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

ABSTRACT: 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?

SUBMITTER: Blackmur JP

PROVIDER: S-EPMC4863766 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature

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

Blackmur James P JP Lone Nazir I NI Stone Oliver D OD Webb David J DJ Dhaun Neeraj N

Medicine 20160501 18

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 examin ...[more]

PMID: 27149449

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Project description: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 and dental training.DesignIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, relevant studies were identified through systematic literature searches. Electronic searches were carried out on EBSCO, EMBASE, Educational Resources Information Centre, SCOPUS, Web of Knowledge. Studies which included the predictive validity of selection criteria including some element of the UKCAT were considered.Results22 papers were identified for inclusion in the study. Four studies describe outcomes from dental programmes with limited results reported. 18 studies reported on relationships between the UKCAT and performance in undergraduate medical training. Of these, 15 studies reported relationships between the UKCAT cognitive tests and undergraduate medical assessments. Weak relationships (r=0.00-0.29) were observed in 14 of these studies; four studies reported some moderate relationships (r=0.30-0.49). The strongest relationships with performance in medical school were observed for the UKCAT total score and the verbal reasoning subtest. Relationships with knowledge-based assessments scores were higher than those for assessments of skills as the outcome. Relationships observed in small (single and double centre studies) were larger than those observed in multicentre studies.ConclusionThe results indicate that UKCAT scores predict performance in medical school assessments. The relationship is generally weak, although noticeably stronger for both the UKCAT total score and the verbal reasoning subtest. There is some evidence that UKCAT continues to predict performance throughout medical school. We recommend more optimal approaches to future studies. This assessment of existing evidence should assist medical/dental schools in their evaluation of selection processes.

Project description:BackgroundThe UMAT is widely used for selection into undergraduate medical and dental courses in Australia and New Zealand (NZ). It tests aptitudes thought to be especially relevant to medical studies and consists of 3 sections - logical reasoning and problem solving (UMAT-1), understanding people (UMAT-2) and non-verbal reasoning (UMAT-3). A substantial proportion of all candidates re-sit the UMAT. Re-sitting raises the issue as to what might be the precise magnitude and determinants of any practice effects on the UMAT and their implications for equity in subsequent selection processes.MethodsBetween 2000 and 2012, 158,909 UMAT assessments were completed. From these, 135,833 cases were identified where a candidate had sat once or more during that period with 117,505 cases (86.5%) having sat once, 14,739 having sat twice (10.9%), 2,752 thrice (2%) and 837, 4 or more times (0.6%). Subsequent analyses determined predictors of multiple re-sits as well as the magnitude and socio-demographic determinants of any practice effects.ResultsIncreased likelihood of re-sitting the UMAT twice or more was predicted by being male, of younger age, being from a non-English language speaking background and being from NZ and for Australian candidates, being urban rather than rurally based. For those who sat at least twice, the total UMAT score between a first and second attempt improved by 10.7 ± 0.2 percentiles, UMAT-1 by 8.3 ± 0.2 percentiles, UMAT-2 by 8.3 ± 0.2 percentiles and UMAT-3 by 7.7 ± 0.2 percentiles. An increase in total UMAT percentile score on re-testing was predicted by a lower initial score and being a candidate from NZ rather than from Australia while a decrease was related to increased length of time since initially sitting the test, older age and non-English language background.ConclusionsRe-sitting the UMAT augments performance in each of its components together with the total UMAT percentile score. Whether this increase represents just an improvement in performance or an improvement in understanding of the variables and therefore competence needs to be further defined. If only the former, then practice effects may be introducing inequity in student selection for medical or dental schools in Australia or NZ.

Project description:BackgroundKnowledge in natural sciences generally predicts study performance in the first two years of the medical curriculum. In order to reduce delay and dropout in the preclinical years, Hamburg Medical School decided to develop a natural science test (HAM-Nat) for student selection. In the present study, two different approaches to scale construction are presented: a unidimensional scale and a scale composed of three subject specific dimensions. Their psychometric properties and relations to academic success are compared.Methods334 first year medical students of the 2006 cohort responded to 52 multiple choice items from biology, physics, and chemistry. For the construction of scales we generated two random subsamples, one for development and one for validation. In the development sample, unidimensional item sets were extracted from the item pool by means of weighted least squares (WLS) factor analysis, and subsequently fitted to the Rasch model. In the validation sample, the scales were subjected to confirmatory factor analysis and, again, Rasch modelling. The outcome measure was academic success after two years.ResultsAlthough the correlational structure within the item set is weak, a unidimensional scale could be fitted to the Rasch model. However, psychometric properties of this scale deteriorated in the validation sample. A model with three highly correlated subject specific factors performed better. All summary scales predicted academic success with an odds ratio of about 2.0. Prediction was independent of high school grades and there was a slight tendency for prediction to be better in females than in males.ConclusionsA model separating biology, physics, and chemistry into different Rasch scales seems to be more suitable for item bank development than a unidimensional model, even when these scales are highly correlated and enter into a global score. When such a combination scale is used to select the upper quartile of applicants, the proportion of successful completion of the curriculum after two years is expected to rise substantially.

Project description:Objectives: A potential new avenue to address the shortage of country doctors is to change the rules for admission to medical school. We therefore study the link between high-school grade point average and prospective physicians' choice to work in rural areas. To further inform the discussion about rules for admission, we also study the effects of other predictors: a measure of students' attitudes towards risk; whether they waited for their place of study (Wartesemester); whether their parents worked as medical doctors; and whether they have some practical experience in the medical sector. Methods: We conducted two internet surveys in 2012 and 2014. In the first survey, the sample comprised 701 students and in the second, 474 students. In both surveys, we asked students for their regional preferences; in the 2014 survey, we additionally asked students for their first, second, and third preferences among a comprehensive set of specializations, including becoming a general practitioner. In both surveys, we asked students for basic demographic information (age and gender), their parents' occupation, a measure of subjective income expectations, a measure of risk attitudes, and their high-school grade point average (Abiturnote), and First National Boards Examination grade (Physikum). In 2014, we additionally asked for waiting periods (Wartesemester) as well as for prior professional experience in the health-care sector. Results: We find that three factors increase the probability of having a preference for working in a rural area significantly, holding constant all other influences: having a medical doctor among the parents, having worse grades in the high-school grade point average, and being more risk averse. Moreover, we find that those willing to work in the countryside have significantly more experience in the medical sector before admission to medical school. Discussion: Our results suggest that a change in the selection process for medical school may increase the supply of country doctors. Instead of focusing on the high-school grade point average, universities could even more intensely screen for study motivation through interviews or by taking into account students' background, extracurricular activities, or waiting periods.

Project description:Admission to undergraduate medical training in Germany occurs by central and local pathways. Central admission includes two distinct groups: Students with top school-leaving grades (best-SLG group) and students with inferior school-leaving grades who are admitted with a delay of up to seven years (delayed admission group). Students with academic difficulties and early dropouts are present in both groups. Local admission at our university involves the German Test for Medical Studies (TMS) and allows the admission by merit of students with a wide range of school-leaving grades.To examine the justification of a TMS-based strategy to reduce the admission of potentially weak best school-leavers and enhance the admission of potentially able candidates with mediocre school-leaving grades.The prognostic contribution of the school-leaving (SL) GPA and the TMS to academic performance and to continuity in the pre-clinical part of the undergraduate medical program was examined in two study groups: best school leavers (SL grade 1.0, SL-GPA 823-900 points) and mediocre school leavers (SL grades 2.0-2.3, SL-GPA 689-660 points). The outcomes in both groups were compared in relation to their TMS results. The prospective study included four consecutive cohorts.In each study group the TMS predicted the academic performance (β=0.442-0.446) and the continuity of studies (OR=0.890-0.853) better than the SL-GPA (β=0.238-0.047; OR=1.009-0.998). Attrition was most strongly associated with failing to take the TMS (OR=0.230-0.380). Mediocre school leavers with TMS scores ≥125 performed as well as the best school leavers. Mediocre school leavers with TMS scores between 110-124 performed on average less well but within the required standards. Best school leavers with mediocre TMS scores and 30% of the best school leavers who hadn't taken the TMS performed less well than most mediocre school leavers with high TMS scores.The TMS appears to differentiate between potentially successful and less successful students in both GPA categories. Mediocre school leavers (SLG 2.0-2.3) with exceptionally high TMS results reach better pre-clinical examination results than best school leavers (SLG 1.0) with mediocre TMS results. Thus, the present data justify the use of the TMS to facilitate the participation of mediocre school leavers in the competition for admission slots.

Dataset Information

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

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

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