Biases or Balance? Qualitative Identification of Candidate Red and Yellow Flags in Physical Therapy Admissions
Purpose/Hypothesis: For Doctor of Physical Therapy programs, admission review committees search for several factors that may distinguish an applicant as successful in their program. Admissions reviewers typically use Graduate Record Exam (GRE) scores, Grade Point Average (GPA), observation hours in physical therapy, volunteer work, essays/ personal statements, and references as components of their evaluative process. While GPA and GRE have been shown to be predictors of success on the National Physical Therapy Examination (NPTE) [1-5], recent literature has demonstrated no significant relationship between GPA and licensure pass rates or retention rates . Other components such as the interviews, essays, and personal experiences that are considered as part of the application process can be subjective. As a result, undefined or unidentified reviewer biases and beliefs may be forcing applicants to surmount challenges they are not even aware of in order to demonstrate they are the best candidate for the program. The aim of this study is to assess what admission reviewers see as "red flags" (automatic no admission to the program), "yellow flags" (cautionary statements that require more reviewing), and successful qualities portrayed by student applicants. The second aim of this study is to observe if these beliefs are held by all faculty or if time spent in academia influences these categories. This study demonstrates its significance by making explicit common beliefs that admissions reviewers may hold and to which they may hold incoming students. By doing so, making this information explicit it creates a more level ‘playing field’ for all candidates, which ultimately may help to develop a diverse physical therapy workforce. Number of Subjects: The results from this study included 90 respondents to the survey which consisted of 144 total red flag comments and 136 yellow flag comments. Of the 90 respondents, 1 (1%) did not indicate rank, 1 (1%) indicated instructor, 16 (18%) indicated Assistant Professor, 46 (51%) indicated Associate Professor, and 26 (26%) indicated Professor rank. Materials and Methods: This study was conducted by surveying faculty from across the country at any rank (Assistant, Associate, and Full-professors), on both the tenure and non-tenure track, that currently surve as admission reviewers for a Doctor of Physical Therapy program.The survey included 10 open-ended questions asking about time in academia, time reviewing applications, perceived "red flags", perceived "yellow flags", and perceived attributes of successful students. Subjects were recruited via word of mouth (person to person or direct, singular email contact) as well as through list-serves. Data from the survey have been reviewed and coded based on general themes. To ensure internal reliability, each researcher initially reviewed 15 responses – 5 from each rank and developed a theme for each response. The researchers then came back together to compare themes and determine a consistent code and operational definittion for each theme/code moving forward. Following this initial process, each researcher coded the rest of the data based on the idenified themes. After finishing the 1st complete round of coding, the researchers reconvened to determine if there were any discrepancies and to discuss any additional modifications to the coding system, prior to a final theme categorization. Any differences that were still outstanding after this discussion were resolved by recruiting a third-party for resolution. This meeting concluded with all comments coded and three primary themes: Professional Representation, Academics, and Mature/ Self-aware Learner. Results: Initial coding identified 7 codes: Professional Reference, Communication (Written/ Verbal), Professional Factor/ Integrity, Interest/ Insight, Professional Demeanor, Previous Academics, Outside Commitments. These codes were then collapsed into 3 primary themes: Professional Representation, Academics, and Mature/ Self-aware Learner. Conclusions: In 2017-2018, PT-CAS data indicates that 43.4% of DPT applicants were not admitted into a DPT program . While applicants can always reach out to their individual schools to learn more about why they were not accepted into a specific program this is often a humiliating process and as such is not followed through on. It is likely that some of these applicants did not meet the minimum quantitative requirements (GPA, GRE) of the schools they applied to. It is also likely that some applicants did meet those requirements but may have had to overcome any undefined or unidentified biases and/or beliefs of the admission reviewer. Based on our results, these beliefs and biases tend to be focused on how professionally the student represents themselves in their verbal and non-verbal communication, including writing samples; how rigorous their prior academic experience was and how successful they were in it; and finally, how mature and self-aware the applicant is – do they know about the profession and the school to make the determination that this is a good fit? Clinical Relevance: Developing an understanding about these biases can thus be helpful to both students as well as admission reviewers. Understanding what admission reviewers consider red flag and yellow flags to admission can create a more even playing field, for students who may otherwise be disadvantaged by lack of experience or exposure to the graduate school admission process. For reviewers, it can steer them clear from problematic bias that are, in fact, discriminating. The admission process is a grueling process for all parties. Developing a more comprehensive understanding of its nuance may be beneficial to all.