United Kingdom Clinical Aptitude Test Research Articles

Factors associated with declaration of disability in medical students and junior doctors, and the association of declared disability with academic performance: observational study using data from the UK Medical Education Database, 2002–2018 (UKMED54)

ObjectivesTo examine factors associated with declaration of disability by medical students and doctors, and the association of declared disability with academic performance.DesignObservational study using record-linked data collected between 2002 and...

UKCAT and medical student selection in the UK \u2013 what has changed since 2006?

BackgroundThe United Kingdom Clinical Aptitude Test (UKCAT) is an aptitude test used since 2006 within selection processes of a consortium of UK medical and dental schools.Since 2006, student numbers have increased in medical training and schools now have an increased focus on widening access. A growing evidence base has emerged around medical student selection (Patterson et al., Med Educ 50:36–60, 2016) leading to changes in practice. However, whilst some papers describe local selection processes, there has been no overview of trends in selection processes over time across Universities.This study reports on how the use of the UKCAT in medical student selection has changed and comments on other changes in selection processes.MethodsTelephone interviews were conducted annually with UKCAT Consortium medical schools. Use of the UKCAT was categorised and data analysed to identify trends over time.ResultsThe number of schools using the UKCAT to select applicants for interview has risen, with cognitive test results contributing significantly to outcomes at this stage at many universities. Where schools use different weighted criteria (Factor Method), the UKCAT has largely replaced the use of personal statements. Use of the test at offer stage has also increased; the most significant use being to discriminate between applicants at a decision borderline. A growing number of schools are using the UKCAT Situational Judgement Test (SJT) in selection.In 2018, all but seven (out of 26) schools made some adjustment to selection processes for widening access applicants. Multiple Mini Interviews (MMIs) are now used by the majority of schools.Whilst medical student numbers have increased over this time, the ratio of applicants to places has fallen. The probability of applicants being invited to interview or receiving an offer has increased.ConclusionsMore medical schools are using the UKCAT in undergraduate selection processes in an increasing number of ways and with increasing weight compared with 2007. It has replaced the use of personal statements in all but a few Consortium medical schools.An increased focus on academic attainment and the UKCAT across medical schools may be leading to the need for schools to interview and make offers to more applicants.

What is the effect of secondary (high) schooling on subsequent medical school performance? A national, UK-based, cohort study

ObjectivesUniversity academic achievement may be inversely related to the performance of the secondary (high) school an entrant attended. Indeed, some medical schools already offer ‘grade discounts’ to applicants from less...

A Cross-sectional Study of Current Doctors' Performance in a Modified Version of a Medical School Admission Aptitude Test: The UKCAT.

The 2-hour long United Kingdom Clinical Aptitude Test (UKCAT) is used by many universities in the United Kingdom as part of their selection process for undergraduate medical and dentistry degrees. We aimed to compare the performance of senior doctors in primary and secondary care and across a range of specialties, in a modified version of the medical school entrance examination-the mUKCAT. Lay people were also included in the study. Despite its widespread use, this is the first study that examines the performance of senior clinicians in the UKCAT.The study used a prospective cross-sectional design. It used mock questions from the UKCAT website to generate an mUKCAT that was anticipated to take 15 minutes to complete. In all, 167 doctors at consultant, general practitioner (GP), or specialty trainee grade and 26 lay people took part.The overall mean mUKCAT score of all participants was 2486 (69.1%). Of the total cohort, 126 (65.3%) scored above our designated threshold of 2368 and were deemed to have passed the mUKCAT. Excluding lay people, 113 (67.7%) of the 167 doctors scored above that threshold. Medical specialty was associated with overall score (P = 0.003), with anesthetists/intensive care physicians scoring highest (n = 20, mean score 2660) and GPs scoring lowest (n = 38, mean score 2302). Academics outperformed nonacademics (mean score of academics, n = 44 vs nonacademics, n = 123: 2750 vs 2406; P < 0.001). Those clinicians in senior management positions scored lower than those in "standard" roles (mean score of senior management, n = 31 vs standard roles, n = 136: 2332 vs 2534, mean difference 202, 95% confidence interval 67-337, P = 0.004).In the situational judgement section, there was no evidence that specialty was associated with score (P = 0.15). Academics exhibited greater situational judgement than their nonacademic colleagues (academics vs nonacademics: 69.8 vs 63.6%; P = 0.01).The majority of senior clinicians passed our mUKCAT. Academics and anesthetists were found to be the best performers, with GPs and those in senior management positions performing the worst.

Disadvantaged pupils less likely to apply or be accepted for career in medicine

Pupils from disadvantaged backgrounds in the United Kingdom are less likely than other pupils to apply to study medicine and are less likely to be accepted when they do, researchers have found. A study of applications to UK medical schools between 2009 and 2012 shows that between a fifth and a third, depending on UK country, of all medical school applicants live in the most affluent areas.1 Researchers from the University of Dundee reviewed applications to 22 UK medical schools between 2009 and 2012 from 32 964 UK residents aged 19 and under, using United Kingdom clinical aptitude test (UKCAT) data. They assessed applicants’ home postcode, type of school, and parents’ jobs and whether they were …

Fair access to medicine? Retrospective analysis of UK medical schools application data 2009-2012 using three measures of socioeconomic status.

BackgroundMedical students have historically largely come from more affluent parts of society, leading many countries to seek to broaden access to medical careers on the grounds of social justice and the perceived benefits of greater workforce diversity. The aim of this study was to examine variation in socioeconomic status (SES) of applicants to study medicine and applicants with an accepted offer from a medical school, comparing the four UK countries and individual medical schools.MethodsRetrospective analysis of application data for 22 UK medical schools 2009/10-2011/12. Data were analysed for all 32,964 UK-domiciled applicants aged <20 years to 22 non-graduate medical schools requiring applicants to sit the United Kingdom Clinical Aptitude Test (UKCAT). Rates of applicants and accepted offers were compared using three measures of SES: (1) Postcode-assigned Index of Multiple Deprivation score (IMD); (2) School type; (3) Parental occupation measured by the National Statistics Socio Economic Classification (NS-SEC).ResultsThere is a marked social gradient of applicants and applicants with accepted offers with, depending on UK country of residence, 19.7–34.5 % of applicants living in the most affluent tenth of postcodes vs 1.8–5.7 % in the least affluent tenth. However, the majority of applicants in all postcodes had parents in the highest SES occupational group (NS-SEC1). Applicants resident in the most deprived postcodes, with parents from lower SES occupational groups (NS-SEC4/5) and attending non-selective state schools were less likely to obtain an accepted offer of a place at medical school further steepening the observed social gradient. Medical schools varied significantly in the percentage of individuals from NS-SEC 4/5 applying (2.3 %–8.4 %) and gaining an accepted offer (1.2 %–7.7 %).ConclusionRegardless of the measure, those from less affluent backgrounds are less likely to apply and less likely to gain an accepted offer to study medicine. Postcode-based measures such as IMD may be misleading, but individual measures like NS-SEC can be gamed by applicants. The previously unreported variation between UK countries and between medical schools warrants further investigation as it implies solutions are available but inconsistently applied.

Evaluating the validity of an integrity-based situational judgement test for medical school admissions.

BackgroundWhile the construct of integrity has emerged as a front-runner amongst the desirable attributes to select for in medical school admissions, it is less clear how best to assess this characteristic. A potential solution lies in the use of Situational Judgement Tests (SJTs) which have gained popularity due to robust psychometric evidence and potential for large-scale administration. This study aims to explore the psychometric properties of an SJT designed to measure the construct of integrity.MethodsTen SJT scenarios, each with five response stems were developed from critical incident interviews with academic and clinical staff. 200 of 520 (38.5 %) Multiple Mini Interview candidates at Dundee Medical School participated in the study during the 2012–2013 admissions cycle. Participants were asked to rate the appropriateness of each SJT response on a 4-point likert scale as well as complete the HEXACO personality inventory and a face validity questionnaire. Pearson’s correlations and descriptive statistics were used to examine the associations between SJT score, HEXACO personality traits, pre-admissions measures namely academic and United Kingdom Clinical Aptitude Test (UKCAT) scores, as well as acceptability.ResultsCronbach’s alpha reliability for the SJT was .64. Statistically significant correlations ranging from .16 to .36 (.22 to .53 disattenuated) were observed between SJT score and the honesty-humility (integrity), conscientiousness, extraversion and agreeableness dimensions of the HEXACO inventory. A significant correlation of .32 (.47 disattenuated) was observed between SJT and MMI scores and no significant relationship with the UKCAT. Participant reactions to the SJTs were generally positive.ConclusionsInitial findings are encouraging regarding the psychometric robustness of an integrity-based SJT for medical student selection, with significant associations found between the SJTs, integrity, other desirable personality traits and the MMI. The SJTs showed little or no redundancy with cognitive ability. Results suggest that carefully-designed SJTs may augment more costly MMIs.

The UKCAT test: developments, research and its use by dental schools in the UK

The United Kingdom Clinical Aptitude Test (UKCAT) has now been an active part of U.K. dental admissions for seven years with the test being used by 11 dental schools within their admissions processes. This paper gives an overview on UKCAT and highlights some of the on-going work in relation to its development. This paper also highlights what UKCAT is and some developments with respect to the UKCAT. It also facilitates the process of keeping dental practitioners informed.

The UKCAT-12 study: educational attainment, aptitude test performance, demographic and socio-economic contextual factors as predictors of first year outcome in a cross-sectional collaborative study of 12 UK medical schools.

BackgroundMost UK medical schools use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the United Kingdom Clinical Aptitude Test (UKCAT), and its four sub-scales, along with measures of educational attainment, individual and contextual socio-economic background factors, as predictors of performance in the first year of medical school training.MethodsA prospective study of 4,811 students in 12 UK medical schools taking the UKCAT from 2006 to 2008 as a part of the medical school application, for whom first year medical school examination results were available in 2008 to 2010.ResultsUKCAT scores and educational attainment measures (General Certificate of Education (GCE): A-levels, and so on; or Scottish Qualifications Authority (SQA): Scottish Highers, and so on) were significant predictors of outcome. UKCAT predicted outcome better in female students than male students, and better in mature than non-mature students. Incremental validity of UKCAT taking educational attainment into account was significant, but small. Medical school performance was also affected by sex (male students performing less well), ethnicity (non-White students performing less well), and a contextual measure of secondary schooling, students from secondary schools with greater average attainment at A-level (irrespective of public or private sector) performing less well. Multilevel modeling showed no differences between medical schools in predictive ability of the various measures. UKCAT sub-scales predicted similarly, except that Verbal Reasoning correlated positively with performance on Theory examinations, but negatively with Skills assessments.ConclusionsThis collaborative study in 12 medical schools shows the power of large-scale studies of medical education for answering previously unanswerable but important questions about medical student selection, education and training. UKCAT has predictive validity as a predictor of medical school outcome, particularly in mature applicants to medical school. UKCAT offers small but significant incremental validity which is operationally valuable where medical schools are making selection decisions based on incomplete measures of educational attainment. The study confirms the validity of using all the existing measures of educational attainment in full at the time of selection decision-making. Contextual measures provide little additional predictive value, except that students from high attaining secondary schools perform less well, an effect previously shown for UK universities in general.

Validity of the UKCAT in Applicant Selection and Predicting Exam Performance in UK Dental Students

The United Kingdom's Clinical Aptitude Test (UKCAT) aims to assess candidates' "natural talent" for dentistry. The aim of this study was to determine the validity of the UKCAT for dental school applicant selection. The relationship of the UKCAT with demographic and academic variables was examined, assessing if the likelihood of being offered a place at a UK dental school was predicted by demographic factors and academic selection tools (predicted grades and existing school results). Finally, the validity of these selection tools in predicting first-year dental exam performance was assessed. Correlational and regression analyses showed that females and poorer students were more likely to have lower UKCAT scores. Gender and social class did not, however, predict first-year dental exam performance. UKCAT scores predicted the likelihood of the candidate being offered a place in the dental course; however, they did not predict exam performance during the first year of the course. Indeed, the only predictor of dental exam performance was existing school results. These findings argue against the use of the UKCAT as the sole determinant in dental applicant selection, instead highlighting the value of using existing school results.

Can personal qualities of medical students predict in-course examination success and professional behaviour? An exploratory prospective cohort study

BackgroundOver two-thirds of UK medical schools are augmenting their selection procedures for medical students by using the United Kingdom Clinical Aptitude Test (UKCAT), which employs tests of cognitive and non-cognitive personal qualities, but clear evidence of the tests’ predictive validity is lacking. This study explores whether academic performance and professional behaviours that are important in a health professional context can be predicted by these measures, when taken before or very early in the medical course.MethodsThis prospective cohort study follows the progress of the entire student cohort who entered Hull York Medical School in September 2007, having taken the UKCAT cognitive tests in 2006 and the non-cognitive tests a year later. This paper reports on the students’ first and second academic years of study. The main outcome measures were regular, repeated tutor assessment of individual students’ interpersonal skills and professional behaviour, and annual examination performance in the three domains of recall and application of knowledge, evaluation of data, and communication and practical clinical skills. The relationships between non-cognitive test scores, cognitive test scores, tutor assessments and examination results were explored using the Pearson product–moment correlations for each group of data; the data for students obtaining the top and bottom 20% of the summative examination results were compared using Analysis of Variance.ResultsPersonal qualities measured by non-cognitive tests showed a number of statistically significant relationships with ratings of behaviour made by tutors, with performance in each year’s objective structured clinical examinations (OSCEs), and with themed written summative examination marks in each year. Cognitive ability scores were also significantly related to each year’s examination results, but seldom to professional behaviours. The top 20% of examination achievers could be differentiated from the bottom 20% on both non-cognitive and cognitive measures.ConclusionsThis study shows numerous significant relationships between both cognitive and non-cognitive test scores, academic examination scores and indicators of professional behaviours in medical students. This suggests that measurement of non-cognitive personal qualities in applicants to medical school could make a useful contribution to selection and admission decisions. Further research is required in larger representative groups, and with more refined predictor measures and behavioural assessment methods, to establish beyond doubt the incremental validity of such measures over conventional cognitive assessments.

Getting on the carousel

Since 2007, almost all UK medical students will have taken the United Kingdom Clinical Aptitude Test (UKCAT), a standardised test that universities use as part of admissions criteria. Similar tests exist in the US (Medical College Admissions Test) and are soon to be rolled out in India (National Eligibility cum Entrance Test). One of the aims of these tests is to widen access to medicine to under-represented groups. Such groups include those from low socio-economic backgrounds and ethnic minorities. But …

The UK Clinical Aptitude Test: Is it a fair test for selecting medical students?

Background: The United Kingdom Clinical Aptitude Test (UKCAT) is designed to increase diversity and fairness in selection to study medicine.Aim: The aim of this study is to determine if differences in: access to support and advice, in modes of preparation, type of school/college attended, level of achievement in mathematics, gender and age influence candidate performance in the UKCAT and thereby unfairly advantage some candidates over others.Methods: Confidential, self-completed, on-line questionnaire of applicants to study on an undergraduate medical degree course who had taken the UKCAT in 2010.Results: Differentials in access to support and advice, in modes of preparation, type of school/college attended, in level of achievement in mathematics, gender and age were found to be associated with candidate performance in the UKCAT.Conclusion: The findings imply that the UKCAT may disadvantage some candidate groups. This inequity would likely be improved if tutors and career advisors in schools and colleges were more informed about the UKCAT and able to offer appropriate advice on preparation for the test.

Use of UKCAT scores in student selection by UK medical schools, 2006-2010

BackgroundThe United Kingdom Clinical Aptitude Test (UKCAT) is a set of cognitive tests introduced in 2006, taken annually before application to medical school. The UKCAT is a test of aptitude and not acquired knowledge and as such the results give medical schools a standardised and objective tool that all schools could use to assist their decision making in selection, and so provide a fairer means of choosing future medical students.Selection of students for UK medical schools is usually in three stages: assessment of academic qualifications, assessment of further qualities from the application form submitted via UCAS (Universities and Colleges Admissions Service) leading to invitation to interview, and then selection for offer of a place. Medical schools were informed of the psychometric qualities of the UKCAT subtests and given some guidance regarding the interpretation of results. Each school then decided how to use the results within its own selection system.MethodsAnnual retrospective key informant telephone interviews were conducted with every UKCAT Consortium medical school, using a pre-circulated structured questionnaire. The key points of the interview were transcribed, 'member checked' and a content analysis was undertaken.ResultsFour equally popular ways of using the test results have emerged, described as Borderline, Factor, Threshold and Rescue methods. Many schools use more than one method, at different stages in their selection process. Schools have used the scores in ways that have sought to improve the fairness of selection and support widening participation. Initially great care was taken not to exclude any applicant on the basis of low UKCAT scores alone but it has been used more as confidence has grown.ConclusionsThere is considerable variation in how medical schools use UKCAT, so it is important that they clearly inform applicants how the test will be used so they can make best use of their limited number of applications.

A mixed-methods study identifying and exploring medical students’ views of the UKCAT

Background: The United Kingdom Clinical Aptitude Test (UKCAT) is used by 23 UK medical schools. Research to date has focused on validity and utility but it is also critical to examine selection processes from the applicant's perspective.Methods: This was a mixed-methods study using a paper-based survey and focus groups with first year medical students in Scotland in 2009–2010. Questionnaire data were analysed using SPSS, focus group data using framework analysis.Results: The survey return rate was 88% (883/1005). More than 99% of respondents had sat the UKCAT. Only 20% of respondents agreed the UKCAT was useful in the selection procedure. Nineteen students then took part in three focus groups held in three medical schools. These identified four themes related to views of the UKCAT: lack of face validity, concerns about fairness and cost, and the use of data by medical schools and influence of preparation.Conclusion: The UKCAT was viewed unfavourably by first year medical students completing it pre-admission. These negative views seem due to concern as to the use of UKCAT data, and the fairness of the test. More evidence as to validity and fairness of the UKCAT and how it is used in practice is required.

UKCAT

The United Kingdom clinical aptitude test was designed to help universities pick out students best suited to studying medicine, but its value has been questioned since its launch in 2006. <b>Helen Jaques</b> looks at the latest evidence on the test and where to go next

Has the UK Clinical Aptitude Test improved medical student selection?

In 2006, the United Kingdom Clinical Aptitude Test (UKCAT) was introduced as a new medical school admissions tool. The aim of this cohort study was to determine whether the UKCAT has made any improvements to the way medical students are selected. Regression analysis was performed in order to study the ability of previous school type and gender to predict UKCAT, personal statement or interview scores in two cohorts of accepted students. The ability of admissions scores and demographic data to predict performance on knowledge and skills examinations was also studied. Previous school type was not a significant predictor of either interview or UKCAT scores amongst students who had been accepted onto the programme (n = 307). However, it was a significant predictor of personal statement score, with students from independent and grammar schools performing better than students from state-maintained schools. Previous school type, personal statements and interviews were not significant predictors of knowledge examination performance. UKCAT scores were significant predictors of knowledge examination performance for all but one examination administered in the first 2 years of medical school. Admissions data explained very little about performance on skills (objective structured clinical examinations [OSCEs]) assessments. The use of personal statements as a basis for selection results in a bias towards students from independent and grammar schools. However, no evidence was found to suggest that students accepted from these schools perform any better than students from maintained schools on Year 1 and 2 medical school examinations. Previous school type did not predict interview or UKCAT scores of accepted students. UKCAT scores are predictive of Year 1 and 2 examination performance at this medical school, whereas interview scores are not. The results of this study challenge claims made by other authors that aptitude tests do not have a place in medical school selection in the UK.

Does the UKCAT predict Year 1 performance in medical school?

The need to identify the best applicants for medicine and to ensure that selection is fair and ethical has led to the development of alternative, or additional, selection tools. One such tool is the United Kingdom Clinical Aptitude Test, or UKCAT. To date there have been no studies of the predictive validity of the UKCAT. This study set out to identify whether UKCAT total score and subtest scores predict Year 1 outcomes in medical school. Year 1 students starting in 2007 at the University of Aberdeen or University of Dundee medical schools were included. Data collected were: UKCAT scores; Universities and Colleges Admissions Service (UCAS) form scores; admission interview scores; final Year 1 degree examination scores, and records of re-sitting examinations and of withdrawing from a course. Correlations were used to select variables for multiple regression analysis to predict examination scores. Data were available for 341 students. Examination scores did not correlate with UKCAT total or subtest scores. Neither UCAS form score nor admission interview score predicted outcomes. None of the UKCAT scores were reliably associated with withdrawals (P-values for all comparisons > 0.05). Only the decision analysis subtest was associated with re-sits of examinations, but the difference in means was contrary to the direction anticipated (P = 0.025, 95% confidence interval = 6.1-89.7). UKCAT scores did not predict Year 1 performance at the two medical schools. Although early prediction is arguably not the primary aim of the UKCAT, there is some cause for concern that the test failed to show even the small-to-moderate predictive power demonstrated by similar admissions tools.

A comparison of the United Kingdom Clinical Aptitude Test (UK-CAT) with a traditional admission selection process

A comparison of the United Kingdom Clinical Aptitude Test (UK-CAT) with a traditional admission selection process

A comparison of the United Kingdom Clinical Aptitude Test (UK-CAT) with a traditional admission selection process

Background: The United Kingdom Clinical Aptitude Test (UK-CAT) was introduced for the purpose of student selection by a consortium of 23 UK University Medical and Dental Schools, including the University of Aberdeen in 2006.Aim: To compare candidate performance on UK-CAT with local medical student selection outcome.Method: We compared the outcomes of all applicants to Medicine, University of Aberdeen (UoA), in 2006 who undertook the UK-CAT. The candidates were selected into one of five outcomes (academic reject, reject following assessment, reject following interview, reserve list or offer). The candidate performance in the UK-CAT was compared to candidate performance on the UoA selection.Results: Data are reported on 1307 (85.0%) students who applied to UoA in 2006 and undertook the UK-CAT. Total UK-CAT scores were significantly correlated with local selection scores. However, of 314 students offered a place following the conventional selection process, only 101 were also in the highest scoring 318 on the UK-CAT.Conclusions: Results from this study indicate that UK-CAT scores show weak correlation with success in our medical admissions process. It appears therefore that the UK-CAT examines different traits compared to our selection process. Further work is required to establish which better predicts success as an undergraduate or as a doctor.