Abstract
In medical school selection, non-cognitive performance in particular correlates with performance in clinical practice. It is arguable, therefore, that selection should focus on non-cognitive aspects despite the predictive value of prior cognitive performance for early medical school performance. The aim of this study at Radboud University Medical Center, the Netherlands, is to determine the effects of admitting students through an autonomous non-cognitive procedure on early medical school performance. We compared their performance to the performance of students selected through an autonomous cognitive selection procedure, enrolling in the Bachelor’s curriculum simultaneously. 574 students (2013 and 2014 cohorts), admitted through non-cognitive selection (based on portfolio, CASPer and MMI, n = 135) or cognitive selection (curriculum sample selection, n = 439) were included in the study. We compared dropout rates, course credits and grades, using logistic and linear regression. The dropout rate was the highest in the non-cognitive selection group (p < 0.001). Students admitted through non-cognitive selection more often obtained the highest grade for the nursing attachment (p = 0.02) and had a higher mean grade for the practical clinical course in year 3 (p = .04). No differences in course grades were found. The results indicate that students perform best on the elements of the curriculum that are represented most strongly in the selection procedure they had participated in. We recommend the use of curriculum sample procedures, resembling the early medical school curriculum,—whether it has a more cognitive or a more non-cognitive focus—, to select the students who are likely to be successful in the subsequent curriculum.
Highlights
A wide range of procedures is currently in use in student selection for medical school, and assessment tools vary widely in terms of their content, characteristics, and number
We focused on differences between students who had been admitted through a cognitive selection procedure and students who had been admitted through a noncognitive selection procedure
In the introduction section of this paper, we suggested that non-cognitive selection is preferable as it correlates to performance in clinical practice, which is the key outcome of medical education
Summary
A wide range of procedures is currently in use in student selection for medical school, and assessment tools vary widely in terms of their content, characteristics, and number. In a comprehensive systematic review, Patterson et al (2016) have recently shown that academic records, Multiple Mini Interviews (MMIs), and Situational Judgment Tests (SJTs) are among the most effective selection methods. They observe that ‘‘achievement in different selection methods may differentially predict performance at the various stages of medical education and clinical practice’’ (Patterson et al 2016). Some studies have already correlated medical school performance with non-cognitive and cognitive elements of a preceding mixed selection procedure, for instance (Adam et al 2015), or have compared the effects of noncognitive versus cognitive selection in different cohorts or programs (Lucieer et al 2015). Lucieer et al, comparing a cognitively selected cohort and a non-cognitively selected cohort, have found no differences in year 1 GPA nor in the probabilities of passing the third-year OSCE or obtaining the Bachelor’s degree within 3 years
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