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Cited by 2Innovations in Medical EducationHigher Education Research StudiesHigher Education Practises and Engagement

Supporting underrepresented students in health sciences: a fuzzy cognitive mapping approach to program evaluation

Open access
Chiang, Danielle F., Guerrero, Scott A., Sexton, Emma C., Gardner, Stephen S.·2024·BMC Medical Education
DOI 10.1186/s12909-024-05292-7PMC PMC10956253
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Abstract

Background: The Students Training in Academia, Health, and Research (STAHR) Program at the University of Missouri-Kansas City (UMKC) strives to help students from low-income families that have experienced educational challenges due to poverty and prepare them to enter, persist, and graduate from a health sciences degree program at UMKC. Students in the program participated in fuzzy cognitive mapping (FCM) sessions to ensure that all voices of the program were heard to improve program implementation, and student success, and contribute to an equitable educational environment. Methods: Fuzzy Cognitive Mapping sessions for the 2020–2021 cohort of students (n = 52) were conducted to assess the strengths and weaknesses in program implementation, especially through the beginning of the COVID-19 pandemic. Students’ maps were coded by a team of researchers and then confirmed using confirmatory factor analysis. Results: Statistical analyses reveal that mentorship, workshops, and social support helped students to work toward their goal of obtaining a professional health sciences degree, while a lack of time, remote learning, and outside stressors inhibited their opportunities for success. Conclusions: The findings from a multipronged analysis of mapping data demonstrate the value of this innovative approach to the field, especially when looking to incorporate student voices.

AI snapshot

Written from the paper’s full text.

TL;DR

This study used fuzzy cognitive mapping (FCM) with 52 STAHR students at the University of Missouri-Kansas City in 2020–2021 to identify program facilitators and barriers, then confirmed the map structure with confirmatory factor analysis (CFA). Students identified mentorship, workshops/meetings, and social support as top facilitators, while time, COVID-19/remote learning, and outside stressors were top barriers.

Key findings

  • In FCMapper centrality results, the top facilitators were Mentorship (n = 46, C = 0.88), Workshop/Meetings (n = 45, C = 0.69), and Social Supports (n = 26, C = 0.46); the top barriers were Time (n = 31, C = 0.55), COVID-19/Remote Learning (n = 29, C = 0.41), and Stressors/Outside Stressors (n = 23, C = 0.41).
  • The CFA two-factor model fit well: χ²(19) = 19.73, p = 0.41, CFI = 0.98, TLI = 0.97, RMSEA = 0.03, SRMR = 0.08. Top facilitator loadings were Workshop/Meetings (λ = 0.80), Social Supports (λ = 0.54), and Mentorship (λ = 0.50); top barrier loadings were Lack of Engagement (λ = 0.56), Outside Stressors (λ = 0.49), and Workshop/Meeting Barriers (λ = 0.44).
  • Combining FCMapper and CFA results, the authors added “Lack of Engagement” to the final list of significant barriers; students described lacking one-on-one opportunities for mentorship, networking, or bonding with mentors.
  • Mentor–mentee encounter data reported by students showed that 81.4% of 117 encounters were virtual (via Zoom, Teams, or phone).

Methods

  • Expert-driven FCM program evaluation: 13 virtual Zoom mapping sessions in April 2021 with 52 STAHR students from the 2020–2021 cohort, each session involving 3–5 students. Students filled blank maps with 3–5 facilitators and 3–5 barriers around the program goal and rated connection strength on a 1–3 scale.
  • Coding: four researchers inductively developed a codebook with nine facilitator codes and eight barrier codes, coded all 52 maps, and reached consensus on discrepancies. Adjacency matrices were built in Microsoft Excel, min–max normalized (raw 1, 2, 3 → 0.25, 0.5, 0.75), combined into a final matrix, and analyzed in FCMapper for centrality.
  • Statistical confirmation: CFA in R with the lavaan package tested a two-factor model with “facilitator” and “barrier” latent variables, using chi-square, SRMR, RMSEA, CFI, and TLI fit indices.

Limitations

  • Stated by the authors: the 3-point scale limited capture of causal magnitudes; data collection was limited to Zoom due to the pandemic; program outcomes were not included; sample size limited subgroup analyses by race, ethnicity, gender, and income; and recruiting diverse mentors may become more challenging post-COVID due to burnout.
  • Evident from the text: this is a single-institution, single-cohort program evaluation using self-reported mapping data, so findings may not generalize and cannot establish causal effects on retention or graduation.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12909-024-05292-7

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

8 of 24 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Cultural mismatch can cause a sense of alienation and discomfort that impedes academic performance.

    “These students, who are often the first in their families to attend college, may experience what researchers call a “cultural mismatch” with college environments that are designed with mostly middle-class students in mind; this can cause a sense of alienation and discomfort that impedes academic performance [3, 4].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [3] Allen, Ivan H., and Samuel M. Lester Jr. 2012. The Impact of a College Survival Skills Course and a Success Coach on Retention and Academic Performance 27. Virginia Tech Publishing. https://doi.org/10.21061/jcte.v27i1.536. source

      The passage on student engagement and grades (indexed under REFERENCES; page unavailable) links engagement to academic outcomes and relationships to integration into college. It does not address whether a cultural mismatch causes alienation or discomfort that impedes performance. Searches for “cultural mismatch,” “alienation discomfort,” and “middle-class first generation college students” found no passage making that point. (LLM, conf=0.73)

      Experimental — accuracy not yet measured
    • cites [4] Stephens NM, Fryberg SA, Markus HR, Johnson CS, Covarrubias R. Unseen disadvantage: How American universities’ focus on independence undermines the academic performance of first-generation college students. J Pers Soc Psychol. 2012;102:1178–97. https://doi.org/10.1037/a0027143. source
  • Premisecitation

    Students who are often the first in their families to attend college may experience a cultural mismatch with college environments that are designed with mostly middle-class students in mind.

    “These students, who are often the first in their families to attend college, may experience what researchers call a “cultural mismatch” with college environments that are designed with mostly middle-class students in mind; this can cause a sense of alienation and discomfort that impedes academic performance [3, 4].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [3] Allen, Ivan H., and Samuel M. Lester Jr. 2012. The Impact of a College Survival Skills Course and a Success Coach on Retention and Academic Performance 27. Virginia Tech Publishing. https://doi.org/10.21061/jcte.v27i1.536. source

      The passages labeled REFERENCES (page unavailable) discuss student engagement, integration, grades, and persistence, but do not address first-generation students or a mismatch with middle-class college environments. Searches for cultural mismatch, first-generation students, and alienation found no passage supporting the attributed claim. (LLM, conf=0.73)

      Experimental — accuracy not yet measured
    • cites [4] Stephens NM, Fryberg SA, Markus HR, Johnson CS, Covarrubias R. Unseen disadvantage: How American universities’ focus on independence undermines the academic performance of first-generation college students. J Pers Soc Psychol. 2012;102:1178–97. https://doi.org/10.1037/a0027143. source
  • Premisecitation

    When first-year college students have access to mentors and peer role models who support them to persist in their studies and connect them with necessary resources, the outcomes improve.

    “When first-year college students have access to mentors and peer role models who support them to persist in their studies and connect them with necessary resources, the outcomes improve [3].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [3] Allen, Ivan H., and Samuel M. Lester Jr. 2012. The Impact of a College Survival Skills Course and a Success Coach on Retention and Academic Performance 27. Virginia Tech Publishing. https://doi.org/10.21061/jcte.v27i1.536. source

      The passage labeled REFERENCES (page unavailable) links first-year student engagement, relationships, and tutoring/coaching with better grades and persistence. It does not establish the more specific claim that access to mentors and peer role models who connect students with resources improves outcomes. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
  • Findingown data

    Five variables were retained in the "barriers" factor.

    “Five variables were retained in the “barriers” factor”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The weights and connections students assigned on the fuzzy cognitive maps validly measure the impact of each concept on student success.
  • Findingown data

    Students who mentioned Lack of Engagement shared feedback about lacking one-on-one opportunities for mentorship, networking, or bonding with mentors.

    “Students who mentioned “Lack of Engagement” shared feedback about lacking one-on-one opportunities for mentorship, networking, or bonding with mentors.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 21
  • Classified as probably not a substantial claim. 33
  • The quote only partly states this claim. 1

  • May combine two claims.

    Premisecitation

    In a cross-sectional study of self-reported race/ethnicity of US medical school graduates from 2002 to 2017, numbers and proportions of Black, Hispanic, and American Indian or Alaska Native medical school matriculants increased, but at a rate slower than their age-matched counterparts in the US population, resulting in increased underrepresentation.

    “In a cross-sectional study of self-reported race/ethnicity of US medical school graduates from 2002 to 2017, “numbers and proportions of Black, Hispanic, and American Indian or Alaska Native medical school matriculants increased, but at a rate slower than their age-matched counterparts in the US population, resulting in increased underrepresentation” [1].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [1] Lett E, Moses Murdock H, Orji WU, Aysola J, Sebro R. Trends in Racial/Ethnic Representation Among US Medical Students. JAMA Netw Open. 2019;2:e1910490. https://doi.org/10.1001/jamanetworkopen.2019.10490. source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There are two general methods for constructing FCMs that can be combined in a hybrid fashion: expert-driven and data-driven.

    “There are two general methods for constructing FCMs that can be combined in a hybrid fashion: expert-driven and data-driven [10].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] Mkhitaryan S, Giabbanelli PJ, De Vries NK, Crutzen R. Dealing with complexity: How to use a hybrid approach to incorporate complexity in health behavior interventions. Intelligence-Based Medicine. 2020;3–4:100008. https://doi.org/10.1016/j.ibmed.2020.100008. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Globally, students have expressed high distress levels, low engagement, and confidence in their academic performance and professional development in the wake of the COVID-19 pandemic.

    “Globally, students have expressed high distress levels, low engagement, and confidence in their academic performance and professional development in the wake of the COVID-19 pandemic [5, 6].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [5] Abbasi MS, Ahmed N, Sajjad B, Alshahrani A, Saeed S, Sarfaraz S, Alhamdan RS, Vohra F, Abduljabbar T. E-Learning perception and satisfaction among health sciences students amid the COVID-19 pandemic. Work (Reading, Mass). 2020;67:549–56. https://doi.org/10.3233/WOR-203308. source
    • cites [6] Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. Investigating Mental Health of US College Students During the COVID-19 Pandemic: Cross-Sectional Survey Study. J Med Internet Res. 2020;22:e22817. https://doi.org/10.2196/22817. source

      The Results (COVID-19–Related Stress; page unavailable) report increased stress or anxiety among surveyed US college students. The Discussion (Principal Findings; page unavailable) reports difficulty concentrating and worry about academic performance. The study does not establish these findings globally or report low engagement or confidence in professional development. (LLM, conf=0.87)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Premisecitation

    FCM takes a semi-quantitative approach to describing complex systems by aggregating qualitative and quantitative data collected from mapping participants and combining the data in a way that permits an understanding of the system as a whole.

    “Overall, FCM takes what Olazabal et al. describe as a “semi-quantitative” approach to describing complex systems by aggregating qualitative and quantitative data collected from mapping participants and combining the data in a way that permits an understanding of the system as a whole [17].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [17] Olazabal M, Neumann MB, Foudi S, Chiabai A. Transparency and Reproducibility in Participatory Systems Modelling: the Case of Fuzzy Cognitive Mapping. Syst Res Behav Sci. 2018;35:791–810. https://doi.org/10.1002/sres.2519. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Representation matters, leading to an increased sense of belonging.

    “Since we know representation matters, leading to an increased sense of belonging [34]”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] Kricorian K, Seu M, Lopez D, Ureta E, Equils O. Factors influencing participation of underrepresented students in STEM fields: matched mentors and mindsets. International Journal of STEM Education. 2020;7:16. https://doi.org/10.1186/s40594-020-00219-2. source

      The Discussion and conclusions section reports that women engineering students assigned a female peer mentor experienced greater belonging, and recommends highlighting diverse STEM professionals to help strengthen belonging. Those passages support the importance of representation, but the paper presents a general increase in belonging as a potential benefit, not an established outcome across settings. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The authors used 17 broad themes to code the maps.

    “We used 17 broad themes to code the maps.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The second and third most impactful barriers in the STAHR Program were "COVID-19/Remote Learning" (n = 29, C = 0.41) and "Stressors/Outside Stressors" (n = 23, C = 0.41), which ranked equally.

    “The second and third most impactful barriers were “COVID-19/Remote Learning” (n = 29, C = 0.41) and “Stressors/Outside Stressors” (n = 23, C = 0.41); these concepts ranked equally in responses.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The weights and connections students assigned on the fuzzy cognitive maps validly measure the impact of each concept on student success.

  • The quote only partly states this claim.

    Findingown data

    The CFA results for the top facilitating variables were consistent with the FCMapper results.

    “which is consistent with the above-mentioned results.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The weights and connections students assigned on the fuzzy cognitive maps validly measure the impact of each concept on student success.

  • Classified as probably not a substantial claim.

    Findingown data

    A total of 52 maps were completed by students in the STAHR Program.

    “A total of 52 maps were completed by students in the STAHR Program.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The top three impactful facilitating variables were Workshop/Meetings (λ = 0.80), Social Supports (λ = 0.54), and Mentorship (λ = 0.50).

    “These results indicated that the top three impactful facilitating variables were 1) Workshop/Meetings (λ = 0.80), 2) Social Supports (λ = 0.54), and 3) Mentorship (λ = 0.50)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The weights and connections students assigned on the fuzzy cognitive maps validly measure the impact of each concept on student success.

  • May combine two claims.

    Findingown data

    Students reported that decreased activities due to COVID, Zoom/technology fatigue, and fewer opportunities for clinical experience hindered their capacity for success.

    “Regarding “COVID-19/Remote Learning,” students shared that the decrease in activities due to COVID, Zoom/technology fatigue, and fewer opportunities for clinical experience hindered their capacity for success.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Low-income, educationally challenged, or first-generation students often carry more external pressures than their peers.

    “especially as low-income, educationally challenged, or first-generation students who often carry more external pressures than their peers.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Students shared experiences that benefited them throughout the year such as being matched with a mentor within the same field of study, one-on-one meetings with mentors, and an overall sense of compassion and encouragement from their mentor.

    “Students shared experiences that benefited them throughout the year such as being matched with a mentor within the same field of study, one-on-one meetings with mentors, and an overall sense of compassion and encouragement from their mentor.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: Students in the FCM sessions are experts with knowledge and experience with the STAHR program.
    • The authors state this as an assumption: Centrality is a measure of the importance of map concepts, and concepts with high centrality indicate a high impact.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The research team finalized nine codes for facilitators and eight codes for barriers.

    “Together and using an inductive process, the research team finalized nine codes for facilitators and eight codes for barriers.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Students struggled with balancing time between school and other programmatic obligations, being in a remote environment due to COVID-19, dealing with outside stressors, a program structure reflective of the program's infancy, and misdirected workshop topics.

    “Alternatively, students struggled with balancing time between school and other programmatic obligations, being in a remote environment due to COVID-19, dealing with outside stressors, a program structure reflective of the program’s infancy, and misdirected workshop topics.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 2020–2021 STAHR cohort’s experiences are representative of STAHR students generally.

  • May combine two claims.

    Findingnone given

    Students sometimes find themselves in a difficult situation where they are worn out from meeting virtually but are also unable to attend in-person meetings because of their schedule.

    “In addition, students sometimes find themselves in a difficult situation where they are worn out from meeting virtually but are also unable to attend the in-person meetings because of their schedule.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Through the 2020-2021 academic year, the most helpful factors the STAHR Program provided were mentorship from peers and mentors in the community, workshops aimed to support academic growth, and social support from the program and from their community.

    “Our study found that through the 2020–2021 academic year, the most helpful factors the STAHR Program provided were mentorship from peers and mentors in the community, workshops aimed to support their academic growth, and social support from the program and from their community.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 2020–2021 STAHR cohort’s experiences are representative of STAHR students generally.

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    Prior to the COVID-19 pandemic, the racially and ethnically diverse students served by the STAHR program relied heavily on support services.

    “Prior to the COVID-19 pandemic, the racially and ethnically diverse students served by the STAHR program relied heavily on support services”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Topics for mentor-mentee discussion included academic/professional development, psychological development, identity development, social development, and leadership development.

    “Topics for discussion included academic/professional development, psychological development, identity development, social development, and leadership development.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Each researcher blindly coded two groups of maps based on the codebook and finalized the third.

    “Each researcher blindly coded two groups of maps based on the codebook and finalized the third.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The four researchers finalized the codes for all maps, discussed discrepancies, and reached a consensus on the codes assigned to each map.

    “The four researchers then got together to finalize the codes for all the maps, discussed any discrepancies, and reached a consensus on the codes assigned to each map.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Written informed consent was provided and obtained from students before each mapping session.

    “Written informed consent was provided and obtained from students before each mapping session.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    The findings from a multipronged analysis of mapping data demonstrate the value of this innovative approach to the field, especially when looking to incorporate student voices.

    “The findings from a multipronged analysis of mapping data demonstrate the value of this innovative approach to the field, especially when looking to incorporate student voices.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: Students in the FCM sessions are experts with knowledge and experience with the STAHR program.
    • The authors state this as an assumption: Centrality is a measure of the importance of map concepts, and concepts with high centrality indicate a high impact.
    • The authors state this as an assumption: FCM captures the intuitive knowledge of students and develops a multi-layered understanding of the critical components and processes within the program that support students to become successful.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Team members were trained in coding and analysis procedures to ensure consistency throughout the evaluation process.

    “Additionally, team members were trained in coding and analysis procedures to ensure consistency throughout the evaluation process.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The FCM analytical method permits qualitative graphs to be computable and analyzed using statistical techniques.

    “The FCM analytical method permits qualitative graphs to be computable and analyzed using statistical techniques [7].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Jetter, Antonie. 2006. Fuzzy Cognitive Maps for Engineering and Technology Management: What Works in Practice? In 2006 Technology Management for the Global Future - PICMET 2006 Conference, 498–512. Istanbul, Turkey: IEEE. https://doi.org/10.1109/PICMET.2006.296648. source

  • Classified as probably not a substantial claim.

    Premisecitation

    FCM includes a causal relationship in the approach, where participants provide quantification for connections based on their perception of the cause-and-effect relationships among concepts.

    “FCM has its uniqueness in including a causal relationship in the approach, where participants provide quantification for connections based on their perception of the cause-and-effect relationships among concepts [9].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Singh PK, Chudasama H. Assessing impacts and community preparedness to cyclones a fuzzy cognitive mapping approach. Climatic Change. 2017;143:337–54. source

  • May combine two claims.

    Premisecitation

    FCM is an evidence-based methodology proven as a reliable knowledge-based model that facilitates sense-making by helping program participants communicate strategies and decisions.

    “FCM is an evidence-based methodology proven as a reliable knowledge-based model that facilitates “sense-making” by helping program participants communicate strategies and decisions [7, 8].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [7] Jetter, Antonie. 2006. Fuzzy Cognitive Maps for Engineering and Technology Management: What Works in Practice? In 2006 Technology Management for the Global Future - PICMET 2006 Conference, 498–512. Istanbul, Turkey: IEEE. https://doi.org/10.1109/PICMET.2006.296648. source
    • cites [8] Kosko B. Fuzzy cognitive maps. Int J Man Mach Stud. 1986;24:65–75. https://doi.org/10.1016/S0020-7373(86)80040-2. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Students were assured that their responses would be held confidential and no identifiable information would be shared with the Program.

    “Before the mapping sessions began, students were assured that their responses would be held confidential and no identifiable information would be shared with the Program.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Several model fit indices were used to determine if a CFA model fit well with the existing data.

    “Several model fit indices were used to determine if a CFA model fit well with the existing data.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Four team members developed a codebook based on relevant and reoccurring themes found in students' responses on the ovals.

    “Four team members carefully read through the maps, listened to the session audios, referred to the notes, and developed a codebook based on relevant and reoccurring themes found in students’ responses on the ovals (see codebook in Additional file 1).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Institutional Review Board approval for the study was secured through the university.

    “Institutional Review Board approval for the study was secured through the university.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Students from lower socioeconomic backgrounds are less likely to persist to a bachelor's degree or to have graduate degree aspirations.

    “Further, students from lower socioeconomic backgrounds are less likely to persist through the first year of college, “less likely to persist to a bachelor’s degree or to have graduate degree aspirations” [2], and their aspirations specifically for pursuing advanced degrees in medicine or law are much lower than those of their higher socioeconomic peers [2].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Walpole MaryBeth. Socioeconomic Status and College: How SES Affects College Experiences and Outcomes. Rev High Educ. 2003;27:45–73. https://doi.org/10.1353/rhe.2003.0044. source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    All researchers were adequately trained to facilitate mapping sessions with students.

    “In preparation, all researchers were adequately trained to facilitate mapping sessions with students.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Many students from all walks of life find mentorship helpful, whether from faculty or upper-level students.

    “As found in other research studies, many students from all walks of life find mentorship helpful, whether it’s from faculty or upper-level students [32].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Crisp G, Cruz I. Mentoring College Students: A Critical Review of the Literature Between 1990 and 2007. Res High Educ. 2009;50:525–45. https://doi.org/10.1007/s11162-009-9130-2. source

  • May combine two claims.

    Interpretationown data

    Our findings highlighted the strengths of the STAHR program, indicating the structural elements that play integral roles in the success of students' experiences.

    “Our findings highlighted the strengths of the STAHR program, indicating the structural elements that play integral roles in the success of students’ experiences.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Studies show that students benefit by receiving support in developing a sense of belonging to the professional field, as well as support in developing their professional identity.

    “For example, studies show that students benefit by receiving support in developing a sense of belonging to the professional field, as well as support in developing their professional identity [33].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Boyer, Kristy Elizabeth, E. Nathan Thomas, Audrey S. Rorrer, Deonte Cooper, and Mladen A. Vouk. 2010. Increasing technical excellence, leadership and commitment of computing students through identity-based mentoring. In Proceedings of the 41st ACM technical symposium on Computer science education, 167–171. Milwaukee Wisconsin USA: ACM. https://doi.org/10.1145/1734263.1734320. source

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationown data

    The FCM results clearly demonstrated the need for why student voices are vital to their personal success as well as to the overall success of the STAHR Program.

    “Further, the FCM results clearly demonstrated the need for why student voices are vital to their personal success as well as to the overall success of the STAHR Program.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationreasoning

    By taking into consideration students' real needs and modifying support, a program promotes increased involvement and retention of students, which can lead to better program outcomes.

    “By doing so, the program promotes increased involvement and retention of students, which can then lead to better program outcomes.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationnone given

    The present study employed fuzzy cognitive mapping as an exemplary tool for researchers and evaluators to seek out the voices of those with lived experiences in a program to better understand facilitators and inhibitors of program or participant success.

    “The present study employed the fuzzy cognitive mapping technique as an exemplary tool for researchers and evaluators alike who aim to seek out the voices of those with lived experiences in a program to better understand the facilitators and inhibitors of program or participant success.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The present study had a limitation of sample size.

    “Another limitation of the present study was the sample size”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The barriers identified by students were particularly valuable in pointing out blind spots in program implementation and directing areas for future program evolvement.

    “In turn, the barriers identified by students were particularly valuable in pointing out the blind spots in the program implementation and directing areas for future program evolvement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Program outcomes were not included in the study.

    “One limitation of the study is that program outcomes were not included in the study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Data collection was limited to Zoom due to the pandemic.

    “In addition, the data collection method was limited to Zoom due to the pandemic.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Factors directly related to outcomes were not investigated.

    “Given the scope of this study, factors directly related to outcomes were not investigated.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    This study used a 3-point scale for simplicity.

    “First of all, this study used a 3-point scale for simplicity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationnone given

    Fuzzy cognitive mapping offers researchers a multi-pronged approach that computes suggestions for improvement while allowing for aspects of programs that work to remain intact.

    “Fuzzy cognitive mapping offers researchers a multi-pronged approach that computes suggestions for improvement while allowing for aspects of programs that work to remain intact.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Utilizing FCM allows analysis of program successes and limitations from students' perspectives, thus creating a program tailored to students' needs from year to year.

    “Utilizing FCM allows us to analyze program successes and limitations from the students’ perspectives, thus creating a program tailored to students’ needs from year to year.”
    Quote in the paperSubstantial claim
47 of 47

  • The authors state this as an assumption.

    Students in the FCM sessions are experts with knowledge and experience with the STAHR program.

    “Under the fuzzy logic theory framework, students in the FCM sessions are experts with knowledge and experience with the STAHR program”

  • The authors state this as an assumption.

    Centrality is a measure of the importance of map concepts, and concepts with high centrality indicate a high impact.

    “Centrality is a measure of the importance of map concepts; therefore, concepts with high centrality indicate a high impact.”

  • The authors state this as an assumption.

    FCM captures the intuitive knowledge of students and develops a multi-layered understanding of the critical components and processes within the program that support students to become successful.

    “FCM helps us capture the intuitive knowledge of the students in the program and helps develop a multi-layered understanding of the critical components and processes within the program that support students to become successful in their program.”

  • The paper relies on this without support.

    The weights and connections students assigned on the fuzzy cognitive maps validly measure the impact of each concept on student success.

    “We conducted CFA (see code attached as Appendix 2) with the weights and connections on the maps to investigate the variables that facilitate or hinder student success.”

  • The paper relies on this without support.

    The mapping sessions and CFA capture the facilitators and barriers that actually affect STAHR students’ success.

    “The FCM approach helped the program understand the urgent needs of students from low-income families experiencing educational challenges due to poverty.”

  • The paper relies on this without support.

    Students’ self-reported mentor–mentee encounter data are accurate.

    “Based on the mentor–mentee encounter data reported by students during this cohort, a majority of their encounters (81.4% out of 117 encounters) were virtual (via Zoom, Teams, or phone).”

  • The paper relies on this without support.

    The 2020–2021 STAHR cohort’s experiences are representative of STAHR students generally.

    “Our study found that through the 2020–2021 academic year, the most helpful factors the STAHR Program provided were mentorship from peers and mentors in the community, workshops aimed to support their academic growth, and social support from the program and from their community.”

  • The paper relies on this without support.

    The traditional higher education environment was not equipped to respond to pandemic challenges.

    “whereas the traditional higher education environment was not equipped to respond in such times.”

  • The paper relies on this without support.

    Lack of readily available resources negatively affected students’ mental health and interrupted their academic performance.

    “For instance, due to a lack of readily available resources, students’ mental health was negatively affected, thus interrupting their academic performance.”

  • The paper relies on this without support.

    Many students lost their jobs and had no way to support themselves with basic needs like food and housing.

    “many students lost their jobs with no way to support themselves with basic needs like food and housing.”
10 of 10

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentχ²(19) = 19.73reported p = .41 · recomputed p = .411

    “χ2(19) = 19.73, p = .41”

1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Student status conflicts with Table 1

    Minor

    The text says all 52 students were full-time, but Table 1 lists 51 full-time students and one part-time student.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Quaglia R, Fox K. A lesson in listening. RSA J. 2016;162(5565):46–8.

Cited by

Sorted by citations

Related

Authors
Chiang, D. F., Guerrero, S. A., Sexton, E. C., & Gardner, S. S.
Affiliations
  • University of Missouri–Kansas City (US)
  • Children's Mercy Hospital (US)
Corresponding author
Chiang, Danielle F.
ORCID
Chiang, Danielle F.
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2024-03-20
Volume
24
Issue
1
Pages
319-319
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/s12909-024-05292-7
PMC
PMC10956253
OpenAlex
W4392989675
Semantic Scholar
d2d7ac67a240f4af5ac31d891f40275b8cf52fb6
Cited by
2
References
30
Citations by year
2026: 1 · 2024: 1
FWCI
0.82
Type
journal article
Language
en
Update notices
correction (2024-04-02)
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Health Resources and Services Administration
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Social Sciences › Education › Higher Education Research Studies
  • Social Sciences › Education › Higher Education Practises and Engagement
Keywords
underrepresented students, health sciences education, fuzzy cognitive mapping, program evaluation, student voice, mentoring, social support, low-income students, educational equity, COVID-19 pandemic, distance education, student stressors, University of Missouri-Kansas City
MeSH terms
Cognition, Humans, Mentors, Students, Program Evaluation, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-11-03.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-11-03.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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