Eamonn Ferguson

Factors associated with success in medical school: systematic review of the literature.

Selection of medical students in the United Kingdom has come under intense scrutiny in recent years. Some authors have claimed that discrimination occurs in favour of white applicants, female applicants, and applicants from independent schools.1 2 3 4 5,w1,w2High profile cases, such as that of Laura Spence, have led to a public questioning of the selection, training, and validation of doctors. The process of selecting medical students is unsatisfactory from a logistical point of view (approximately 40 000 applications are allowed from 10 000 students for just 5000 places) and leads to chance playing a big part and to apparent unfairness. The criteria medical schools use to select future doctors are similar across the country.4 They include academic ability, insight into medicine (including work experience), extracurricular activities and interests, personality, motivation, and linguistic and communication skills. But what is the evidence base for using these criteria? The Committee of Deans and Heads of Medical Schools commissioned a systematic review of factors believed to be significant predictors of success in medicine. We report the results of that systematic review, which was carried out from June to August 2000. The review examines data on the predictive validity of the eight criteria that have been studied in relation to the selection of medical students: cognitive factors (previous academic ability), non-cognitive factors (personality, learning styles, interviews, references, personal statements), and demographic factors (sex, ethnicity). Previous academic ability, personal statements, references, and interviews are all traditionally used in selection, but how good are they at predicting future performance? Personality and learning styles are not traditionally used, but should they be? #### Summary points Previous academic performance is a good, but not perfect, predictor of achievement in medical training It accounts for 23% of the variance in performance in undergraduate medical training and 6% of …

Effects of daily hassles and eating style on eating behavior.

OBJECTIVE This study investigated the daily hassles-eating behavior relationship and its moderators in a naturalistic setting. DESIGN A multilevel diary design was used to examine day-to-day within-person effects of daily hassles on eating behavior (N = 422), together with the individual and simultaneous influence of potential moderating variables. MAIN OUTCOME MEASURES Daily diary reports of between-meal snacking, fruit and vegetable consumption and perceived variations in daily food intake. RESULTS The results showed daily hassles were associated with increased consumption of high fat/sugar snacks and with a reduction in main meals and vegetable consumption. Ego-threatening, interpersonal and work-related hassles were associated with increased snacking, whereas, physical stressors were associated with decreased snacking. The overall hassles-snacking relationship was significantly stronger and more positive at high compared to low levels of restraint, emotional eating, disinhibition, external eating and in females and obese participants. Simultaneous consideration of these moderators indicated that emotional eating was the pre-eminent moderator of the hassles-snacking relationship. CONCLUSION Daily hassles were associated with an increase in unhealthy eating behavior. These changes may indicate an important indirect pathway through which stress influences health risk.

The Appraisal of Life Events (ALE) scale: Reliability and validity.

Objectives. Monroe & Kelley (1995) have called for the urgent development of theoretically and psychometrically robust measures of primary appraisal. This paper highlights problems with existing measures and provides detail on the psychometric development of the Appraisal of Life Events (ALE) scale. Design. Five studies are reported. The first two studies examine the factor structure of the ALE scale and confounding with social desirability (Ns=260 and 344). Studies 3 and 4 examine the test-retest reliability of the ALE scale (Ns=17 and 77). Finally, Study 5 examines the relationship between the ALE scale and the other parameters of the stress process (personality, coping and health) across two separate stressful transactions (N=268). Methods. A questionnaire methodology was used. The data were analysed using a mixture of exploratory factor analysis, confirmatory factor analysis and bivariate correlations. Results. The ALE scale demonstrated: (a) three stable factors (threat, challenge and loss), (b) no confounding with social desirability, (c) excellent internal and test-retest reliabilities, and (d) theoretically appropriate associations with various stressors, coping behaviours, personality and health measures. Conclusions. This paper has answered Monroe & Kelleys (1995) call for the urgent development of theoretically and psychometrically robust measures of primary appraisal.

Intellectual aptitude tests and A levels for selecting UK school leaver entrants for medical school

An extension of A level grades is the most promising alternative to intellectual aptitude tests for selecting students for medical school

A Taxometric Analysis of Type-D Personality

Objective: To test the dimensionality of Type-D personality, using taxometric procedures, to assess if Type-D personality is taxonic or dimensional. Type-D personality is treated as a categorical variable and caseness has been shown to be a risk factor for poor prognosis in coronary heart disease. However, at present, there is no direct evidence to support the assumption that Type D is categorical and able to differentiate true cases from noncases. Methods: In total, 1012 healthy young adults from across the United Kingdom and Ireland completed the DS14, the standard index of Type D, and scores were submitted to two taxometric procedures MAMBAC and MAXCOV. Results: Graphical representations (comparing actual with simulated data) and fit indices indicated that Type D is more accurately represented as a dimensional rather than categorical construct. Conclusion: Type D is better represented as a dimensional construct. Implications for theory development and clinical practice with respect to Type D are examined as well as the wider use of taxometrics within psychosomatic medicine (e.g., to investigate if there are medically unexplained syndrome taxons, such as a Gulf War Syndrome taxon). NA = negative affectivity; SI = social inhibition; MAMBAC = mean above minus below a cut; MAXCOV = maximum covariance; MAXEIG = maximum Eigenvalue; L-MODE = L-mode factor analysis; CCFI = curve comparison fit index.

A taxometric analysis of health anxiety.

BACKGROUND A long-standing issue in the health anxiety literature is the extent to which health anxiety is a dimensional or a categorical construct. This study explores this question directly using taxometric procedures. METHOD Seven hundred and eleven working adults completed an index of health anxiety [the Whiteley Index (WI)] and indicated their current health status. Data from those who were currently healthy (n=501) and receiving no medical treatment were examined using three taxometric procedures: mean above minus below a cut (MAMBAC), maximum eigenvalue (MAXEIGEN) and L-mode factor analysis (L-MODE). RESULTS Graphical representations (comparing actual to simulated data) and fit indices indicate that health anxiety is more accurately represented as a dimensional rather than a categorical construct. CONCLUSIONS Health anxiety is better represented as a dimensional construct. Implications for theory development and clinical practice are examined.

Individual strategies for coping with stress at work: A review

Abstract This paper discusses some of the conceptual and methodological issues involved in the study of coping. It focuses on individual coping with work and work-related problems, and adopts a transactional framework for the definition of the key concepts of stress, appraisal and coping. It identifies and reviews 17 recent papers which are representative of the coping literature, as defined by the scope of the paper. What it draws out of this review largely concerns issues of measurement, and four particular issues are flagged as important for future research. It concludes that there is a need for more and more adequate studies, particularly in relation to the classification and modelling of coping, and that the adequacy of those future studies should be partly judged in terms of how well they deal with the issues raised here.

Improving blood donor recruitment and retention: integrating theoretical advances from social and behavioral science research agendas

BACKGROUND: Increasing blood donor recruitment and retention is of key importance to transfusion services. Research within the social and behavioral science traditions has adopted separate but complementary approaches to addressing these issues. This article aims to review both of these types of literature, examine theoretical developments, identify commonalities, and offer a means to integrate these within a single intervention approach.

Predictive validity of personal statements and the role of the five‐factor model of personality in relation to medical training

This paper explores the role of personality, and the predictive validities of personal statements (PSs) and previous academic performance in relation to future performance in medical training. One hundred and seventy-six medical students had their application PSs coded into information categories and were followed over a 1-year period and assessed on (1) 21 different assessments (observations, exams, essays, etc.) and (2) the dimensions of the five-factor model (FFM) of personality. Neither the PS information categories nor the amount of information in PSs were found to be predictive of future performance. However, both previous academic performance (Betas .41 and .45) and conscientiousness (Betas .58 and .49), from the FFM, were related to success in medical training. Conscientiousness also demonstrated incremental validity over previous academic performance. Implications concerning the role of personality in medical selection are discussed in terms of trait complexes and trait facets.

Measurement of the subjective work environment

Abstract This paper considers the various issues that frame the development and use of measures of the subjective work environment. It begins by questioning the role of the work environment in determining occupational health, and explores the possible mechanisms by which that environment might exert its influence. It concludes that one of the important final common pathways is psycho-physiological in nature, and is rooted in individual perception and cognition and the experience of stress. Important for this model are the concepts of mediation and moderation. The measurement of the subjective work environment has often been idiosyncratic to the study in hand, and there are few well-established measures in common use. It is argued that researchers should be careful when deciding not to use established measures and effectively ‘invent’ their own. In developing new measures, decisions have to be made concerning the nature of the measure along with its ‘granularity’ and complexity. It is also argued that it i...