Variables Associated with Attrition from Uniformed Services University of the Health Sciences Medical School

Military Medicine, Feb 2004 by Stetto, Jayne E, Gackstetter, Gary D, Cruess, David F, Hooper, Tomoko I

Just over one-quarter of the USUHS records of those who disenrolled (28%) contained no information on issues that may have contributed to student attrition. Among the 70 students who disenrolled from USUHS for whom data were available, the qualitative or noncognitive factors included: personal, family, and health (51%); change in motivation for pursuing either medical or military career (26%); other reasons (19%), such as reported difficulty with the curriculum; and failure to meet military standards (4%). However, without similar information on the group of USUHS students who did successfully graduate or remained enrolled, these characteristics cannot be quantified and analyzed as predictors of attrition.

A limitation of this study is the amount of missing data, which commonly occurs when existing datasets, in this case collected for administrative purposes, are used for research. On the other hand, this study identifies and evaluates selected demographic and cognitive variables as predictors for attrition at this unique medical school for uniformed service members. The findings of this study raise additional questions that deserve evaluation, for instance: (1) What are the personal characteristics (noncognitive/qualitative) of all USUHS students? (2) Are there noncognitive variables associated with attrition at USUHS? (3) Are there noncognitive differences between those USUHS students who decelerate and ultimately disenroll and those who decelerate but go on to graduate? To answer these questions, information on noncognitive/qualitative characteristics needs to be formally and systematically collected both when assessing prospective students and when students leave medical school, either with or without graduating.

A structured or semistructured interview that focuses on nonacademic dimensions could, according to the published literature,8,10,16,22,23 enable the interviewer to elicit specific information from the student that cannot be collected in any other manner. These nonacademic dimensions include motivation, self-efficacy, interpersonal skills, maturity, and coping skills. Although logistically more difficult to accomplish, the published literature also favors a panel interview approach (two to five members) to decrease individual interviewer bias and subjectivity and to improve overall reliability.20,23 Finally, selecting and training interviewers are also advocated as critical components to ensure a valid interview process.16,20

Additionally, an exit interview or administration of a validated exit survey instrument could serve as a formal and systematic method for gathering noncognitive information on those students who disenroll. To provide comparison data, a random sample of students graduating every year could also be selected to be interviewed or to complete a survey instrument. This information could then be quantified and added to the existing computerized database for subsequent analysis with the ultimate goal of understanding the reasons for attrition and possibly designing and evaluating specific interventions.