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A large majority of research portrays the achievement gap as an outcome and a primary focus of what is wrong in American schools when instead it is a symptom of a larger issue. Defining the problem in education in terms of achievement ignores a much more pervasive issue, which is an understanding of the causes behind these results. Studies of the achievement gap commonly result in looking at the individual, ignoring structural and systematic inequities and limitations, that promote deficit thinking. Early research into the achievement gap believed that family background was the strongest indicator of achievement. Educators widely accepted this theory and believed that schools could do little to assist Black students to be successful. But these beliefs are now understood to be heavily entrenched in deficit thinking, perpetuating structural inequalities, and the consequences have been educators who have largely bypassed the needs of Black male students for decades. Deficit thinking and institutional racism is an underlying factor in lagging achievement because the result is an education that lacks rigor and has lower expectations, which is detrimental to Black students. Research exists on teacher perception of students identifying deficit thinking, but there is no research on assistant principals, who are arguably one of the most influential persons for at-risk students, therefore, as in the case of this study, for Black males. Perceptions of Black males inside and outside of school may impact the decision-making process by which assistant principals perform their administrative functions. This study examines the role these perceptions play by White male assistant principals in the lives of Black males, and in so doing, this study examines institutional racism in schools, leadership, and achievement. Results of this study show assistant principals never cited school leadership, teachers, or policies as having an impact on Black male students, thereby illustrating their lack of consciousness of institutional racism. By comparing the results of this study to historical and current research, the results show that White assistant principals act upon outdated and deficit understandings of Black males, and this which contributes to the structural inequalities that limit opportunities for students of color.

Objective: This dissertation analyzed one state's physician assistant (PA) workforce focusing on recruitment and retention. The goal was to identify factors associated with Indiana PAs working in medically underserved, rural, and primary-care medicine. The study evaluated characteristics of PAs who chose initially to work in rural versus urban areas and who have continued to do so. From the literature and as a result of study outcomes, a framework was developed, upon which recommendations were made for effective methods of increasing and retaining the number of PAs in primary care within rural areas. Subjects: Data were obtained from applications for PA licensure submitted to the Indiana Professional Licensing Agency between the years 2000 and 2010. Additionally, PAs working in Indiana who graduated during this period were surveyed. Methods: Descriptive statistics quantitatively defined the Indiana PA workforce. Survey questions to this population focused on provider upbringing, education, and specialization interest, as well as recruitment and retention to rural, primary-care, or underserved areas. Chi Square tests and logistic regression were used, where appropriate, to examine the influence of independent variables on the choice of practicing in rural, primary-care, and medically underserved areas. Based on these responses, recommendations were developed for strategies to increase the supply of physician assistants in rural areas. Findings: Among applicants for PA licensure in Indiana from 2000 to 2010, there were more females (70%) than males (30%), and the median age of applicants was 35 years. Respondent PAs predominantly worked in counties that were designated by the United States Department of Agriculture as metropolitan (91.3%) and largely in areas designated as Code 1 according to Rural-Urban Continuum Codes, the highest level of urbanicity. Additionally, more PAs worked in a specialty area (79%) than in primary care (21%). Chi Square analyses revealed significant relationships (p < .05) between primary care and gender; educated outside of Indiana and working in an underserved area; and being born in a rural area and choosing to practice in a rural area. Binary logistic regression identified that female gender was predictive of the decision to practice in primary care, and birth in a rural area was predictive of current rural practice. In reflecting upon their first employment following training, 70 percent of respondents believed that the job offer was neither directly nor indirectly a result of having completed a clinical rotation at that particular site, or having worked with a particular preceptor, during their experiential training. A relationship was found between the respondents' initial job location being urban and living in a metro location at the time of high school graduation. Finally, educational debt influenced males' initial practice location and specialty but did not similarly affect choice of practice among females. Conclusions: There were several important characteristics of recently licensed PAs in Indiana that were identified in this study. Educational institutions, policymakers, and communities may increase recruitment and retention of PAs to rural and primary-care practice by actively identifying PAs who possess selected characteristics for the area of interest and providing incentives to reduce educational debt.

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