Kevin W. Eva, Ph.D., of the University of British Columbia, Vancouver, and colleagues conducted a study to determine whether students deemed acceptable through a revised admissions protocol using a 12-station multiple mini-interview (MMI) would outperform rejected medical students when they later took the Canadian national licensing examinations after completing medical school. The MMI process requires candidates to rotate through brief sequential interviews with structured tasks and independent assessment within each interview.
"Modern conceptions of medical practice demand more of practitioners than a strong knowledge base. By emphasizing compassionate care, professionalism, and interpersonal skill, the Accreditation Council for Graduate Medical Education core competencies indicate that physicians are expected to possess strong personal qualities distinct from academic achievement. There is evidence of a link between these aspects of practice and quality of care," according to background information in the article. "There has been difficulty designing medical school admissions processes that provide valid measurement of candidates' nonacademic qualities."
The study included potential medical students who were interviewed at McMaster University in Hamilton, Canada, using an MMI in 2004 or 2005 and accepted (whether or not they matriculated [enrolled] at McMaster) with those who were interviewed and rejected but gained entry elsewhere.
The computer-based Medical Council of Canada Qualifying Examination (MCCQE) part I (aimed at assessing medical knowledge and clinical decision making) can be taken on graduation from medical school; MCCQE part II (involving simulated patient interactions testing various aspects of practice) is based on the objective structured clinical examination and typically completed 16 months into postgraduate training. Interviews were granted to 1,071 candidates, and those who gained entry could feasibly complete both parts of their licensure examination between May 2007 and March 2011. Scores could be matched on the examinations for 751 (part I) and 623 (part II) interviewees. Admissions decisions were made with use of scores assigned to autobiographical essays, grade point average (GPA), and MMI performance. Academic and nonacademic measures contributed equally to the final ranking.
The researchers found that compared with students who were rejected by an admission process that used MMI assessment, students who were accepted scored higher on Canadian national licensing examinations, whether they had attended McMaster or another school.
"In conclusion, there appears to be a complementary relationship between GPA and the MMI process, with the former related to more knowledge-oriented outcome measures and the latter to more clinical/ethical/interpersonal skill-oriented outcomes. Our study demonstrates that at McMaster, a GPA plus MMI approach has yielded better outcomes than were achieved by the historical use of GPA plus panel-style interview/simulated tutorial."
More information: JAMA. 2012;308:2233-2240