Selection to medicine: Aptitude testing may negatively predict student performance. An Irish cohort study

Background : Aptitude testing and other traditional tools are used for selection in Ireland. Multiple Mini Interview (MMI) is not routinely used. This study compared currently used selection tools with MMI to determine the best predictors of students’ subsequent examination performance. Summary of Work: EU applicants (EU), n= 64, were selected by an aptitude test, Health Professions Admission Test-Ireland (HPAT-Ireland) and academic record measured by the Adjusted Leaving Certificate Score (ALCS). Non-EU applicants, n=45, were selected by interview, Grade Point Average (GPA) and International English Language Testing System (IELTS). A cohort of 109 First Year students completed a 10 station Multiple Mini Interview. Performance was compared with First Year examination results-comprising knowledge based MCQ tests and an OSCE. Summary of Results: Strong correlations emerged between overall First Year results and ALCS (r=0.49; p<0.001; n=56) and IELTS (r=0.44; p=0.006; n=38). HPATIreland was negatively correlated (r=-0.27; p=0.03; n= 63). MMI predicted EU student performance on a communication/ clinical skills OSCE (r=0.27; p=0.03; n=64). Multiple regression modelling, using variable selection tools, identified previous academic record as the best predictor of overall First Year Examination results for both EU and Non EU students: ALCS (p<0.001); GPA (p<0.001). Conclusions: Academic record and English language proficiency remain strong predictors of performance. It is counter-intuitive and concerning that HPAT-Ireland negatively correlated. MMI appears to have a role in the prediction of communication and clinical skills. Take-home Messages: Further follow up is warranted to establish the predictive patterns of these selection tools as students become more clinically proficient