Preaching to the choir? Sociodemographic differences in medical students’ evaluation of an undergraduate diversity training module

Abstract

This article was migrated. The article was marked as recommended. Introduction: Patients with diverse cultural backgrounds experience barriers in access to care, and do not always receive the care they need. To prepare future doctors to provide high quality care for all patients, adequate diversity education is essential. At VUmc School of Medical Sciences, we therefore developed a bachelor second year module on Care ethics and Diversity using an arts-based approach. The aim of this study was to evaluate the module from the students' perspective, and to gain insight in the relationship between evaluation outcomes and student sociodemographic characteristics. Methods: Design: cross-sectional evaluation study. Module content: after watching three short film fragments, students engaged in a structured dialogue about diversity in relation to care and care giving. Data collection: in 2015 and 2016, a questionnaire containing 12 evaluation items based on module learning outcomes were administered to second year medical students (N=287) immediately after receiving the module. Overall satisfaction with the module was measured using a 1-10 scale (with 1 indicating a very poor, and 10 indicating an excellent evaluation score); learning objective-related items were measured using a 5-point Likert scale. Results were analyzed using multiple linear regression, Pearson's correlation and Chi-square tests. Results: The average overall satisfaction score was 7.3. We found a strong positive correlation between the overall satisfaction score and the score of the item that measured students' level of interest (r=.70). Multiple linear regression showed a significant positive effect of identifying as non-native Dutch on multiple evaluation outcomes. Students with non-native Dutch backgrounds reported higher satisfaction with the module, perceived the module as more interesting and more personally relevant, and had higher scores on four of the six learning objective items. Discussion: Our findings indicate that students with non-native Dutch backgrounds were more satisfied with the module and reported more learning than their native Dutch peers. This might be explained by the fact that diversity education acknowledges Dutch students' lived experiences and builds on preexisting embodied diversity knowledge. Conversely, (white) native Dutch students might not always perceive diversity knowledge as legitimate or consider diversity as something that does not concern them. Conclusion: Non-native Dutch students reported more overall satisfaction with diversity education and more diversity learning than majority students. To secure and advance high quality health care for all patients, medical schools should invest in researching and developing diversity content that engages all students.