Increasing the number and diversity of biomedical scientists interested in clinical research is critical to advancing a vital healthcare workforce. The paucity of biomedical scientists in academic medicine was originally reported by Kelley and Randolph (1994)
over a decade ago and remains a current concern within the medical profession (Nathan and Varmus, 2000
; “Promoting Translational and Clinical Science,” 2006
). Women and people of color especially continue to be underrepresented in academic medicine to an alarming degree considering that between 2002 and 2006 an average of 46% women and 36% racial minorities graduated from medical school (“FACTS,” 2007
). The proportion of underrepresented racial and ethnic minorities among clinical and, more broadly, biomedical researchers has not changed appreciably over three decades despite multiple efforts to promote their access to and interest in research careers (“Final Report of the NAGMS Council,” 2006
). Similarly, female academicians within the medical field have made only marginal gains in their research productivity (Jagsi et al., 2006
) and minority female academicians, in particular, have made relatively undetectable professional gains (Wong et al., 2001
). These trends threaten the translation of basic science discoveries into applications that can benefit human health, especially for populations experiencing great health disparities, such as racial and ethnic minorities. Moreover, these trends reduce the available number of diverse medical scientists to train emerging physicians.
A few studies have indicated that research interests and intentions to pursue a research career decline as one matriculates through medical school (Guelich et al., 2002
) and decline even further during residency (Reck et al., 2006
). Reck et al. (2006)
reported that the reasons for this decline are largely due to environmental factors, such as bureaucratic obstacles, financial issues, lack of effective role models and mentors, and geographical location or practice environment. Women specifically cite lack of role models or poor career guidance as key factors in altering their career goals more frequently than men do (Watt et al., 2005
). These issues are critical since female medical students are more interested in pursuing a clinical research career than are male medical students (Watt et al., 2005
) and represent a large portion of the pool of potential biomedical researchers. Although environmental factors are important in shaping research interests (Gelso and Lent, 2000
), they contribute to only a portion of the factors that determine one’s interests and productivity in research (Hollingsworth and Fassinger, 2002
; Kahn, 2001
; Kahn and Scott, 1997
Social Cognitive Career Theory (SCCT; Lent et al., 1994
) posits that career interests largely form and career decisions are made based upon individuals’ perceptions of their confidence to perform within a given career domain (career self-efficacy) and the outcomes they expect from pursuing that career pathway (i.e., outcome expectations). Within the domain of research, research self-efficacy (confidence in one’s abilities to perform research-related tasks and activities) and outcome expectations mediate the relationship between the research training environment and interest in research and predict one’s productivity as she or he pursues a research career (Hollingsworth and Fassinger, 2002
; Kahn, 2001
). The primary purpose of this study was to investigate whether a theoretically-informed intervention would increase the research self-efficacy beliefs for emerging and early career biomedical scientists. The secondary purpose of this study was to examine the potential variation in research self-efficacy beliefs across gender as well as racial groups.
Gender and racial/ethnic differences in self-efficacy beliefs have been observed in SCCT research. In general, women and minorities tend to have lower self-efficacy than men when making career-related decisions (Bakken et al., 2003
; Blustein, 1989
; Taylor and Betz, 1983
); thus, they are less likely to retain their interests along a given career pathway (Bakken et al., 2003
; Blustein, 1989
). Furthermore, underrepresented minority women tend to perceive more educational and career-related barriers than men and White women as a result of low perceived abilities to cope with these barriers (Luzzo and McWhirter, 2001
). A meta-analysis conducted by Multon, Brown, and Lent (1991)
suggested that self-efficacy enhancing interventions may serve to strengthen relationships between self-efficacy, interest and ultimately, performance. Self-efficacy interventions, therefore, may be useful for stimulating or sustaining biomedical scientists’ interest in clinical research careers, particularly that of women and underrepresented minorities. Recent studies also suggest that interventions be targeted to learning experiences since they may be the sources of previously reported gender differences in self-efficacy (Williams and Subich, 2006
In a previous study, we found higher clinical research self-efficacy beliefs for men than for women in a post-graduate physician population. This gender difference was exaggerated after a short research training program (i.e. a learning experience); although, self-efficacy for both women and men significantly increased after the training program (Bakken et al., 2003
). One would expect an educational activity to increase self-efficacy beliefs (Bandura, 1986
); however, it seems unusual that gender differences would be exacerbated by it. Because there were more male faculty presenters, same-gender modeling may have enhanced research self-efficacy for men more so than for women. Subsequently, we designed this study to determine whether an intervention targeted at increasing research self-efficacy of female biomedical scientists would diminish this gap. What elements should a self-efficacy intervention contain?
described four types of experiences that inform self-efficacy beliefs: performance accomplishments, vicarious (observational) learning, emotional arousal, and verbal persuasion. Performance accomplishments,
which are personal success experiences, for women often occur at a slower rate than they do in men, (Bickel et al., 2002
; Buckley et al., 2000a
; Buckley et al., 2000b
) in part because of women’s non-linear career paths (Bierema, 2001
), conflicting family responsibilities, and lack of institutional support (Andrews, 2002
; Reck et al., 2006
). Performance accomplishments might also be indirectly influenced by the values that women, and especially underrepresented minority women, place on family over work (Buckley, Sanders, Shih, Kallar, et al., 2000
; Flores and O’Brien, 2002
). Furthermore, women’s performance accomplishments are often overlooked in the workplace (Valian, 2000
, pp. 127–129), which in turn, may deflate their efficacy beliefs. Women may lack female mentors or colleagues who contribute to vicarious learning experiences
through positive role modeling and verbal persuasion
(e.g., encouragement) that support a “you can do it” attitude (Stalker, 1994
). Emotional arousal
can also influence women’s efficacy beliefs such that negative affective states, in the form of anxiety or negative self-talk for instance, associated with a given task can decrease efficacy perceptions; the converse is also true. The potential consequences of low self-efficacy are avoidance behaviors, compromised performance and diminished persistence in the face of obstacles or disconfirming experiences (Bandura, 1997
). These behaviors can have profound consequences for women and underrepresented minorities during their career pursuits.
Previous researchers have used the four sources of self-efficacy as a framework for designing interventions to improve career related self-efficacy in women and underrepresented minority women (Ross-Gordon and Brown-Haywood, 2000
) with positive results (Luzzo et al., 1996
; Sullivan and Mahalik, 2000
). However, only a few studies have examined self-efficacy in the context of biomedical research and to the best of our knowledge, no study has used SCCT to design an intervention to increase research self-efficacy of clinically-oriented biomedical scientists. Therefore, this study was designed to examine the effects of an intervention based on the work of Sullivan and Mahalik (2000)
and others to better understand how self-efficacy beliefs toward research may affect the career decisions of biomedical scientists.
We hypothesized that an intervention emphasizing the four sources of self-efficacy (performance accomplishments, emotional arousal, vicarious learning experiences, and verbal persuasion) would increase women’s confidence in their abilities to perform the tasks necessary to be an effective biomedical researcher. The specific hypotheses for this study were:
- Women in the intervention will have greater differences in their pre- to posttest research self-efficacy scores following a two-day clinical research training program than the women who have not participated in the intervention.
- Gender differences will exist in research self-efficacy following a two-day clinical research training program and these gender differences will be greater when men’s scores are compared to the scores of women who do not participate in the self-efficacy intervention.
- There will be no significant differences by race in women’s pre- to posttest research self-efficacy scores following the self-efficacy intervention or two-day clinical research training program.
Knowledge gained from this study is important for designing educational interventions that effectively encourage, support, and facilitate clinician-scientists’ entry and persistence in biomedical research careers and their ultimate contributions to and application of scientific discoveries. If we do not understand variables such as self-efficacy that underlie the career development of biomedical scientists, especially for women and underrepresented minorities, then our efforts to provide training programs, such as the two-day clinical research course described in this present study, will have limited impact on stimulating interest and retaining scientists in biomedical research careers.