UK Clinical Aptitude Test Scores Research Articles

Does the UKCAT predict performance in medical and dental school? A systematic review

ObjectivesFor the first time, this systematic review provides a summary of the literature exploring the relationship between performance in the UK Clinical Aptitude Test (UKCAT) and assessments in undergraduate medical...

Impact of accelerated, graduate-entry medicine courses: a comparison of profile, success, and specialty destination between graduate entrants to accelerated or standard medicine courses in UK

BackgroundLittle research has compared the profile, success, or specialty destinations of graduates entering UK medical schools via accelerated, 4-yr, standard 5-yr and 6-yr programmes. Four research questions directed this investigation:-What are the success rates for graduates entering graduate-entry vs. undergraduate medicine courses?How does the sociodemographic and educational profile differ between these two groups?Is success – in medical school and foundation training – dependent on prior degree, demographic factors, or aptitude test performance at selection?What specialty do graduate entry medicine students subsequently enter?MethodsThe data from two cohorts of graduates entering medical school in 2007 and 2008 (n = 2761) in the UKMED (UK Medical Education Database) database were studied: 1445 taking 4-yr and 1150 taking 5-yr medicine courses, with smaller numbers following other programmes.ResultsCompletion rates for degree programmes were high at 95%, with no significant difference between programme types. 4-yr entrants were older, less likely to be from Asian communities, had lower HESA (Higher Education Statistics Agency) tariff scores, but higher UKCAT (UK Clinical Aptitude Test) and GAMSAT (Graduate Medical School Admissions Test) scores, than 5-yr entrants.Higher GAMSAT scores, black or minority ethnicity (BME), and younger age were independent predictors of successful completion of medical school. Foundation Programme (FPAS) selection measures (EPM – educational performance measure; SJT – situational judgment test) were positively associated with female sex, but negatively with black or minority ethnicity. Higher aptitude test scores were associated with EPM and SJT, GAMSAT with EPM, UKCAT with SJT. Prior degree subject, class of degree, HESA tariff, and type of medicine programme were not related to success.ConclusionsThe type of medicine programme has little effect on graduate entrant completion, or EPM or SJT scores, despite differences in student profile.Aptitude test score has some predictive validity, as do sex, age and BME, but not prior degree subject or class. Further research is needed to disentangle the influences of BME.

Predictors of fitness to practise declarations in UK medical undergraduates

BackgroundMisconduct during medical school predicts subsequent fitness to practise (FtP) events in doctors, but relatively little is known about which factors are associated with such issues during undergraduate education. This study exploits the newly created UK medical education database (UKMED), with the aim of identifying predictors of conduct or health-related issues that could potentially impair FtP. The findings would have implications for policies related to both the selection and support of medical students.MethodsData were available for 14,379 students obtaining provisional registration with the General Medical Council who started medical school in 2007 and 2008. FtP declarations made by students were available, as were various educational and demographic predictor variables, including self-report ‘personality measures’ for students who participated in UK Clinical Aptitude Test (UKCAT) pilot studies. Univariable and multivariable logistic regression models were developed to evaluate the predictors of FtP declarations.ResultsSignificant univariable predictors (p < 0.05) for conduct-related declarations included male gender, white ethnicity and a non-professional parental background. Male gender (OR 3.07) and higher ‘self-esteem’ (OR 1.45) were independently associated with an increased risk of a conduct issue.Female gender, a non-professional background, and lower self-reported ‘confidence’ were, among others, associated with increased odds of a health-related declaration. Only ‘confidence’ was a significant independent predictor of a health declaration (OR 0.69). Female gender, higher UKCAT score, a non-professional background and lower ‘confidence’ scores were significant predictors of reported depression, and the latter two variables were independent predictors of declared depression.ConclusionsWhite ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits. Students from non-professional backgrounds may be at increased risk of depression and therefore could benefit from targeted support. The small effect sizes observed for the ‘personality measures’ suggest they would offer little potential benefit for selection, over and above those measures already in use.

Are efforts to attract graduate applicants to UK medical schools effective in increasing the participation of under-represented socioeconomic groups? A national cohort study

IntroductionAttracting graduates was recommended as a means of diversifying the UK medical student population. Graduates now make up nearly a quarter of the total medical student population. Research to date...

The relationship between school type and academic performance at medical school: a national, multi-cohort study

ObjectivesDifferential attainment in school examinations is one of the barriers to increasing student diversity in medicine. However, studies on the predictive validity of prior academic achievement and educational performance at...

Predictive validity of the UKCAT for medical school undergraduate performance: a national prospective cohort study.

BackgroundThe UK Clinical Aptitude Test (UKCAT) has been shown to have a modest but statistically significant ability to predict aspects of academic performance throughout medical school. Previously, this ability has been shown to be incremental to conventional measures of educational performance for the first year of medical school. This study evaluates whether this predictive ability extends throughout the whole of undergraduate medical study and explores the potential impact of using the test as a selection screening tool.MethodsThis was an observational prospective study, linking UKCAT scores, prior educational attainment and sociodemographic variables with subsequent academic outcomes during the 5 years of UK medical undergraduate training. The participants were 6812 entrants to UK medical schools in 2007–8 using the UKCAT. The main outcome was academic performance at each year of medical school. A receiver operating characteristic (ROC) curve analysis was also conducted, treating the UKCAT as a screening test for a negative academic outcome (failing at least 1 year at first attempt).ResultsAll four of the UKCAT scale scores significantly predicted performance in theory- and skills-based exams. After adjustment for prior educational achievement, the UKCAT scale scores remained significantly predictive for most years. Findings from the ROC analysis suggested that, if used as a sole screening test, with the mean applicant UKCAT score as the cut-off, the test could be used to reject candidates at high risk of failing at least 1 year at first attempt. However, the ‘number needed to reject’ value would be high (at 1.18), with roughly one candidate who would have been likely to pass all years at first sitting being rejected for every higher risk candidate potentially declined entry on this basis.ConclusionsThe UKCAT scores demonstrate a statistically significant but modest degree of incremental predictive validity throughout undergraduate training. Whilst the UKCAT could be considered a fairly crude screening tool for future academic performance, it may offer added value when used in conjunction with other selection measures. Future work should focus on the optimum role of such tests within the selection process and the prediction of post-graduate performance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-016-0682-7) contains supplementary material, which is available to authorized users.

Predictive value of the admissions process and the UK Clinical Aptitude Test in a graduate-entry dental school.

To assess the association between admissions performance and the UK Clinical Aptitude Test (UKCAT), and subsequent achievement within a graduate-entry dental school. The study was conducted at the University of Aberdeen Dental School between 2010 and 2014. Student demographics, pre-admission scores (PAS), Universities and Colleges Admissions Service (UCAS) tariffs, multiple mini-interview (MMI) grades, UKCAT scores and percentiles were correlated with academic performance reported as the University Common Assessment Scale (0-20). Data were analysed by Pearson correlation and multiple regression (IBM(®) SPSS(®) Statistics 21). Data were obtained for 71 students (F: 44; M: 27). Student age, MMI, UKCAT scores and UKCAT percentiles demonstrated a correlation with CAS scores (r(2) = 0.119, P = 0.001, r(2) = 0.136, P = 0.001, r(2) = 0.077, P = 0.019 and r(2) = 0.118, P = 0.001, respectively). This study suggests that student age, candidate performance at MMI and the UKCAT might be a predictor of academic achievement for graduate-entry dental students.

Predictors of professional behaviour and academic outcomes in a UK medical school: A longitudinal cohort study

Background: Over the past 70 years, there has been a recurring debate in the literature and in the popular press about how best to select medical students. This implies that we are still not getting it right: either some students are unsuited to medicine or the graduating doctors are considered unsatisfactory, or both.Aim: To determine whether particular variables at the point of selection might distinguish those more likely to become satisfactory professional doctors, by following a complete intake cohort of students throughout medical school and analysing all the data used for the students’ selection, their performance on a range of other potential selection tests, academic and clinical assessments throughout their studies, and records of professional behaviour covering the entire five years of the course.Methods: A longitudinal database captured the following anonymised information for every student (n = 146) admitted in 2007 to the Hull York Medical School (HYMS) in the UK: demographic data (age, sex, citizenship); performance in each component of the selection procedure; performance in some other possible selection instruments (cognitive and non-cognitive psychometric tests); professional behaviour in tutorials and in other clinical settings; academic performance, clinical and communication skills at summative assessments throughout; professional behaviour lapses monitored routinely as part of the fitness-to-practise procedures. Correlations were sought between predictor variables and criterion variables chosen to demonstrate the full range of course outcomes from failure to complete the course to graduation with honours, and to reveal clinical and professional strengths and weaknesses.Results: Student demography was found to be an important predictor of outcomes, with females, younger students and British citizens performing better overall. The selection variable “HYMS academic score”, based on prior academic performance, was a significant predictor of components of Year 4 written and Year 5 clinical examinations. Some cognitive subtest scores from the UK Clinical Aptitude Test (UKCAT) and the UKCAT total score were also significant predictors of the same components, and a unique predictor of the Year 5 written examination. A number of the non-cognitive tests were significant independent predictors of Years 4 and 5 clinical performance, and of lapses in professional behaviour. First- and second-year tutor ratings were significant predictors of all outcomes, both desirable and undesirable. Performance in Years 1 and 2 written exams did not predict performance in Year 4 but did generally predict Year 5 written and clinical performance.Conclusions: Measures of a range of relevant selection attributes and personal qualities can predict intermediate and end of course achievements in academic, clinical and professional behaviour domains. In this study HYMS academic score, some UKCAT subtest scores and the total UKCAT score, and some non-cognitive tests completed at the outset of studies, together predicted outcomes most comprehensively. Tutor evaluation of students early in the course also identified the more and less successful students in the three domains of academic, clinical and professional performance. These results may be helpful in informing the future development of selection tools.

Predictive power of UKCAT and other pre-admission measures for performance in a medical school in Glasgow: a cohort study.

BackgroundThe UK Clinical Aptitude Test (UKCAT) and its four subtests are currently used by 24 Medical and Dental Schools in the UK for admissions. This longitudinal study examines the predictive validity of UKCAT for final performance in the undergraduate medical degree programme at one Medical School and compares this with the predictive validity of the selection measures available pre-UKCAT.MethodsThis was a retrospective observational study of one cohort of students, admitted to Glasgow Medical School in 2007. We examined the associations which UKCAT scores, school science grades and pre-admissions interview scores had with performance indicators, particularly final composite scores that determine students’ postgraduate training opportunities and overall ranking (Educational Performance Measure - EPM, and Honours and Commendation – H&C). Analyses were conducted both with and without adjustment for potential socio-demographic confounders (gender, age, ethnicity and area deprivation).ResultsDespite its predictive value declining as students progress through the course, UKCAT was associated with the final composite scores. In mutually adjusted analyses (also adjusted for socio-demographic confounders), only UKCAT total showed independent relationships with both EPM (p = 0.005) and H&C (p = 0.004), school science achievements predicted EPM (p = 0.009), and pre-admissions interview score predicted neither. UKCAT showed less socio-demographic variation than did TSS.ConclusionUKCAT has a modest predictive power for overall course performance at the University of Glasgow Medical School over and above that of school science achievements or pre-admission interview score and we conclude that UKCAT is the most useful predictor of final ranking.

Predictive validity of the UK clinical aptitude test in the final years of medical school: a prospective cohort study.

BackgroundThe UK Clinical Aptitude Test (UKCAT) was designed to address issues identified with traditional methods of selection. This study aims to examine the predictive validity of the UKCAT and compare this to traditional selection methods in the senior years of medical school. This was a follow-up study of two cohorts of students from two medical schools who had previously taken part in a study examining the predictive validity of the UKCAT in first year.MethodsThe sample consisted of 4th and 5th Year students who commenced their studies at the University of Aberdeen or University of Dundee medical schools in 2007. Data collected were: demographics (gender and age group), UKCAT scores; Universities and Colleges Admissions Service (UCAS) form scores; admission interview scores; Year 4 and 5 degree examination scores. Pearson’s correlations were used to examine the relationships between admissions variables, examination scores, gender and age group, and to select variables for multiple linear regression analysis to predict examination scores.ResultsNinety-nine and 89 students at Aberdeen medical school from Years 4 and 5 respectively, and 51 Year 4 students in Dundee, were included in the analysis. Neither UCAS form nor interview scores were statistically significant predictors of examination performance. Conversely, the UKCAT yielded statistically significant validity coefficients between .24 and .36 in four of five assessments investigated. Multiple regression analysis showed the UKCAT made a statistically significant unique contribution to variance in examination performance in the senior years.ConclusionsResults suggest the UKCAT appears to predict performance better in the later years of medical school compared to earlier years and provides modest supportive evidence for the UKCAT’s role in student selection within these institutions. Further research is needed to assess the predictive validity of the UKCAT against professional and behavioural outcomes as the cohort commences working life.

Comparison of the sensitivity of the UKCAT and A Levels to sociodemographic characteristics: a national study

BackgroundThe UK Clinical Aptitude Test (UKCAT) was introduced to facilitate widening participation in medical and dental education in the UK by providing universities with a continuous variable to aid selection; one that might be less sensitive to the sociodemographic background of candidates compared to traditional measures of educational attainment. Initial research suggested that males, candidates from more advantaged socioeconomic backgrounds and those who attended independent or grammar schools performed better on the test. The introduction of the A* grade at A level permits more detailed analysis of the relationship between UKCAT scores, secondary educational attainment and sociodemographic variables. Thus, our aim was to further assess whether the UKCAT is likely to add incremental value over A level (predicted or actual) attainment in the selection process.MethodsData relating to UKCAT and A level performance from 8,180 candidates applying to medicine in 2009 who had complete information relating to six key sociodemographic variables were analysed. A series of regression analyses were conducted in order to evaluate the ability of sociodemographic status to predict performance on two outcome measures: A level ‘best of three’ tariff score; and the UKCAT scores.ResultsIn this sample A level attainment was independently and positively predicted by four sociodemographic variables (independent/grammar schooling, White ethnicity, age and professional social class background). These variables also independently and positively predicted UKCAT scores. There was a suggestion that UKCAT scores were less sensitive to educational background compared to A level attainment. In contrast to A level attainment, UKCAT score was independently and positively predicted by having English as a first language and male sex.ConclusionsOur findings are consistent with a previous report; most of the sociodemographic factors that predict A level attainment also predict UKCAT performance. However, compared to A levels, males and those speaking English as a first language perform better on UKCAT. Our findings suggest that UKCAT scores may be more influenced by sex and less sensitive to school type compared to A levels. These factors must be considered by institutions utilising the UKCAT as a component of the medical and dental school selection process.

UKCAT does not predict medical school performance, study finds

Scores in the UK clinical aptitude test (UKCAT) do not accurately predict subsequent performance at medical school, indicate the results of a study from the University of Nottingham.1 UKCAT was designed to help medical schools distinguish between the large number of candidates with top grades, but the ability of the UKCAT to select the students best suited to studying medicine has been questioned since its launch. The research aimed to assess whether UKCAT scores accurately predicted student performance in the latter part of the medical course, which is mainly delivered on …

The UK clinical aptitude test and clinical course performance at Nottingham: a prospective cohort study

BackgroundThe UK Clinical Aptitude Test (UKCAT) was introduced in 2006 as an additional tool for the selection of medical students. It tests mental ability in four distinct domains (Verbal Reasoning, Quantitative Reasoning, Reasoning, and Decision Analysis), and the results are available to students and admission panels in advance of the selection process. Our first study showed little evidence of any predictive validity for performance in the first two years of the Nottingham undergraduate course.The study objective was to determine whether the UKCAT scores had any predictive value for the later parts of the course, largely delivered via clinical placements.MethodsStudents entering the course in 2007 and who had taken the UKCAT were asked for permission to use their anonymised data in research. The UKCAT scores were incorporated into a database with routine pre-admission socio-demographics and subsequent course performance data. Correlation analysis was followed by hierarchical multivariate linear regression.ResultsThe original study group comprised 204/254 (80%) of the full entry cohort. With attrition over the five years of the course this fell to 185 (73%) by Year 5. The Verbal Reasoning score and the UKCAT Total score both demonstrated some univariate correlations with clinical knowledge marks, and slightly less with clinical skills. No parts of the UKCAT proved to be an independent predictor of clinical course marks, whereas prior attainment was a highly significant predictor (p <0.001).ConclusionsThis study of one cohort of Nottingham medical students showed that UKCAT scores at admission did not independently predict subsequent performance on the course. Whilst the test adds another dimension to the selection process, its fairness and validity in selecting promising students remains unproven, and requires wider investigation and debate by other schools.

Can the UK Clinical Aptitude Test (UKCAT) select suitable candidates for interview?

UK medical school traditional selection processes are faltering in their ability to distinguish among highly qualified candidates. New methods of selection, including the UK Clinical Aptitude Test (UKCAT), herald a new era in which candidates are selected on aptitude and also aim to widen participation. However, the predictive validity of UKCAT and its role in the selection process are yet to be defined. This paper examines current selection practices and questions the role that such an aptitude test may take. This study is intended to determine whether UKCAT can select suitable candidates for interview. The study was designed to determine whether selectors rejected fewer candidates with high rather than low UKCAT scores using routine selection techniques. Selector rejection rates for 812 candidates with high UKCAT scores and 200 candidates with low UKCAT scores were compared. Additionally, any relationships among UKCAT and subsequent interview performance scores were explored by examining the correlation coefficients between overall and component UKCAT and interview scores for 637 candidates with high UKCAT scores. The rejection rate before interview of candidates with low UKCAT scores was 2.7 times that of candidates with high UKCAT scores. However, no relationship between overall UKCAT score and overall interview score existed within a pre-selected cohort of applicants with high UKCAT scores (Kendall's correlation coefficient, tau b =- 0.004; p = 0.88). UKCAT can facilitate the independent selection of appropriate candidates for interview when used as described. However, UKCAT is not predictive of success at interview. The long-term predictive validity of UKCAT is currently under investigation. Therefore, we conclude that UKCAT is best viewed as a useful adjunct to current selection processes.

The value of the UK Clinical Aptitude Test in predicting pre-clinical performance: a prospective cohort study at Nottingham Medical School

BackgroundThe UK Clinical Aptitude Test (UKCAT) was introduced in 2006 as an additional tool for the selection of medical students. It tests mental ability in four distinct domains (Quantitative Reasoning, Verbal Reasoning, Reasoning, and Decision Analysis), and the results are available to students and admissions panels in advance of the selection process. As yet the predictive validity of the test against course performance is largely unknown.The study objective was to determine whether UKCAT scores predict performance during the first two years of the 5-year undergraduate medical course at Nottingham.MethodsWe studied a single cohort of students, who entered Nottingham Medical School in October 2007 and had taken the UKCAT. We used linear regression analysis to identify independent predictors of marks for different parts of the 2-year preclinical course.ResultsData were available for 204/260 (78%) of the entry cohort. The UKCAT total score had little predictive value. Quantitative Reasoning was a significant independent predictor of course marks in Theme A ('The Cell'), (p = 0.005), and Verbal Reasoning predicted Theme C ('The Community') (p < 0.001), but otherwise the effects were slight or non-existent.ConclusionThis limited study from a single entry cohort at one medical school suggests that the predictive value of the UKCAT, particularly the total score, is low. Section scores may predict success in specific types of course assessment.The ultimate test of validity will not be available for some years, when current cohorts of students graduate. However, if this test of mental ability does not predict preclinical performance, it is arguably less likely to predict the outcome in the clinical years. Further research from medical schools with different types of curriculum and assessment is needed, with longitudinal studies throughout the course.

Comparison of A level and UKCAT performance in students applying to UK medical and dental schools in 2006: cohort study

Objectives To determine whether the UK Clinical Aptitude Test (UKCAT) adds value to the selection process for school leaver applicants to medical and dental school, and in particular whether UKCAT...