New non-cognitive procedures for medical applicant selection: a qualitative analysis in one school

BACKGROUND: Recent data have called into question the reliability and predictive validity of standard admission procedures to medical schools. Eliciting non-cognitive attributes of medical school applicants using qualitative tools and methods has thus become a major challenge. METHODS: 299 applicants aged 18–25 formed the research group. A set of six research tools was developed in addition to the two existing ones. These included: a portfolio task, an intuitive task, a cognitive task, a personal task, an open self-efficacy questionnaire and field-notes. The criteria-based methodology design used constant comparative analysis and grounded theory techniques to produce a personal attributes profile per participant, scored on a 5-point scale holistic rubric. Qualitative validity of data gathering was checked by comparing the profiles elicited from the existing interview against the profiles elicited from the other tools, and by comparing two profiles of each of the applicants who handed in two portfolio tasks. Qualitative validity of data analysis was checked by comparing researcher results with those of an external rater (n =10). Differences between aggregated profile groups were checked by the Npar Wilcoxon Signed Ranks Test and by Spearman Rank Order Correlation Test. All subjects gave written informed consent to their participation. Privacy was protected by using code numbers. RESULTS: A concept map of 12 personal attributes emerged, the core constructs of which were motivation, sociability and cognition. A personal profile was elicited. Inter-rater agreement was 83.3%. Differences between groups by aggregated profiles were found significant (p < .05, p < .01, p < .001). A random sample of sixth year students (n = 12) underwent the same admission procedure as the research group. Rank order was different; and arrogance was a new construct elicited in the sixth year group. CONCLUSIONS: This study suggests a broadening of the methodology for selecting medical school applicants. This methodology differentiates between both individuals and groups, providing a personal attribute profile of applicants, useful for admission procedures. The qualitative procedures are cost-effective, can easily be taught and used by faculty members. The predictive validity of the presented model requires a longitudinal trial.