Do Health Professions Graduate Programs Increase Diversity by Not Requiring the Graduate Record Examination for Admission

PURPOSE: Seeking to increase the diversity of the health care workforce, prominent national commissions have called on health professions graduate schools to deemphasize standardized tests in admissions. Have programs that do not require standardized tests observed an increase in students from under-represented minority groups? METHODS: The websites of the centralized application services for occupational therapy, physical therapy, physician assistant studies, and speech-language pathology programs were reviewed, and programs were identified that do not require the Graduate Record Examination (GRE) for admissions. Representatives were then invited to participate in a hypothesis-generating interview. The transcripts were coded using grounded theory to identify emerging themes. STUDY SAMPLE: Faculty and administrators with admissions responsibilities representing 30 graduate programs in the health professions participated. RESULTS: Fewer than one-third of programs in each health profession surveyed do not require the GRE for admission. While test-optional programs attract students who might otherwise not apply to graduate school, the lack of a GRE requirement does not automatically increase the representation of under-represented minority students in the matriculated class. The programs most successful in meeting their diversity goals also engage in deliberate recruitment activities. J Allied Health 2015; 44(1):51-56.IN 2001, REPRESENTATIVES from the Institute of Medicine, Association of Academic Medical Colleges, and the Association of Academic Health Centers convened a symposium to develop strategies that would enhance the number of under-represented minority students entering the health professions. Citing the racial performance gap on standardized tests, several participants recommended that graduate schools deemphasize quantitative scores in their admissions decisions.1 The authors proposed, as a more valid assessment, that reviewers consider a broad definition of merit and the full scope of abilities necessary to succeed as a health professional.Three years later, an interprofessional commission chaired by former U.S. Secretary of Health and Human Services Louis W. Sullivan revisited the need for increasing the diversity of the health care workforce. Its report also highlighted the barrier that overreliance on standardized tests in admissions poses for minority students to gain entry to the health professions.2 The commission heard testimony asserting that performance on standardized tests predicts neither an applicant's future clinical skills nor her academic achievement. To develop a more diverse pipeline to the health professions, the report concluded that graduate schools should use test scores to identify areas where students might need academic support, not as a disqualification for admission.The visibility of these national reports gave renewed urgency to longstanding criticisms of standardized tests among educational psychologists.3-5 Some graduate schools in the health professions examined their own use of standardized tests in admissions decisions. Concerned about erecting barriers to entry for students from under-represented backgrounds, faculty from the University of Washington School of Nursing analyzed the relationship between score on the Graduate Record Examination (GRE) and cumulative graduate grade point average (GPA) for over 200 of their students. When they found that a student's GRE scores accounted for only 5 to 8% of the variance in cumulative GPA, the school successfully petitioned the university to remove standardized test scores as a requirement for admission.6 Their decision mirrors a recent move among medical schools to experiment with alternative admissions requirements that deemphasize test scores in favor of a more holistic review of applicants.7,8To test whether adopting a test-optional approach to admissions increased the representation of students from traditionally disadvantaged backgrounds, I sought to identify graduate programs in the health professions that have a history of not requiring applicants to submit standardized test scores. …