Miles Bore

Assessment of personal qualities in relation to admission to medical school

Background  Recently there has been much scrutiny of the medical school admissions process by universities, the General Medical Council and the public. Improved objectivity, fairness and effectiveness of selection procedures are desirable. The ultimate outcome sought is the graduation of competent doctors who reflect the values of and are in tune with the communities they serve.

Personality factors in professional ethical behaviour: Studies of empathy and narcissism

An investigation into personality factors possibly underlying ethical behaviour in medical students and doctors indicated the importance of two primary dimensions, empathy and narcissism. Experimental questionnaires based on these dimensions were constructed and administered to large samples of medical school applicants. Factor analyses suggested the presence of four factors, labelled Narcissism, Aloofness, Empathy and Confidence. These were combined in a 100-item instrument intended for screening purposes. This paper reports on two construct validation studies for the intrument, with New Zealand medical students (n = 237) and Scottish medical school applicants (n = 510), using overlapping batteries of personality scales. The validity coefficients for the samples indicate similar constructs for narcissism (related to disagreeableness, aggressiveness, aloofness from others, sensitivity to rewards, and anxiety), and empathy (related positively to emotional intelligence, extraversion, open-mindedness, compli...

A comprehensive model for the selection of medical students

Background: Medical schools have a need to select their students from an excess of applicants. Selection procedures have evolved piecemeal: Academic thresholds have risen, written tests have been incorporated and interview protocols are developed. Aim: To develop and offer for critical review and, ultimately, present for adoption by medical schools, an evidence-based and defensible model for medical student selection. Methods: We have described here a comprehensive model for selecting medical students which is grounded on the theoretical and empirical selection and assessment literature, and has been shaped by our own research and experience. Results: The model includes the following selection criteria: Informed self-selection, academic achievement, general cognitive ability (GCA) and aspects of personality and interpersonal skills. A psychometrically robust procedure by which cognitive and non-cognitive test scores can be used to make selection decisions is described. Using de-identified data (n = 1000) from actual selection procedures, we demonstrate how the model and the procedure can be used in practice. Conclusion: The model presented is based on a currently best-practice approach and uses measures and methods that maximise the probability of making accurate, fair and defensible selection decisions.

Selection of medical students according to their moral orientation

Introduction  Consideration has been given to the use of tests of moral reasoning in the selection procedure for medical students. We argue that moral orientation, rather than moral reasoning, might be more efficacious in minimising the likelihood of inappropriate ethical behaviour in medicine. A conceptualisation and measure of moral orientation are presented, together with findings from 11 samples of medical school applicants and students.

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.

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.

Not moral “reasoning”: A Libertarian – Communitarian dimension of moral orientation and Schwartz's value types

Most studies of moral reasoning are based on the Kohlberg cognitive developmental model. Using an alternative scoring procedure for the Sociomoral Reflective Objective Measure Short-Form (Basinger & Gibbs, 1987) revealed a dimension unrelated to moral reasoning. This was identified as a Libertarian – Communitarian dimension of moral orientation and the development of a new scale to measure this, involving 6650 applicants to medical schools, is described. The moral orientation scores of 166 medical school applicants and undergraduate psychology students were correlated with the Schwartz Values Survey (SVS). Conceptually coherent significant relationships were observed. Factor analysis indicated that a bipolar value dimension of Freedom of the Individual versus Duty to the Group could be added to Schwartzs two-dimensional values structure. The relationships observed between responses to the moral dilemmas of the Mojac scale and the values and value types of the SVS suggest that the Libertarian – Communitar...

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.

Emotional Intelligence and Personality as Predictors of Psychological Well-Being.

Research studies have reported elevated rates of psychological distress (e.g., depression) in practicing lawyers yet little research has examined predictors of such problems in law students. Specific personality traits have been shown to be predictors of a range of psychological problems. We administered a battery of tests to a cohort of 1st-year law students (n = 150) and measured the Big Five personality traits and emotional intelligence (EI) to examine their relationships to psychological well-being as indicated by coping styles, satisfaction with life, performance-based self-esteem (PBSE), Global Severity Index (GSI) scores from the Brief Symptom Inventory (BSI), depression, and alcohol use. We found that whereas EI was significantly related to three of the five well-being variables, the Big Five personality factor of neuroticism was found to be a stronger predictor of well-being. The findings suggest that EI does not account for additional variance in well-being over personality.