Evaluating non-cognitive skills in medical school applicants

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Abstract

Medical school candidates must have both the cognitive and professional competencies required to become good physicians. In this commentary, we outline the evidence and outcomes associated with the implementation of these selection methodologies and evaluate their ability to assess non-cognitive skills.

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Most cited references 23

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An admissions OSCE: the multiple mini-interview.

Kevin Eva, Jack Rosenfeld, Harold I Reiter … (2004)

Although health sciences programmes continue to value non-cognitive variables such as interpersonal skills and professionalism, it is not clear that current admissions tools like the personal interview are capable of assessing ability in these domains. Hypothesising that many of the problems with the personal interview might be explained, at least in part, by it being yet another measurement tool that is plagued by context specificity, we have attempted to develop a multiple sample approach to the personal interview. A group of 117 applicants to the undergraduate MD programme at McMaster University participated in a multiple mini-interview (MMI), consisting of 10 short objective structured clinical examination (OSCE)-style stations, in which they were presented with scenarios that required them to discuss a health-related issue (e.g. the use of placebos) with an interviewer, interact with a standardised confederate while an examiner observed the interpersonal skills displayed, or answer traditional interview questions. The reliability of the MMI was observed to be 0.65. Furthermore, the hypothesis that context specificity might reduce the validity of traditional interviews was supported by the finding that the variance component attributable to candidate-station interaction was greater than that attributable to candidate. Both applicants and examiners were positive about the experience and the potential for this protocol. The principles used in developing this new admissions instrument, the flexibility inherent in the multiple mini-interview, and its feasibility and cost-effectiveness are discussed.

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The Multiple Mini-Interview (MMI) for student selection in health professions training - a systematic review.

Allan Pau, Kamalan Jeevaratnam, Yu Chen … (2013)

The Multiple Mini-Interview (MMI) has been used increasingly for selection of students to health professions programmes. This paper reports on the evidence base for the feasibility, acceptability, reliability and validity of the MMI. CINAHL and MEDLINE STUDY ELIGIBILITY CRITERIA: All studies testing the MMI on applicants to health professions training. Each paper was appraised by two reviewers. Narrative summary findings on feasibility, acceptability, reliability and validity are presented. Of the 64 citations identified, 30 were selected for review. The modal MMI consisted of 10 stations, each lasting eight minutes and assessed by one interviewer. The MMI was feasible, i.e. did not require more examiners, did not cost more, and interviews were completed over a short period of time. It was acceptable, i.e. fair, transparent, free from gender, cultural and socio-economic bias, and did not favour applicants with previous coaching. Its reliability was reported to be moderate to high, with Cronbach's alpha = 0.69-0.98 and G = 0.55-0.72. MMI scores did not correlate to traditional admission tools scores, were not associated with pre-entry academic qualifications, were the best predictor for OSCE performance and statistically predictive of subsequent performance at medical council examinations. The MMI is reliable, acceptable and feasible. The evidence base for its validity against future medical council exams is growing with reports from longitudinal investigations. However, further research is needed for its acceptability in different cultural context and validity against future clinical behaviours.

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Adjusting medical school admission: assessing interpersonal skills using situational judgement tests.

Filip Lievens (2013)

Today's formal medical school admission systems often include only cognitively oriented tests, although most medical school curricula emphasise both cognitive and non-cognitive factors. Situational judgement tests (SJTs) may represent an innovative approach to the formal measurement of interpersonal skills in large groups of candidates in medical school admission processes. This study examined the validity of interpersonal video-based SJTs in relation to a variety of outcome measures. This study used a longitudinal and multiple-cohort design to examine anonymised medical school admissions and medical education data. It focused on data for the Flemish medical school admission examination between 1999 and 2002. Participants were 5444 candidates taking the medical school admission examination. Outcome measures were first-year grade point average (GPA), GPA in interpersonal communication courses, GPA in non-interpersonal courses, Bachelor's degree GPA, Master's degree GPA and final-year GPA (after 7 years). For students pursuing careers in general practice, additional outcome measures (9 years after sitting examinations) included supervisor ratings and the results of an interpersonal objective structured clinical examination (OSCE), a general practice knowledge test and a case-based interview. Interpersonal skills assessment carried out using SJTs had significant added value over cognitive tests for predicting interpersonal GPA throughout the curriculum, doctor performance, and performance on an OSCE and in a case-based interview. For the other outcomes, cognitive tests emerged as the better predictors. Females significantly outperformed males on the SJT (d = -0.26). The interpersonal SJT was perceived as significantly more job-related than the cognitive tests (d = 0.55). Video-based SJTs as measures of procedural knowledge about interpersonal behaviour show promise as complements to cognitive examination components. The interpersonal skills training received during medical education does not negate the selection of students on the basis of interpersonal skills. Future research is needed to examine the use of SJTs in other cultures and student populations. © Blackwell Publishing Ltd 2013.

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Author and article information

Contributors

Mark J. Eisenberg: mark.eisenberg@mcgill.ca

Journal

Journal ID (nlm-ta): BMC Med Educ

Journal ID (iso-abbrev): BMC Med Educ

Title: BMC Medical Education

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6920

Publication date (Electronic): 23 January 2024

Publication date PMC-release: 23 January 2024

Publication date Collection: 2024

Volume: 24

Electronic Location Identifier: 82

Affiliations

[1 ]Lady Davis Institute for Medical Research, Jewish General Hospital, ( https://ror.org/056jjra10) Montreal, QC Canada

[2 ]Departments of Medicine and of Epidemiology, Biostatistics and Occupational Health, McGill University, ( https://ror.org/01pxwe438) Montreal, QC Canada

[3 ]GRID grid.14709.3b, ISNI 0000 0004 1936 8649, Division of Cardiology, Jewish General Hospital, , McGill University, ; 3755 Côte Ste-Catherine Road, Suite H-421.1, H3T 1E2 Montreal, QC Canada

Article

Publisher ID: 5046

DOI: 10.1186/s12909-024-05046-5

PMC ID: 10804460

SO-VID: 094f7b08-2ede-4a2f-9c75-7302e7d069f0

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 3 August 2023

Date accepted : 9 January 2024

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Evaluating non-cognitive skills in medical school applicants

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Special feature: Decolonising the School Curriculum

Most cited references 23

An admissions OSCE: the multiple mini-interview.

The Multiple Mini-Interview (MMI) for student selection in health professions training - a systematic review.

Adjusting medical school admission: assessing interpersonal skills using situational judgement tests.

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