Abstract
Non-local ethnicity or nationality and lower English proficiency have been linked with poor performance in health professional education. This study sought to compare the relative contributions of ethnicity and English proficiency, and to do so in a context where students had not been selected via interviews or some other proxy for language proficiency. Ethnicity, citizenship, and demographic data, as well as academic performance and progress were obtained for three successive cohorts (entering in 2007, 2008 and 2009) into a three-year pharmacy programme, following a common first-year. Complete data was available for all 297 students entering via this path. By the end of the programme, controlling for grades at entry, students from some non-local ethnic backgrounds (p < .001) underperformed local students, as did males (p < .001) and those who had been identified as having low English proficiency in year 1 (p < .01). Males (p < .01) and one non-local ethnic group (p < .01) were also more likely to have to repeat a year of study. Ethnicity was a stronger predictor than English proficiency or acculturation, but English proficiency was still independently and additively predictive. This suggests that targeted support strategies for students with lower English language proficiency are still important, but that cultural differences should not be underestimated.
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References
Bhutta, M. F. (2011). Widening access to medical school. Could proficiency in English be a factor? BMJ, 342, d1942. doi:10.1136/bmj.d1942.
Bleakley, H., & Chin, A. (2008). What holds back the second generation? The intergenerational transmission of language human capital among immigrants. Journal of Human Resources, 43, 267–298.
Chur-Hansen, A. (1997). Language background, proficiency in English, and selection for language development. Medical Education, 31, 312–319.
Chur-Hansen, A. (1999). Teaching support in the behavioural sciences for non-English speaking background medical undergraduates. Medical Education, 33, 404–410.
Cleland, J., Mackenzie, R. K., Ross, S., Sinclair, H. K., & Lee, A. J. (2010). A remedial intervention linked to a formative assessment is effective in terms of improving student performance in subsequent degree examinations. Medical Teacher, 32, E185–E190. doi:10.3109/01421591003657485.
Eseonu, K., Wedderburn, C., & Maurice, J. (2011). Clinical communication for international students in the UK undergraduate curriculum. Clinical Teacher, 8, 186–191. doi:10.1111/j.1743-498X.2011.00460.x.
Fernandez, A., Wang, F., Braveman, M., Finkas, L. K., & Hauer, K. E. (2007). Impact of student ethnicity and primary childhood language on communication skill assessment in a clinical performance examination. Journal of General Internal Medicine, 22, 1155–1160. doi:10.1007/s11606-007-0250-0.
Flaherty, J. A., Rezler, A., & McGuire, C. (1982). Clinical reading and writing skills of junior medical students. Journal of Medical Education, 57, 848–853.
Frischenschlager, O., Haidinger, G., & Mitterauer, L. (2005). Factors associated with academic success at Vienna Medical School: Prospective survey. Croatian Medical Journal, 46, 58–65.
Haq, I., Higham, J., Morris, R., & Dacre, J. (2005). Effect of ethnicity and gender on performance in undergraduate medical examinations. Medical Education, 39, 1126–1128. doi:10.1111/j.1365-2929.2005.02319.x.
Hayes, S. C., & Farnill, D. (1993). Medical training and English-language proficiency. Medical Education, 27, 6–14.
Kay-Lambkin, F., Pearson, S.-A., & Rolfe, I. (2002). The influence of admissions variables on first year medical school performance: A study from Newcastle University, Australia. Medical Education, 36, 154–159. doi:10.1046/j.1365-2923.2002.01071.x.
Liddell, M. J., & Koritsas, S. (2004). Effect of medical students’ ethnicity on their attitudes towards consultation skills and final year examination performance. Medical Education, 38, 187–198.
Lumb, A. B., & Vail, A. (2004). Comparison of academic, application form and social factors in predicting early performance on the medical course. Medical Education, 38, 1002–1005. doi:10.1111/j.1365-2929.2004.01912.x.
Mann, C., Canny, B., Lindley, J., & Rajan, R. (2010). The influence of language family on academic performance in year 1 and 2 MBBS students. Medical Education, 44, 786–794. doi:10.1111/j.1365-2923.2010.03711.x.
McManus, I. C., Elder, A. T., & Dacre, J. (2013). Investigating possible ethnicity and sex bias in clinical examiners: An analysis of data from the MRCP(UK) PACES and nPACES examinations. BMC Medical Education, 13, 103. doi:10.1186/1472-6920-13-103.
Parry, J., Mathers, J., Stevens, A., Parsons, A., Lilford, R., Spurgeon, P., et al. (2006). Admissions processes for five year medical courses at English schools: Review. British Medical Journal, 332, 1005–1009. doi:10.1136/bmj.38768.590174.55.
Shulruf, B., Poole, P., Wang, G. Y., Rudland, J., & Wilkinson, T. (2012). How well do selection tools predict performance later in a medical programme? Advances in Health Sciences Education, 17, 615–626. doi:10.1007/s10459-011-9324-1.
Stegers-Jager, K. M., Steyerberg, E. W., Cohen-Schotanus, J., & Themmen, A. P. N. (2012). Ethnic disparities in undergraduate pre-clinical and clinical performance. Medical Education, 46, 575–585. doi:10.1111/j.1365-2923.2012.04265.x.
Woolf, K., Haq, I., McManus, I. C., Higham, J., & Dacre, J. (2008). Exploring the underperformance of male and minority ethnic medical students in first year clinical examinations. Advances in Health Sciences Education, 13, 607–616. doi:10.1007/s10459-007-9067-1.
Woolf, K., McManus, I. C., Potts, H. W. W., & Dacre, J. (2013). The mediators of minority ethnic underperformance in final medical school examinations. British Journal of Educational Psychology, 83, 135–159. doi:10.1111/j.2044-8279.2011.02060.x.
Woolf, K., Potts, H. W., & McManus, I. C. (2011). Ethnicity and academic performance in UK trained doctors and medical students: Systematic review and meta-analysis. BMJ, 342, d901. doi:10.1136/bmj.d901.
Woolf, K., Potts, H. W. W., Patel, S., & McManus, I. C. (2012). The hidden medical school: A longitudinal study of how social networks form, and how they relate to academic performance. Medical Teacher, 34, 577–586. doi:10.3109/0142159X.2012.669082.
Yates, J. (2011). Development of a ‘toolkit’ to identify medical students at risk of failure to thrive on the course: An exploratory retrospective case study. BMC Medical Education, 11. doi:10.1186/1472-6920-11-95.
Yates, J., & James, D. (2006). Predicting the “strugglers”: Case–control study of students at Nottingham University Medical School. British Medical Journal, 332, 1009–1012. doi:10.1136/bmj.38730.678310.63.
Yates, J., & James, D. (2007). Risk factors for poor performance on the undergraduate medical course: Cohort study at Nottingham University. Medical Education, 41, 65–73. doi:10.1111/j.1365-2929.2006.02648.x.
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Green, J.A. The effect of English proficiency and ethnicity on academic performance and progress. Adv in Health Sci Educ 20, 219–228 (2015). https://doi.org/10.1007/s10459-014-9523-7
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DOI: https://doi.org/10.1007/s10459-014-9523-7