Where Extrinsic Meets Intrinsic Motivation: An Investigation of Black Student Persistence in Pre-Health Careers.

Abstract

AbstractIn order to increase the number of health care providers in underserved communities, numerous efforts are being made to increase the number of Black students in the health professions. Research supports the idea that individuals from minority populations seek doctors of the same race or culture. In an effort to provide increased health care to minority communities, researchers and educators endeavor to understand the factors that prevent Black students from matriculating in and graduating from professional schools. In this study we explored how students persist in health professions, despite academic and social challenges. Specifically, the career persistence of four Black pre-health students was explored using semi-structured interviews. Career persistence and motivation were investigated using the framework of self-determination theory (SDT). Results indicate that the SDT framework does not fully incorporate the motivational experiences of these students. Further, we propose an expansion of the current SDT model.IntroductionAs the diversity of the United States population is increasing, the number of non-White health care professionals remains stagnant. Research demonstrates that an increase in the number of non-White or minority (i.e., Hispanic, Native American, and Black American) physicians could increase care to the underserved as minority physicians are more likely to treat minority patients, many of whom are in underserved populations. Minority patients are more likely to seek out minority physicians who consider their patients' customs, beliefs, and language in their treatment plan (Hargraves, Stoddard & Trude, 2001; Riley, 2007; Saha, Taggart, Komaromy, & Bindman, 2000). Marc Nivet, the Association of American Medical Colleges chief diversity officer, reinforces research findings by stating that increased diversity in healthcare impacts not only the patients served, but also improves the cultural competency of all health care providers (M. A. Nivet, personal communication, February 2, 2011). Therefore, in order to increase the number of minority physicians, it is necessary to increase the number of minority pre-health students by recruiting and retaining Black and other non-Black pre-health students.In attempts to cultivate a more diverse and culturally competent workforce, professional schools have made efforts to increase the application of Black students by hiring recruiters, developing summer pre-professional programs and science camps to develop early interest in the health professions (Grumbach Researchers have suggested several reasons for decreased career persistence including: motivation, advising, past academic achievement, career aspirations upon entering college, satisfaction with college, engagement, peer groups, academic major, standardized test scores, Grade Point Average (GPA), campus climate, selectivity and size, faculty student interactions, academic major, student perception of the environment, and the number of pre-medical students (Antony, 1996, 1998; Barr, Gonzalez, «fe Wanat, 2008; Fries-Britt, 1997; Hollow, Patterson, Olsen, «fe Baldwin, 2006). However, Lovecchio and Dundes (2002) indicate that the predominant reasons for Black students' decreased persistence are: (a) academic challenges, (b) advisement, (c) campus climate, and (d) motivation. Despite these challenges, a portion of Black students do continue to persist in health-related careers. …