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Multiple Mini Interviews in the UK Jon Dowell - University of Dundee Aileen OBrien - St George's University of London.

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Presentation on theme: "Multiple Mini Interviews in the UK Jon Dowell - University of Dundee Aileen OBrien - St George's University of London."— Presentation transcript:

1 Multiple Mini Interviews in the UK Jon Dowell - University of Dundee Aileen OBrien - St George's University of London

2 Rationale Personal qualities considered important but not very reliably assessed by interview and without much predictive validity. (Goho + Blackman cognitive r 0.06, clinical r 0.17) Introduced for assessing medical school applicants at McMaster University, Canada. (Reiter, Eva et al) Piloted 2002 – 12 x 8 min. Generalisability since +/- 0.7 Predicted OSCE performance ß 0.44 (interview nil) Clerkship ratings ß 0.57 (interview nil) MCC Part 1 (selected components) ß (interview nil or negative) Supporting evidence from Canberra- Harris and Owen 2007 Calgary- Brownell et al 2007 Dundee- Ponnamperuma 2008 / 4 station trial

3 Domains assessed Dundee Interpersonal and communication skills Critical thinking, problem solving Team work Robustness against stress Ethical/moral reasoning Integrity/honesty Preparation and motivation for medical school Georges Empathy Communication Organisation and problem solving Team work Initiative and resilience Insight and integrity Effective learning style Academic ability & intellect ability & intellect (already tested)

4 Dundee Stations 2010 Role play OCD discussion 1:1 Professional Integrity Task Sort it out - cards 1:1 Issues in Medicine Task Puzzle Role play Fitness to Practice 1:1 Medicine as a career 1:1 About you - UCAS Role play Medications Muddle 1:1Moral Dilemmas

5 How it runs

6 Marking Training 30 min general 20 min station specific Optimal criteria for each domain defined Name Label

7 Stations St Georges Standard interview questions Prioritising Scenario/ breaking bad news Presentation Observation Communication/ giving instructions

8 Candidates name……………………………………………… Motivation to do medicine What are you looking forward to about being a doctor? Points for guidance: Personal satisfaction from helping people Satisfaction from achieving something worthwhile Working with a diverse range of people Combining an interest in science with caring for people Variety of career opportunities once qualified Job status and security Good income The opportunity to work abroad Intellectual rigour Lifelong learning and clear professional career structure Camaraderie from clinical teams Research collaboration Please mark out of 5 Poor motivation good motivation Please also assign an overall impression of the candidates suitability to be offered a place at medical school based on their performance at this station (please circle and comment as appropriate). EXCELLENTACCEPTABLECAUSE FOR CONCERN Red card Comments: Georges Marking Scheme

9 Georges results Graduates and non graduates did equally well No correlation with – Gender – Age – 4 year and 5 year course – UKCAT and GAMSAT scores – Reliable (kappa 0.68)

10 Georges Conclusions Successful pilot 2009 Ran this year with 1000 candidates Smooth (two breakdowns!) Graduates and school leavers same cut off score for admission

11 Dundee results 2009n = 452 Cronbachs Alpha = n = 477 Cronbachs Alpha =.69 No correlation in 2009 with – Gender – Age – Overseas candidates – School type – Small age gender interaction

12 2010 MMIs: Gender Females performed significantly better than males. t(475) = 3.19, p = <.01 Effect size: 0.14

13 2010 MMIs: Applicant Group Significant differences between groups. F(4) = 2.50, p <.05 Graduates/Mature perform significantly better than all other groups

14 Domain Reliability Number of Stations Number of Scores Cronbachs alpha Communication Critical Thinking Integrity11- Moral Reasoning Motivation Teamwork23.395

15 Correlations between scales No correlation between UKCAT and MMI scores No correlation between our UCAS form and MMI scores

16 Dundee MMI - Conclusions Good reliability in last two years. o All stations were reliable enough. No negative Item- total correlations; no reason to reject any station. Successfully ran for over 900 candidates with no significant problems (no breakdowns, tears etc!) Putting more weight on MMI may increase female and graduate/mature candidates compared to the Pre-Interview Score

17 MMI/Pre-Interview 40/6060/4080/20 Male Female A-Level Scottish G/M EU1617 OS Selection Difference

18 So what do the punters think?

19 Assessors Survey Dundee 116 /157 assessors (88% of students and 50% of staff) completed online survey to find out how they viewed MMI. 91% thought the process fair. 88% thought stress on applicants moderate or less.

20 Candidates Survey Dundee 324 /433 (75%) of Candidates completed online survey. 94% felt MMI was fair. 90% felt it is a valid way to assess candidates. 71% preferred MMI to traditional interview. Student Counselor (role play) cited as the most enjoyable (153/172).

21 Assessors Survey Georges Equally fair Equally accurate Equally able to pick best candidate Interviews coached MMIs can be boring MMIs good distinguishing tool

22 Candidates survey Georges 5 years- MMI more fair -MMI more accurate -interview more difficult 4 years- MMI more difficult -equally fair and accurate

23 Conclusions and next steps MMIs becoming an interview tool at many schools. Is it justifiable not to use them? How to develop new stations? Collectively? Reliability potentially increased (above 0.8) using Rasch analysis – alters decision for 10% Predictive validity in UK? – could UKCAT help? Questions...

24 Options to improve? ? Rasch Modeling

25 Examiner A B C D E Station Variation in outcomes can be enhanced by using multiple tracks Track

26 Yardstick

27 Effect of using Rasch Reliability based on fair scores % different candidates would be given offers. (+ 10% not) Only the top 169 stable. Could not be 100% confident in process this year, so not applied. (complex black box stuff)

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