Insights into undergraduate medical student selection tools: a systematic review and meta-analysis

Abstract

Evaluating medical school selection tools is vital for evidence-based student selection. With previous reviews revealing knowledge gaps, this meta-analysis offers insights into the effectiveness of these selection tools. A systematic review and meta-analysis were conducted applying the following criteria: peer-reviewed articles available in English, published from 2010 and which include empirical data linking performance in selection tools with assessment and dropout outcomes of undergraduate entry medical programs. Systematic reviews, meta-analyses, general opinion pieces, or commentaries were excluded. Effect sizes (ESs) of the predictability of academic and clinical performance within and by the end of the medicine program were extracted, and the pooled ESs were presented. Sixty-seven out of 2,212 articles were included, which yielded 236 ESs. Previous academic achievement predicted medical program academic performance (Cohen’s d=0.697 in early program; 0.619 in end of program) and clinical exams (0.545 in end of program). Overall aptitude tests predicted academic achievement in both the early and last years (0.550 & 0.371, respectively). Within aptitude tests, verbal reasoning and quantitative reasoning best predicted academic achievement in the early program (0.704 & 0.643, respectively). Neither panel interviews, multiple mini-interviews, nor situational judgement tests (SJT) yielded statistically significant pooled ES. Current evidence suggests that learning outcomes are predicted by previous academic achievement and aptitude tests. The predictive value of SJT and topics such as selection algorithms, features of interview (e.g., content of the questions) and the way the interviewers’ reports are used, warrant further research.