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Abstract

Purpose: Health professions education programs often use holistic reviews to promote a more diverse student body, leading to a more diverse healthcare workforce. Although many organizations and educational institutions advocate for holistic reviews of applicants, there are inconsistencies in the literature as to what this practice entails. Thus, the purpose of this concept analysis was to identify the defining attributes of holistic reviews and provide an operational definition. Methods: Walker and Avant’s description of a concept analysis served as a guide for this review. This systematic process included an analysis of current literature, legal proceedings, and organizational documents; identification of defining attributes, antecedents, consequences, and empirical referents; and development of an operational definition of the concept. Results: Five defining attributes emerged as critical to the definition of holistic review in the health professions. These attributes included individualized, balanced, flexible, reflective of mission, and contextualized. Following the identification of these attributes, sample cases that depicted the attributes of holistic reviews further illustrated the concept. Prior to adopting holistic reviews in admissions, programs should have a clear mission statement, individuals trained to implement holistic reviews of applicants, and an application that allows for prospective students to provide adequate information on their background and experiences. Programs should also evaluate their holistic reviews using established scoring models or checklists and assess the outcomes of holistic reviews on the diversity of matriculated students. Finally, an operational definition of holistic review was generated based on the defining attributes. Conclusions: The proposed definition of holistic review can inform higher education admissions practices and be used in future research investigating the impact of holistic review admissions policies and practices on student body diversity and learning outcomes. Health professions programs may also consider institutionalizing the antecedents that support holistic reviews and measuring its consequences using the established empirical referents.

Author Bio(s)

Andrea Bowens, PT, DPT, PhD is an Associate Professor of Physical Therapy within the School of Health Professions at the University of Alabama at Birmingham (UAB). She has over nine years of academic teaching experience in the areas of therapeutic exercise, differential diagnosis, imaging, and management of orthopedic conditions. Prior to teaching, Dr. Bowens worked in an outpatient orthopedic and sports medicine clinic. Her research interests include outcomes related to teaching and learning strategies in physical therapist education and issues impacting the physical therapy workforce. Dr. Bowens’s doctoral work focused on holistic admissions as one strategy to diversify the profession and address health disparities. She has served alongside students providing pro-bono care to medically underserved communities and participated in international medical mission trips. She currently serves as the APTA Alabama Chief Delegate to the House of Delegates.

Acknowledgements

The author would like to thank Drs. Jane West and Deana Ford at Mercer University’s Tift College of Education for their feedback and support in the development of this manuscript.

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