Increasing Dental Hygiene Student Diversity

Journal of Allied Health, Winter 2003 by Helm, Denise Muesch, Grabarek, Ellen S, Reveal, Marjorie

Life-Performance Questions as Alternative Admissions Criteria

The goal of this study was to create a race/ethnic-neutral admission process. An increase in student diversity in the Northern Arizona University Dental Hygiene Program (NAU DH) was accomplished through modification of its acceptance process. Sixty students, 22% underrepresented minority (URM), were selected using alternative criteria compared with 6.7% URM that would have been accepted using traditional criteria. For the purpose of this study, URM are defined as African American, Hispanic, Native American, or bicultural, groups that are underrepresented in dental hygiene. Six life-performance questions were added on the written application and were designed to assess the candidates' personal characteristics, including (1) leadership, (2) community service, (3) realistic self-appraisal, (4) personal support system, (5) ability to deal with racism, (6) ability to set goals and self-responsibility. Scores from the response to these questions were used as part of the total selection criteria. Data analysis revealed that white candidates scored higher than URM candidates on grade point average (GPA), science GPA, and total points, yet both groups scored the same on life-performance questions. On the basis of these findings, we conclude that alternative criteria in the acceptance process more fairly assesses candidates' qualifications and increases the diversity of the NAU DH student population. These alternative acceptance criteria may serve as a model for dental hygiene and other allied health programs. J Allied Health. 2003; 32:279-284.

MOST OF NORTHERN ARIZONA University's Dental Hygiene Program (NAU DH) graduates have been white and female,1 in a state that is 67% white, 22% Hispanic, 4% African American, 5% Native American, and 2% Asian.2 The American Dental Association reported that most (86.0%) of all dental hygiene graduates in the United States in 1997-1998 were white,3 which is not representative of the population, which is 74% white.4 For the purpose of this study, underrepresented minorities (URM) are defined as African American, Hispanic, Native American, or bicultural, groups that are underrepresented in dental hygiene.5,6 Although NAU DH has a slightly higher percentage of URM graduates, 20.1%, than other dental hygiene schools,1 it is nevertheless neither representative of the Arizona nor the United States population. These data indicate a shortage in the number of URM dental hygienists preparing to meet the needs of their respective ethnic and racial groups.

In contrast to the graduates, the ethnic and racial composition of the NAU DH candidate pool for the past 2 years is more comparable to the population of Arizona-31% URM. Despite this fact, the pool of accepted students historically has not been representative of this population. Traditional selection and admission processes may have acted as a barrier to their acceptance into the program.

The purpose of this study was to create a race/ethnic-neutral admission process at NAU DH to increase the ethnic diversity. Responses to six life-performance questions were assessed to determine each candidate's relative strength or weakness in seven personal characteristics: (1) leadership, (2) community service, (3) realistic self-appraisal, (4) personal support system, (5) ability to deal with racism, (6) ability to set goals, and (7) self-responsibility. The long-range goal of this project was to create a model application for increasing ethnic diversity through selection processes for allied health programs nationwide.

Review of the Literature

The Pew Health Professions Commission recommended that health professions schools realign education to be more consistent with the changing needs of the health care delivery system. The Pew Commission and others have recommended that admission policies incorporate criteria of ethnicity, cross-cultural experience, and a commitment to community service.7-10 Minority health professionals historically have provided more health care for the poor and uninsured and for patients in their own racial and ethnic groups than nonminority providers.11,12

Minority students face numerous barriers in their pursuit of an education in allied health fields, most of which are unrelated to their potential as skilled professionals. One barrier is the fact that the major acceptance criterion for professional programs is based on grade point average (GPA),13-15 which selects against URM students.16 Schools of allied health have been attempting to increase the diversity of their student populations through various programs since 1970. Efforts primarily have emphasized the recruitment and retention of URM students,17-21 with little attention to the application criteria.

Although URM students apply to allied health programs, they continue to be underrepresented. Some researchers on increasing diversity believe that URM student GPAs are one grade point lower than that of white students,22 yet their clinical performance was equivalent to white students.23 Another study found that admissions processes that consider additional characteristics in admission decisions have a positive impact on the diversity of the student population and can be used in predicting success in medical school.24