Bursting bubbles: Exploring discourses, perceptions and experiences of widening participation in two UK medical schools

Abstract

Many UK medical schools support students from underrepresented groups to access and gain medical degrees through widening participation strategies like Gateway programmes, which provide an additional year of study to support transition to university. Additional support through widening participation can lead to underrepresented students being viewed as lacking, leading to a student deficit discourse. Little is known about how increasing student diversity through gateway programmes impacts the experiences of all medical students.
Through a qualitative, comparative case study, I explored the discourses, perceptions and experiences of increasing student diversity through widening participation at the University of Southampton (UoS) and University of Aberdeen (UoA) medical schools. A Critical Discourse Analysis of the relevant institutional webpages revealed different understandings about the purpose of gateway programmes. Although the UoS webpages challenged the deficit discourse by highlighting gateway students’ academic success and progression, neither institution promoted any benefits of increasing diversity.
Medical students in Years 1-3 and staff at each institution participated in focus group discussions about their perceptions of widening participation, student diversity and integration in medical school; data were thematically analysed. Experiences of interacting with students from different backgrounds were explored in greater depth through narrative interviews with students in their clinical years (3-5) of medical school.
At the UoS, gateway students were perceived as different to their peers and discrimination inhibited their integration. Nonetheless, their expressions of differences were valued and encouraged. UoA gateway students were integrated as equals within the main cohort, but the value of their ‘unique’ contributions was sometimes questioned. Some participants felt professional assimilation (being “moulded”) in the clinical years mitigated the potential for gateway students to have a positive impact on others’ learning.
Interactions between students from different backgrounds triggered various epiphanies and realisations for my participants, which transformed their learning experiences by:

• Bursting Bubbles: raising awareness of taken-for granted assumptions and ways of thinking, legitimising differences through experience, and transforming worldviews
• Enriching all student learning: through cultural knowledge exchange and diversifying curricula
• Enhancing soft skills: communication, teamwork, problem-solving with ‘Others’
• Facilitating recognition of own strengths: “people have little things you could kind of add to them”

These benefits must be widely promoted to eradicate harmful discourses of deficit and promote a culture that celebrates the diversity of insights, experiences and skills that are necessary to provide healthcare in our multicultural society. Medical educators should reflect on the aims of widening participation to ensure institutional goals and the potential rewards of increasing medical school diversity are achieved. Diversity and reflexivity training are necessary to create culturally safe spaces in which educators and students alike can benefit from identifying their own unique contributions, and what they can learn from others

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Identifiers

ORCID for Sally Curtis: orcid.org/0000-0002-8026-6284

ORCID for Marcus Grace: orcid.org/0000-0002-1949-1765

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