Abstract
BackgroundThere has been little study of the role of the essay question in selection for medical school. The purpose of this study was to obtain a better understanding of how applicants approached the essay questions used in selection at our medical school in 2007.MethodsThe authors conducted a qualitative analysis of 210 essays written as part of the medical school admissions process, and developed a conceptual framework to describe the relationships, ideas and concepts observed in the data.ResultsFindings of this analysis were confirmed in interviews with applicants and assessors. Analysis revealed a tension between "genuine" and "expected" responses that we believe applicants experience when choosing how to answer questions in the admissions process. A theory named "What do they want me to say?" was developed to describe the ways in which applicants modulate their responses to conform to their expectations of the selection process; the elements of this theory were confirmed in interviews with applicants and assessors.ConclusionsThis work suggests the existence of a "hidden curriculum of admissions" and demonstrates that the process of selection has a strong influence on applicant response. This paper suggests ways that selection might be modified to address this effect. Studies such as this can help us to appreciate the unintended consequences of admissions processes and can identify ways to make the selection process more consistent, transparent and fair.
Highlights
There has been little study of the role of the essay question in selection for medical school
A qualitative analysis of nursing school admission essays demonstrated that essays could differentiate between students who would complete their studies from those who would not, and that the essay question was a better predictor than measures of prior academic performance [10]
This work suggests the existence of a “hidden curriculum of admissions”, and demonstrates that the process of selection for medical school has a strong influence on applicant response
Summary
There has been little study of the role of the essay question in selection for medical school. The purpose of this study was to obtain a better understanding of how applicants approached the essay questions used in selection at our medical school in 2007. There is evidence that performance on an essay question reflects post-entry performance in applicants entering health-related professions [8], and that admissions essays scored for writing skills, clarity, organization and cohesiveness can predict academic success, and identify “problem students”[9]. A qualitative analysis of nursing school admission essays demonstrated that essays could differentiate between students who would complete their studies from those who would not, and that the essay question was a better predictor than measures of prior academic performance [10]. It has been suggested that writing skills should be included in admissions processes because they are an essential part of healthcare education and practice [11,12]
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