Abstract
BackgroundMedical school admission procedures have the common goal to select applicants with the greatest potential of becoming successful physicians. Hamburg Medical Faculty selects medical students by grade point average (GPA) and employs a two-step selection process of a natural sciences test (HAM-Nat), in some cases followed by multiple mini-interviews (HAM-Int). Multiple mini-interviews can predict non-cognitive outcomes, while GPA has predictive validity for cognitive outcomes. The aim of our study was to explore communication skills and clinical knowledge of advanced medical students according to their respective admission procedure.MethodsIn July 2019, 146 students grouped according to their admission procedure into GPA-only (19.2 %), HAM-Nat (33.6 %), HAM-Int (30.8 %), and Waiting List (16.4 %) participated in four OSCE stations which equally assessed students’ communication skills (OSCE part 1) and clinical knowledge (OSCE part 2) in simulated patient encounters, rated by physicians with checklists. Additionally, psychosocial assessors ranked communication skills with a global rating scale (GR). The students also participated in a multiple choice (MC) exam testing clinical knowledge. Kruskal-Wallis analyses of variance of test performance and Spearman correlation of instruments were calculated.ResultsStudents from the Waiting List group performed significantly worse on the MC exam compared to GPA-only and HAM-Int (adjusted p = .029 and 0.018, respectively). No significant differences were found between the admission groups with respect to communication skills. Global Rating and OSCE part 1 (communication) correlated significantly (ρ = 0.228, p = .006) as did OSCE part 2 (clinical knowledge) and MC exam (ρ = 0.242, p = .003), indicating criterion validity. Constructs did not overlap, indicating divergent validity.ConclusionsAdvanced medical students selected for undergraduate studies by multiple mini-interviews assessing psychosocial skills showed similar communication skills compared to students admitted to medical school by other entryways. It is unclear whether these similarities are due to an effective undergraduate longitudinal communication curriculum. Assessing baseline communication skills of all medical students at entry-level may aid with this question.
Highlights
Medical school admission procedures have the common goal to select applicants with the greatest potential of becoming successful physicians
While high school grade-point average (GPA) seems to have predictive validity for cognitive outcomes of undergraduate medical education [7, 8], a systematic review showed that both Multiple mini-interview (MMI) and Situational judgment test (SJT) can predict non-cognitive outcomes such as personal attributes, e.g. empathy and integrity [4], which are desirable traits for successful medical graduates besides medical knowledge [9]
Of the 186 students who participated in the Objective structured clinical examination (OSCE), the admissions quota could not be identified for 40 students
Summary
Medical school admission procedures have the common goal to select applicants with the greatest potential of becoming successful physicians. Among the most practiced selection methods, high school records, multiple mini-interviews (MMIs), aptitude tests, situational judgment tests (SJTs), and selection centres (SCs) are considered fairer than unstructured interviews, personal statements, or references [4] As they are adaptable to the specific medical schools’ values and requirements [5], MMIs differ on the constructs they intend to measure, but e.g. communication skills, integrity, empathy, or ethical decision making are frequently assessed domains [6]. Since 2010, the Hamburg Medical Faculty invites approximately 1,000 to 1,300 applicants based on a cut-off GPA to sit a natural sciences test (HAM-Nat) and accepts the best 100 [11] After this process, the applicants ranked from 101 to 300 are invited to participate in a validated MMI (HAM-Int), which measures psychosocial competencies such as empathy, communication skills, and self-regulation [12, 13]. Thereafter, the 100 best applicants of that cohort get admitted to undergraduate medical studies
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