Don Munro

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.

Relationships between Computer Self-Efficacy, Technology, Attitudes and Anxiety: Development of the Computer Technology Use Scale (CTUS)

Two studies are reported which describe the development and evaluation of a new instrument, the Computer Technology Use Scale (CTUS), comprising three domains: computer self-efficacy, attitudes to technology, and technology related anxiety. Study 1 describes the development of the instrument and explores its factor structure. Study 2 used confirmatory factor analysis to evaluate the stability of the factors identified and to examine relationships between computer self-efficacy, attitudes, and anxiety. There were 479 (Study 1) and 352 (Study 2) University—recruited subjects who volunteered for the project. The initial five factor solution of the CTUS scale was confirmed which include the following factors: computer efficacy, technology related anxiety, complexity, positive attitudes, and negative attitudes. Computer efficacy was positively related to positive attitudes and negatively related to other factors. The relationship between the factors is discussed.

Using Personal Quality Assessment for Selection of Social Work Students

Abstract The social work profession has long struggled to find fair and effective ways of selecting students into their education programs. A psychometric test battery, gathered together under the title “Personal Qualities Assessment” (PQA) has been developed at the University of Newcastle to identify a range of qualities in aspiring health professionals. Two of its components were used to determine whether there was a relationship between scores obtained by social work students in these tests and scores achieved in an empathic listening and critical review hurdle assessment prior to the first field placement. The results showed that social work students who were moderately empathic, not narcissistic, and moderately libertarian in their moral orientation performed better on the assessment than students who were less empathic, more narcissistic, or extreme in their moral orientation. These results suggest that measurement of these qualities could be useful in selecting the most suitable individuals for social work programs.

Using personality as a predictor of diet induced weight loss and weight management

BackgroundA major challenge for successful weight management is tailoring weight loss programs to individual needs. The aim of this study was to investigate whether personality traits could be used to match individuals to a compatible weight loss program that would maximize weight loss.MethodTwo different weight loss trials were conducted, both with a weight loss greater than 5% the measure of success. Fifty-four individuals, BMI 30-40 kg/m2, either followed a slow, healthy eating weight loss diet (HEWLD) of 5000-6000 kJ/day for 12 weeks (n = 22), or a fast, very low energy diet (VLED) of 3000 kJ/day for 4 weeks (n = 32). Anthropometric measurements were recorded at baseline, at the end of the weight loss period and, for VLED, at the end of 10 weeks of weight maintenance. Personality traits were measured at baseline using the Tangney Self Control Scale plus 3 of the scales from the Five Factor Model - Neuroticism, Conscientiousness and Extraversion.ResultsThe percentage weight loss was significantly greater in VLED (-7.38%) compared to HEWLD (-4.11%), (p < 0.001). Weight loss in HEWLD was positively correlated with Anxiety, a facet of Neuroticism. Weight loss in VLED was positively correlated with Neuroticism (r = 0.5, p < 0.01), and negatively correlated with Dutifulness and Discipline, facets of Conscientiousness, (p < 0.05 for both). No link was observed between weight loss and the personality trait, Self Control, in either HEWLD or VLED.ConclusionThe personality factor, Neuroticism, was linked to successful weight loss (that is ≥ 5%) with a particular weight loss treatment, suggesting that there is a potential to use measures of personality to identify appropriate weight loss/management strategies for individuals.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000716965

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

Abstract 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 validity of the personal qualities assessment for selection of medical students in Scotland

Background: The Personal Qualities Assessment (PQA) was developed to enhance medical student selection by measuring a range of non-cognitive attributes in the applicants to medical school. Applicants to the five Scottish medical schools were invited to pilot the test in 2001 and 2002. Aims: To evaluate the predictive validity of PQA for selecting medical students. Methods: A longitudinal cohort study was conducted in which PQA scores were compared with senior year medical school performance. Results: Consent to access performance markers was obtained from 626 students (61.6% of 1017 entrants in 2002–2003). Linkable Foundation Year (4th) rankings were available for 411 (66%) students and objective structured clinical examination (OSCE) rankings for 335 (54%) of those consenting. Both samples were representative of the original cohort. No significant correlations were detected between separate elements of the PQA assessment and student performance. However, using the algorithm advocated by Powis et al. those defined as ‘non-extreme’ (<±1.5 SD from the cohort mean scores; SD, standard deviation) character types on the involved-detached and on the libertarian–communitarian moral orientation scales were ranked higher in OSCEs (average of 7.5% or 25 out of 335, p = 0.049). Conclusions: This study was limited by high attrition and basic outcome markers which are insensitive to relevant non-cognitive characteristics. However, it is the largest currently available study of predictive validity for the PQA assessment. There was one finding of significance: that those students who were identified by PQA as ‘not extreme’ on the two personal characteristics scales performed better in an OSCE measure of professionalism. Futures studies are required since psychometric testing for both cognitive and non-cognitive attributes are increasingly used in admission process and these should include more and better measures of professionalism against which to correlate non-cognitive traits.

Observation Indigenising Organisational change: Localisation in Tanzania and Malawi

In a supposedly “globalising” world, we offer a “localisation” counterbalance from Tanzania and Malawi. Our perspective is purposely anchored in the socio‐cultural perceptions of indigenous employees working within organisations in these two African nations. From these Afrocentric perspectives, as reflected in adages and complementary data, need for achievement, need hierarchies, and expatriate acceptability are heavily influenced by local, social norms. The latter may accord priority to social achievement, social identity, and social need. The article ends with a new technique for gauging the influence of these social factors, with applications to improving the degree of fit between organisational change and community context.

Maslow's hierarchy of needs and its relationship with psychological health and materialism

Maslows (1954) theory of a hierarchy of human needs has generated little research, perhaps because of the lack of specific, concrete operationalisation of concepts such as ‘psychological well-being’ and basic need satisfaction. The Need Satisfaction Inventory (NSI: Lester, 1990) was developed to measure basic need satisfaction and 157 undergraduate subjects completed both it and the Beck Depression (BDI) and Anxiety Inventories (BAI), as well as Spielbergers (1986) Anger-Expression questionnaire (AX). The latter three questionnaires represent an operationalisation of Spielberger, Ritterband, Sydeman, Reheiserdc Ungers (1995) notion that emotions act as indicators of psychological well-being. The hypothesis that scores on the NSI would be significantly correlated with the BDI, BAI, and AX was supported. Ss also completed the Richins and Dawson (1992) materialism index, and it was hypothesised that if hoarding material goods does in fact represent compensatory neurotic behaviour, then materialism would also be negatively correlated with the NSI. The hypothesis was confirmed, providing further evidence for Maslows (1970) theory that basic need satisfaction is associated with psychological health. However, in the absence of norms for the NSI, there was no conclusive evidence to suggest that basic needs reside in a consistent, and strict global hierarchy.

Measuring motivational gravity: Likert or scenario scaling?

Despite a growing body of findings that individualistic achievers incur punitive social costs in the workplaces of collectivistic and equalitarian cultures, little attention has so far been paid to measuring such motivational gravity in psychometrically appropriate ways. From egalitarian Australia, reports psychometric data from two organizational surveys, evaluating the 20‐item “Tall Poppy Scale” (TPS), a Likert instrument which measures attitudes towards high achievers in society, and the twin‐item “Motivational Gravity Scenario Scale” (MGSS), which focuses instead on behavioural intentions towards high achievers in one’s own workplace. In Study I, involving 80 employees of a retail chain, scores on the TPS were significantly and positively associated with social desirability effects on the Marlowe‐Crowne Scale, whereas the MGSS remained free of such confounding. In Study II, 47 employees of a major service organization rated the MGSS as significantly more satisfactory than did 49 university undergraduates, who preferred the TPS. Workplace scenarios may be more appropriate than the conventional Likert TPS for describing organizational cultures, but recommends the development of multiple‐item instruments for assessing individual differences in motivational gravity.

Trial use of the Personal Qualities Assessment (PQA) in the entrance examination of a Japanese medical university: similarities to the results in western countries.

Background: The Personal Qualities Assessment (PQA), developed by the University of Newcastle, Australia to assess the aptitude of future medical professionals, has been used in Western countries. Purposes: The objective was to investigate whether the PQA is appropriate for Japanese medical school applicants. Methods: Two of the PQA tests, Libertarian-Dual-Communitarian moral orientations (Mojac) and Narcissism, Aloofness, Confidence, and Empathy (NACE), were translated into Japanese, and administered at the Tokyo Womens Medical University entrance examinations from 2007 to 2009. Results: The distributions of the applicants’ Mojac and NACE scores were close to the normal distribution, and the mean scores did not exhibit a large difference from those in Western countries. The only significant difference was that the mean score of the NACE test was slightly lower than the Western norm. Conclusions: The translated PQA tests may be appropriate for use with Japanese applicants, though further research considering cultural differences is required.