Meaningful Interactional Diversity, Professional Development, and Service Intent in White Medical Students

TL;DR

White medical students who report meaningful cross-cultural interactions show greater personal and professional development and are more likely to serve underserved communities.

Contribution

This study demonstrates that meaningful interactional diversity benefits White medical students by enhancing development and service intentions.

Findings

Strong agreement with meaningful interactional diversity is linked to higher personal and professional development.

Students with strong agreement are more likely to plan service in underserved areas.

Competence to work with diverse backgrounds increases with higher levels of meaningful interactional diversity.

Abstract

Is self-reported meaningful interactional diversity (defined as cross-cultural engagement influencing knowledge or opinions) in medical school associated with perceived development, professional competence, and service intentions among White students?

In this cross-sectional study of 80 542 White students from 155 US medical schools, meaningful interactional diversity showed graded associations with personal and professional development as well as competence to care for and work with people from different backgrounds, whereas associations with intentions to serve underserved communities occurred only with strong endorsement of meaningful interactional diversity.

The findings of this study suggest that meaningful interactional diversity may positively influence key educational outcomes and service intentions among White US medical students.

This cross-sectional study evaluates whether White medical students’ experience of meaningful interactional diversity—the experience of changing one’s knowledge or opinions as a result of encountering the perspectives of individuals from different backgrounds—is associated with personal and professional competencies as well as plans to work with underserved populations.

At a time when diversity in higher education is increasingly perceived as beneficial only to minority students and disadvantaging to majority-group students, it is crucial to investigate its benefits broadly.

To assess whether meaningful interactional diversity (ie, cross-cultural engagement that influences knowledge or opinions) is associated with key educational outcomes among White medical students.

This cross-sectional study included self-identified White-only medical students who matriculated to a US allopathic medical school between 2013 and 2022, graduated between 2015 and 2024, and responded to the Association of American Medical Colleges Graduation Questionnaire (GQ). GQ responses were anonymous. Data were analyzed from September 2024 to April 2025.

Meaningful interactional diversity, defined by agreement on a 5-point Likert scale with the GQ item, “My knowledge or opinion was influenced or changed by becoming more aware of the perspectives of individuals from different backgrounds.”

Six self-reported binary outcomes derived from the GQ were assessed: personal and professional development fostered by medical schools, ability to care for and work with people from different backgrounds, and intention to work in an underserved area and with an underserved population regardless of practice location.

Among 80 542 students (38 589 [47.91%] female) from 155 medical schools, 495 (0.61%) strongly disagreed, 1416 (1.76%) disagreed, 7387 (9.17%) were neutral, 35 155 (43.65%) agreed, and 36 089 (44.81%) strongly agreed with meaningful interactional diversity. Across increasing agreement with meaningful interactional diversity, higher likelihoods of personal and professional development and care and teamwork competence were observed, whereas associations with service intentions were confined to strong agreement. Compared with strong disagreement, strong agreement was associated with greater personal (adjusted relative risk [aRR], 2.37; 95% CI, 2.05-2.74) and professional (aRR, 1.59; 95% CI, 1.42-1.69) development, competence to care for (aRR, 1.23; 95% CI, 1.17-1.29) and work with (aRR, 10.69; 95% CI, 7.84-14.57) people from different backgrounds, and plans to work in underserved areas (aRR, 1.31; 95% CI, 1.08-1.58) or with underserved populations regardless of practice location (aRR, 1.59; 95% CI, 1.30-1.93).

In this cross-sectional study of White medical students, meaningful interactional diversity was associated with graded improvements in core developmental outcomes and threshold-level associations with service intentions.

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