The Nuts & Bolts of Implementing a Holistic Admissions Process
The healthcare system has widespread disparities with minority patients experiencing poorer health outcomes whether that is due to race, ethnicity, gender, sexual identity or socioeconomic status. These disparities are particularly apparent during the novel coronavirus 2019 pandemic (COVID-19) where the loss of life is disproportionately greater for economically vulnerable populations and African Americans. Healthcare provider diversity is an evidence based initiative that has been shown to improve healthcare access for minority patients as well as increase patient satisfaction and improve health outcomes.
Our program goal was to create an inclusive environment with greater student diversity that will ultimately improve healthcare diversity. To achieve these goals, in 2019 we initiated a holistic admissions review process. The process included a comprehensive review of an applicantÕs personal experiences, academic metrics and character attributes. A rubric was developed for each part of the holistic review process. These rubrics were developed with consideration of: 1) alignment with the programÕs mission and vision, 2) consideration of legal issues, 3) discussion on the role of implicit bias in admissions decisions and 4) review of the research on holistic admissions. Additionally as a program, we explicitly demonstrated our diversity focus by amending the PTCAS program specific question, where we asked applicants to reflect on how diversity, equity and inclusion has impacted their desire to become a physical therapist.
Rubric scoring consistency and accuracy was ensured by each applicant being independently assessed by two faculty. Scoring differences greater than 2 points initiated a third faculty assessor to determine final score agreement. A third assessor was needed in only 4 of 131 qualified applicants. ApplicantsÕ experiences were assessed for the quantity and quality of experiences across five different areas (life/resiliency, leadership, community service, healthcare & research experience). The metrics we took into account were math/science GPA in our predetermined prerequisite courses, cumulative GPA and the GPA for the last 60 credits. We decided to not use the GRE in the metric scoring rubric since it is an expensive test and can disadvantage applicants from a socioeconomic perspective. The character attributes rubric was comprised of the interview score, recommendation letters and quality of the program specific question on diversity, equity and inclusion.
Conclusions/Relevance to the conference theme:
The implementation of a holistic admissions process based on experiences, attributes and metrics was an effective process in creating greater diversity in the student body. However, a holistic process does require thoughtful planning and a commitment of additional time to assess each applicant. Additionally, it has enabled us as a program to reexamine our preparedness for educating a more diverse student body and facilitate programmatic review of policies, procedures and culture. Ultimately, we believe this process will provide greater care for underrepresented persons and impact healthcare disparities.