analysis conducted. Results Three superordinate themes arose from patient interviews: ‘the importance of considering social circumstances and trauma’, ‘managing the intra- and interpersonal impact of psychosis’ and ‘lack of control and collaboration in care’ and three from staff interviews: ‘multidisciplinary facilitators of care’, ‘treating complexity and incorporating social factors’ and ‘restrictive practices preventing quality care provision’. Comparison of patient and staff themes identified unmet needs in addressing social marginalisation, trauma and distress, and the importance of collaborative treatment process and inclusion of spirituality. Conclusions There are gaps between staff and patient perspectives on important priorities for in-patient care that may help explain persistent patient dissatisfaction with in-patient care. Findings suggest the need for coproduced work to develop and test interventions that address broader therapeutic priorities. Declaration of interest None.

Intended and unintended test constructs in a Multiple-Mini admission Interview. A validity study.

Admission interviews in higher education may be developed with the intention to select applicants with specific personal competences not captured by traditional grade-based admission. In this study, we examined whether the data structure of multiple-mini admission interview scores supported the presence of communication, empathy, collaboration, and resilience as independent test dimensions. In addition, the associations between the interview scores and unintended test constructs (station format, pre-university grades, age, gender) were examined. Confirmatory and exploratory factor analyses and regression analyses were used to examine interview data from a cohort of Danish medical school applicants. The proposed multi-dimensionality was not supported by the data structure. The influence of the unintended constructs examined was limited or non-existing. These results are in line with the scarce existing literature. This situation makes a priori claims that the multiple-mini interview can measure multi-dimensional personal competences inadvisable, and care should be taken about what is communicated to stakeholders.

Competing systems in Philadelphia phonology

This is a study of the competition of linguistic systems within the speech community, tracing the opposition of distinct phonological configurations. Among younger Philadelphians oriented to higher education, the traditional short-a system is giving way to the nasal system, in which all prenasal vowels are tense. We present evidence that this shift occurs systematically in both the lax and tense allophones. The degree of conformity to each system is measured for 106 subjects by the Pillai statistic; community-wide patterns are revealed by regression modeling and bimodality diagrams. Adherence to the traditional system is greatest for White speakers who graduated from Catholic high schools, while the nasal system is strongest for graduates from elite schools with special admission requirements. African American students show no orientation to the traditional system, but parallel White students in the shift to the nasal system. The histories of students through the educational system show that the speaker's short-a system is largely determined during their middle and high school years, before entering college. Special admission interviews play a special role in this process, as brief speech events that strongly determine the person's linguistic environment for the years that follow.