Selection into medicine: the predictive validity of an outcome-based procedure

Sanne Schreurs (Corresponding Author), Kitty B. Cleutjens, Arno M. M. Muijtjens, Jennifer Cleland, Mirjam G. A. Oude Egbrink

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Abstract

BACKGROUND: Medical schools must select students from a large pool of well-qualified applicants. A challenging issue set forward in the broader literature is that of which cognitive and (inter)personal qualities should be measured to predict diverse later performance. To address this gap, we designed a 'backward chaining' approach to selection, based on the competences of a 'good doctor'. Our aim was to examine if this outcome-based selection procedure was predictive of study success in a medical bachelor program.

METHODS: We designed a multi-tool selection procedure, blueprinted to the CanMEDS competency framework. The relationship between performance at selection and later study success across a three-year bachelor program was examined in three cohorts. Study results were compared between selection-positive and selection-negative (i.e. primarily rejected) students.

RESULTS: Selection-positive students outperformed their selection-negative counterparts throughout the entire bachelor program on assessments measuring cognitive (e.g. written exams), (inter)personal and combined outcomes (i.e. OSCEs). Of the 30 outcome variables, selection-positive students scored significantly higher in 11 cases. Fifteen other, non-significant between-group differences were also in favor of the selection-positives. An overall comparison using a sign test indicated a significant difference between both groups (p < 0.001), despite equal pre-university GPAs.

CONCLUSIONS: The use of an outcome-based selection approach seems to address some of the predictive validity limitations of commonly-used selection tools. Selection-positive students significantly outperformed their selection-negative counterparts across a range of cognitive, (inter)personal, and mixed outcomes throughout the entire three-year bachelor in medicine.

Original languageEnglish
Article number214
Number of pages10
JournalBMC Medical Education
Volume18
Issue number1
DOIs
Publication statusPublished - 17 Sep 2018

Keywords

  • selection
  • backward chaining
  • outcome-based
  • predictive validity

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    Schreurs, S., Cleutjens, K. B., Muijtjens, A. M. M., Cleland, J., & Oude Egbrink, M. G. A. (2018). Selection into medicine: the predictive validity of an outcome-based procedure. BMC Medical Education, 18(1), [214]. https://doi.org/10.1186/s12909-018-1316-x