What predicts performance during clinical psychology training?

OBJECTIVES: While the question of who is likely to be selected for clinical psychology training has been studied, evidence on performance during training is scant. This study explored data from seven consecutive intakes of the UK's largest clinical psychology training course, aiming to identify what factors predict better or poorer outcomes. DESIGN: Longitudinal cross-sectional study using prospective and retrospective data. METHOD: Characteristics at application were analysed in relation to a range of in-course assessments for 274 trainee clinical psychologists who had completed or were in the final stage of their training. RESULTS: Trainees were diverse in age, pre-training experience, and academic performance at A-level (advanced level certificate required for university admission), but not in gender or ethnicity. Failure rates across the three performance domains (academic, clinical, research) were very low, suggesting that selection was successful in screening out less suitable candidates. Key predictors of good performance on the course were better A-levels and better degree class. Non-white students performed less well on two outcomes. Type and extent of pre-training clinical experience on outcomes had varied effects on outcome. Research supervisor ratings emerged as global indicators and predicted nearly all outcomes, but may have been biased as they were retrospective. Referee ratings predicted only one of the seven outcomes examined, and interview ratings predicted none of the outcomes. CONCLUSIONS: Predicting who will do well or poorly in clinical psychology training is complex. Interview and referee ratings may well be successful in screening out unsuitable candidates, but appear to be a poor guide to performance on the course. PRACTITIONER POINTS: While referee and selection interview ratings did not predict performance during training, they may be useful in screening out unsuitable candidates at the application stage. High school final academic performance was the best predictor of good performance during clinical psychology training. The findings are derived from seven cohorts of one training course, the UK's largest; they cannot be assumed to generalize to all training courses;