[Selection of medical students : Measurement of cognitive abilities and psychosocial competencies]

Predicting undergraduate OSCE performance using traditional and construct-driven situational judgment tests at admission

Situational Judgement Tests (SJTs) are popular to screen for social skills during undergraduate medical admission as they have been shown to predict relevant study outcomes. Two different types of SJTs can be distinguished: Traditional SJTs, which measure general effective behavior, and construct-driven SJTs which are designed to measure specific constructs. To date, there has been no comparison of the predictive validity of these two types of SJTs in medical admission. With the present research, we examine whether the HAM-SJT, a traditional SJT, and the CD-SJT, a construct-driven SJT with an agentic and a communal scale, administered during undergraduate medical admission can predict OSCE (i.e., objective structured clinical examination) performance in a low-stakes (nLS = 159) and a high-stakes (nHS = 160) sample of medical students. Results showed a moderate positive relation between the communal scale of the CD-SJT and performance in OSCE stations with trained patients in the high-stakes sample (r =.20, p =.009). This SJT had also an incremental value in predicting the OSCE performance above and beyond GPA (i.e., grade point average), a science test (i.e., HAM-Nat), and gender (ß = 0.18, 95% CI [0.03; 0.33], p =.020). That is, individuals who chose more communal behavioral responses in the SJT were rated more favorably in interactions with trained patients in the OSCE. A comparable correlation coefficient was observed for the HAM-SJT when controlling for range restriction due to admission (rraw = 0.14 vs. rcontrolled = 0.20). Our research provides a first indication for the predictive validity of construct-driven SJTs in high-stakes undergraduate medical admission.

Examining interviewer bias in medical school admissions: The interplay between applicant and interviewer gender and its effects on interview outcomes

Selection interviews have long been integral to medical school admissions, yet their limited predictive validity and susceptibility to bias raise concerns. This study delves into potential interviewer bias within the dynamics of interviewee and interviewer gender. We analyze a dataset of 5,200 applicants and over 370 selection committees engaged in semi-structured interviews from 2006 to 2019 at a large German medical school with multiple linear and non-linear regression analyses. Our findings reveal that all-female committees tended to award male candidates, on average, one point more than their female counterparts, significantly enhancing the chances of submission for male applicants despite lower academic grades, which constituted 51% of the selection process points. All-male and mixed-gender committees exhibited similar ratings for both genders. The role of valuing voluntary services emerged prominently: all-male and mixed committees acknowledged women's volunteer work but not men's, while all-female committees demonstrated the opposite pattern. Our results attribute variations in interview outcomes to the absence of standardization, such as insufficient interviewer training, divergent rating strategies, variations in interviewer experience, and imbalances in candidate allocation to selection committees, rather than to a "gender bias", for example by favoritism of males because of their gender.

Measuring personal characteristics in applicants to German medical schools: Piloting an online Situational Judgement Test with an open-ended response format

Objectives

Situational Judgement Tests (SJT) are a cost-efficient method for the assessment of personal characteristics (e.g., empathy, professionalism, ethical thinking) in medical school admission. Recently, complex open-ended response format SJTs have become more feasible to conduct. However, research on their applicability to a German context is missing. This pilot study tests the acceptability, reliability, subgroup differences, and validity of an online SJT with open-ended response format developed in Canada ("Casper").

Methods

German medical school applicants and students from Hamburg were invited to take Casper in 2020 and 2021. The test consisted of 12 video- and text-based scenarios, each followed by three open-ended questions. Participants subsequently evaluated their test experience in an online survey. Data on sociodemographic characteristics, other admission criteria (Abitur, TMS, HAM-Nat, HAM-SJT) and study success (OSCE) was available in a central research database (stav).

Results

The full sample consisted of 582 participants. Test-takers' global perception of Casper was positive. Internal consistency was satisfactory in both years (α=0.73; 0.82) while interrater agreement was moderate (ICC(1,2)=0.54). Participants who were female (d=0.37) or did not have a migration background (d=0.40) received higher scores. Casper scores correlated with HAM-SJT (r=.18) but not with OSCE communication stations performance. The test was also related to Abitur grades (r=-.15), the TMS (r=.18), and HAM-Nat logical reasoning scores (r=.23).

Conclusion

This study provides positive evidence for the acceptability, internal consistency, and convergent validity of Casper. The selection and training of raters as well as the scenario content require further observation and adjustments to a German context to improve interrater reliability and predictive validity.

The effects of language proficiency and awareness of time limit in animated vs. text-based situational judgment tests

BACKGROUND

Situational Judgment Tests (SJTs) are commonly used in medical school admissions. However, it has been consistently found that native speakers tend to score higher on SJTs than non-native speakers, which can be particularly problematic in the admission context due to the potential risk of limited fairness. Besides type of SJT, awareness of time limit may play a role in subgroup differences in the context of cognitive load theory. This study examined the influence of SJT type and awareness of time limit against the background of language proficiency in a quasi high-stakes setting.

METHODS

Participants (N = 875), applicants and students in healthcare-related study programs, completed an online study that involved two SJTs: one with a text-based stimulus and response format (HAM-SJT) and another with a video-animated stimulus and media-supported response format (Social Shapes Test, SST). They were randomly assigned to a test condition in which they were either informed about a time limit or not. In a multilevel model analysis, we examined the main effects and interactions of the predictors (test type, language proficiency and awareness of time limit) on test performance (overall, response percentage).

RESULTS

There were significant main effects on overall test performance for language proficiency in favor of native speakers and for awareness of time limit in favor of being aware of the time limit. Furthermore, an interaction between language proficiency and test type was found, indicating that subgroup differences are smaller for the animated SJT than for the text-based SJT. No interaction effects on overall test performance were found that included awareness of time limit.

CONCLUSION

A SJT with video-animated stimuli and a media-supported response format can reduce subgroup differences in overall test performance between native and non-native speakers in a quasi high-stakes setting. Awareness of time limit is equally important for high and low performance, regardless of language proficiency or test type.

[Integration of natural sciences and basic medical subjects in the integrated dentistry program (iMED DENT) at the University of Hamburg]

In October 2019, an integrated dentistry program (iMED DENT) was implemented at the University of Hamburg and was the first of its kind in Germany. This model curriculum builds on didactic concepts that have been applied successfully for many years in curricula for human medicine, including interdisciplinary teaching, early clinical experience, and scientific education. The first year focuses on the healthy situation ("normal function") and aims to integrate the natural sciences (biology, chemistry, physics) and the basic medical subjects (anatomy, biochemistry, physiology, medical terminology) in the context of dental health. Further, basic practical and clinical tasks are assigned to the students during the first year.From the experience of the first four cohorts, initial conclusions can be drawn about this stage of study. Generally, its modular structure results in a condensation of learning content, which students judge as demanding. However, its interdisciplinary approach is well accepted. For instance, presenting the basics of the natural sciences in the context of their dental relevance is much better evaluated in the new compared to the previous curriculum, in which this content was taught without specific references to dental health. Teaching the basics of medicine within clinical context and the inclusion of early clinical practice are similarly appreciated. Presently, the interdisciplinary approach is limited by the focus on practical competencies of the dentistry curriculum, as some practical courses offer only few opportunities for other disciplines to interconnect their teaching. The continuous evaluation of the curriculum and exchange of experiences between the disciplines will further improve the integrative concept of the curriculum.

Effects of the alternative medical curriculum at the Hannover Medical School on length of study and academic success

Objective

The model curriculum HannibaL (Hannoversche integrierter berufsorientierter und adaptiver Lehrplan) differs significantly from other medical study programs in Germany in terms of its structure with which, among other factors, the Hannover Medical School (MHH) saw an opportunity to positively influence the length of study. We investigate how the length of medical study is influenced by the curriculum's structure and whether this has any impact on academic success.

Methods

We use data from over 2,500 students who studied medicine at MHH between 2011 and 2021. We measure study time as the number of years which pass until completion of the respective study phases and academic success as the grades achieved on final exams.

Results

Since they more often fail or postpone exams, students admitted based on special quotas (VQ) or a waiting list (WQ) need significantly more time to complete the first study phase (M1) compared to students who were admitted based on a selection process (AdH) or who belong to the "best school graduates" quota (AQ) because they earned the highest scores on the final secondary school exam. Yet, students from all admission groups reach the written state exam (M2) almost simultaneously. In HannibaL, WQ and VQ manage to catch up on delays from M1 with no negative impact on success in M2. In general, however, VQ and WQ achieve lower grades and drop out more often than students from AQ and AdH.

Discussion

In the regular curriculum, students can only proceed with their studies once M1 has been entirely completed. HannibaL, on the other hand, allows for the catching up of delays from the first two years of study by integrating both study phases. The curricular structure thus accommodates students with lower academic performance who accumulate delays early on in their studies. By contrast, delays in the AQ and AdH groups arise during the second phase of study (M2).

[Multimodal selection of medical students: The predictive power of individual process components in the two-stage selection process at Witten/Herdecke University (UW/H)]

OBJECTIVE

According to the legislator's ideas, the selection of medical students in Germany should no longer be based on the Abitur grade alone. This approach has already been implemented in the two-stage selection process at Witten/Herdecke University (UW/H) using several criteria. On the one hand, the present study aims to determine the prognostic value of the procedural components for the overall performance on the selection day. On the other hand, the different strategies of the applicants in processing the written task (phase 1) will be examined with regard to their application success.

METHODOLOGY

Data on applications for the summer semester 2020 (N = 819 phase 1; N = 233 phase 2) were available retrospectively. A stepwise regression analysis was conducted to determine the predictive power of each procedural component. Using a summary content analysis, the four essays from the applicants' motivation letters were structured and categories were identified, and an extreme group comparison (Group 1: Not invited; Group 2: University acceptance; N = 60 essays) was conducted.

RESULTS

As the stepwise regression analysis shows, the individual biographical interview emerged as the strongest predictor in terms of overall performance, followed by lecture, group interview, and multiple mini interviews. Content analysis extracted content and scaling categories for the individual essays, as well as an additional meta-category (Impression Management, IM). Successful applicants demonstrated, among other things, better judgment skills, more sophisticated reasoning skills, and an internalized role model as a physician. In addition, they used defensive IM strategies, e.g., subjectification and self-deprecation, more frequently.

CONCLUSION

Biographical interview is considered the strongest predictor of overall performance. The dimensions of impression management, reasoning quality and judgment proved to be reliable predictors of successful performance in the selection process. In addition, role image as a physician and professional commitment had a favorable effect on the selection decision.

Can Different Admissions to Medical School Predict Performance of Non-Technical Skill Performance in Simulated Clinical Settings?

Non-technical skills (NTS) in medical care are essential to ensure patient safety. Focussing on applicants' NTS during medical school admission could be a promising approach to ensure that future physicians master NTS at a high level. Next to pre-university educational attainment, many selection tests have been developed worldwide to facilitate and standardise the selection process of medical students. The predictive validity of these tests regarding NTS performance in clinical settings has not been investigated (yet). Therefore, we explored the predictive validities and prognosis of the Hamburg MMI (HAM-Int), HAM-Nat, PEA, and waiting as well as other quota (as example) designated by the Federal Armed Forces) for NTS performance in clinical emergency medicine training of medical students. During 2017 and 2020, N = 729 second, third, and fourth year students were enrolled within the study. The mean age of participants was 26.68 years (SD 3.96) and 49% were female students. NTS of these students were assessed during simulation scenarios of emergency training with a validated rating tool. Students admitted via waiting quota and designated by the Armed Forces performed significantly better than students admitted by excellent PEA (p = 0.026). Non-EU students performed significantly inferior (p = 0.003). Our findings provide further insight to explain how and if admission to medical school could predict NTS performance of further physicians.

Can selection interviews predict OSCE performance? Evidence from Hannover Medical School

OBJECTIVES

We analyze whether the student selection process at Hannover Medical School (MHH), which combined a semi-structured interview with school leaving grades, can predict performances in an Objective Structured Clinical Examination (OSCE). We also check whether there are differences between assessments of clinical knowledge, practical skills, and communication abilities.

METHODS

We use data from 525 medical students who were admitted after a successful selection process and who completed the OSCE in the years 2015-2019. We employ multivariate regressions and a mediation analysis approach to learn whether study success after admission and prior to the OSCE mediates the outcome of the latter.

RESULTS

A better performance in the MHH's selection interview is unrelated to success in the OSCE. However, there is a small but significant influence of school grades on OSCE results in each part except for the assessment of communication skills. The impact of the school grade is partially mediated by performances in written and oral exams preceding the OSCE.

DISCUSSION

School grades matter for the OSCE outcome, albeit to different degrees for more learning-based vs. practical parts of the examination. The interview at MHH was purely informative and unrelated to study success, also in the assessment of communication skills. Better structured interview tools may yield better results.

CONCLUSION

Students' cognitive abilities predict study success in an undergraduate OSCE. Performances in a semi-structured selection interview have no impact, not even the assessment of communication skills.

What factors motivate male and female Generation Z students to become engaged as peer teachers? A mixed-method study among medical and dental students in the gross anatomy course

Peer-teaching is widely established in anatomy teaching and offers well-described advantages. Nevertheless, at Ulm University, Germany, a reduction in the number of peer teacher applicants for the dissection course was observed. This study examined factors related to the attractiveness of a position as a peer teacher for Generation Z students. Participants of the gross anatomy course were asked to evaluate factors influencing the attractiveness of a peer teacher position using a six-point Likert scale. Additionally, open-ended questions were analyzed qualitatively. Sex-specific subgroup analysis was performed comparing students of low and high motivation to apply for a tutorship. Of the 374 students who participated in this study (response rate 53%), 38% stated that they were intending to apply as peer teachers. Data indicated that students displayed intrinsic motivation to apply for a tutorship because of the opportunity to improve their anatomy knowledge and/or their pleasure in teaching. In contrast, extrinsic factors like remuneration of the tutorship and its relevance for their curriculum vitae were least important. Anatomy educators underestimated the demotivating factor of the workload associated with the tutorship and encouraged students less frequently to apply than peer teachers. Only minor sex-specific differences could be identified. Nevertheless, female students were encouraged less frequently to apply than their male peers. In summary, Generation Z students apply as peer teachers because they are enthusiastic about the task. To motivate students to commit to extracurricular activities like a tutorship, anatomy educators should actively encourage students-particularly females-more frequently to apply.

A video-based situational judgement test of medical students' communication competence in patient encounters: Development and first evaluation

OBJECTIVE

We developed and evaluated the Video-Based Assessment of Medical Communication Competence (VA-MeCo), a construct-driven situational judgement test measuring medical students' communication competence in patient encounters.

METHODS

In the construction phase, we conducted two expert studies (n_panel1 = 6, n_panel2 = 13) to ensure curricular and content validity and sufficient expert agreement on the answer key. In the evaluation phase, we conducted a cognitive pre-test (n = 12) and a pilot study (n = 117) with medical students to evaluate test usability and acceptance, item statistics and test reliability depending on the applied scoring method (raw consensus vs. pairwise comparison scoring).

RESULTS

The results of the expert interviews indicated good curricular and content validity. Expert agreement on the answer key was high (ICCs> .86). The pilot study showed favourable usability and acceptance by students. Irrespective of the scoring method, reliability for the complete test (Cronbach's α >.93) and its subscales (α >.83) was high.

CONCLUSION

There is promising evidence that medical communication competence can be validly and reliably measured using a construct-driven and video-based situational judgement test.

PRACTICE IMPLICATIONS

Video-based SJTs allow efficient online assessment of medical communication competence and are well accepted by students and educators.

Assessing distinguishable social skills in medical admission: does construct-driven development solve validity issues of situational judgment tests?

BACKGROUND

Social skills are important for future physicians and are therefore increasingly considered in selection processes. One economic assessment method from which different social skills can be inferred are Situational Judgment Tests (SJTs) in which applicants are asked to rate behavioral responses in context-relevant situations. However, traditional SJTs have so far failed to distinctively measure specified constructs. To address this shortcoming in the medical admission context, we applied a construct-driven approach of SJT development in which test development was deductively guided by agency and communion as target constructs.

METHOD

The final version of the construct-driven SJT includes 15 items per construct with three behavioral responses. Medical school applicants (N = 1527) completed the construct-driven SJT, a traditional SJT, and an aptitude test under high-stakes condition as part of their application. A subsample (N = 575) participated in a subsequent voluntary online study with self-report measures of personality and past behavior.

RESULTS

The proposed two-factor structure and internal consistency of the construct-driven SJT was confirmed. Communal SJT scores were positively associated with self-reported communal personality and communal behavior, yet effects were smaller than expected. Findings for agentic SJT scores were mixed with positive small associations to self-reported agentic personality scores and agentic behavior but unexpected negative relations to communal self-reported measures.

CONCLUSIONS

Results suggest that construct-driven SJTs might overcome validity limitations of traditional SJTs, although their implementation is challenging. Despite first indicators of validity, future research needs to address practical points of application in high-stakes settings, inclusion of other constructs, and especially prediction of actual behavior before the application of construct-driven SJTs for selection purposes in medical admission can be recommended.

Does medical school cause depression or do medical students already begin their studies depressed? A longitudinal study over the first semester about depression and influencing factors

OBJECTIVE

In the past, medical students have been found to be at increased risk for depressive symptoms compared to the general population. This study addresses the question, whether medical students already show these elevated depression scores at the beginning of medical school or whether it is the studies of medicine that leads to symptoms of depression.

METHODS

In the winter semester 2018/2019, 148 medical students at a middle-sized German university answered a questionnaire during the first (T0) and last week (T1) of their first semester that examined various risk and resilience factors for initial depressive symptoms and their course. The severity of symptoms was assessed with the Beck´s Depression Inventory II (BDI-II). A subscale of the NEO-FFI was used to investigate the personality factor neuroticism.

RESULTS

Over the study period, the percentage of students suffering from at least mild depressive symptoms increased from 16.3% in the first week of their studies (T0) to 21.4% at the end of the first semester (T1). The use of drugs or medication, loneliness, mental overload, performance pressure and financial burden show the strongest influence on the development of depressive symptoms. Concerning surveyed resilience factors, in particular emotional support, physical workout and sufficient time for social contact appear to be protective. The more risk factors are concentrated on an individual, the higher its increase of depressive symptoms. The opposite is prevailing for the investigated resilience factors. Except for the use of drugs or medication, no other criterion than the BDI-II value at T0 was able to predict the BDI-II score at T1. This underlines that especially the interplay of factors is decisive.

CONCLUSION

The findings of this study could indicate a worsening tendency of the BDI-II score in the further course of medical school. Ultimately, we emphasize the importance of offering preventive measures to medical students as early as possible.

Association of professional pre-qualifications, study success in medical school and the eligibility for becoming a physician: A scoping review

BACKGROUND

Literature, individual experiences and common considerations suggest that prior professional qualification can be an advantage for later career development. For instance, in Germany, professional pre-qualification has been honored by medical faculties in selection procedures for several years. However, a systematic evaluation of this relationship lacks. This scoping review summarizes existing literature and addresses the role of prior professional pre-qualifications on objective or subjective study success and the choice of a specialization.

METHODS

The scoping review was performed oriented on the PRISMA guidelines. PsycINFO and PubMed databases were searched for relevant studies that included data of medical students with and without professional pre-qualifications. To answer the underlying research questions, this scoping review also includes studies that examine professional pre-qualifications in association with non-cognitive "soft" criteria.

RESULTS AND FURTHER DIRECTIONS

1055 items were identified and reviewed by two independent reviewers with final 11 studies were included for this scoping review. The results of identified studies that report possible effects of prior pre-professional qualifications are inconclusive but suggest that prior professional qualifications tend not to have rather an advantage on study success. Medical school success for students with prior professional qualifications tended to be below average in the preclinical setting, and there were no differences in the clinical setting compared with students without prior professional qualifications. The influence of professional pre-qualifications has not yet been adequately studied without the moderator variable "waiting time" and "A-levels grade". The scoping review indicates insufficient number of articles stating a co-relation of prior pre-qualifications and subjective data. Again, the results found are not sufficient to state a clear relationship between professional pre-qualifications and the choice of a specific speciality preference. However, professional pre-qualifications, both in medicine and as "practical experience in rural areas", tend to be beneficial for the choice of becoming a rural physician. Large-scale cross-sectional and longitudinal studies are needed to investigate the influence of professional pre-qualifications on different study trajectory parameters.

Selection procedure human medicine and psychology at the University of Witten/Herdecke: adaptation to the virtual zoom room

Introduction: For the selection of students for the winter semester 2020/21, the established selection procedure of the University of Witten/Herdecke (UW/H) was adapted to the virtual space in view of the current contact ban and recommended keeping of distance. The three stations in the second step of the procedure, the biographical one-on-one interview, presentation and discussion on a subject-specific topic as well as multiple mini interviews (MMI) on the social skills of the applicants were audiovisual and in real time in zoom meetings. Project description: The medical, psychological and student reviewers were prepared for the virtual selection procedure in training sessions. Three weeks before the selection days, the applicants received information on the technical requirements for the interviews and on data protection for the persons affected by the collection of personal data. The evaluation of the virtual selection procedure was carried out by the reviewers using an online questionnaire with 8 socio-demographic, 5 organizational, 8 content and 3 open questions. Results: The 108 reviewers conducted selection interviews in tandems (medical/psychological and student reviewers) with 178 applicants for human medicine and 105 applicants for psychology. The online evaluation by 58 reviewers (response rate 53.7%) showed a positive agreement with the virtual selection procedure, with a more favorable assessment of organization and content by the medical and psychological reviewers compared to the student reviewers. Discussion: The adequate adaptation of the selection procedure of the UW/H to the virtual zoom room as well as its acceptance are confirmed by the successful execution of the selection days for the students for the winter semester 2020/21 and the evaluation of the reviewers. Conclusion: The results and analysis of this exceptional situation will be used to also conduct the upcoming selection procedure for the summer semester 2021 in the virtual space. A valid assessment for the future use of a virtual selection procedure as a possible supplement to the personal selection interviews at the University of Witten/Herdecke remains to be made.

[Personality traits in anesthesiology : Results from a questionnaire-based requirements analysis]

BACKGROUND

Criteria for the identification of suitable applicants for undergraduate and postgraduate medical education are greatly and ubiquitously discussed. Apart from the acquisition of theoretical knowledge and practical skills, certain personality traits are necessary for practicing the medical profession; however, little is known on the personality traits required for medical subspecialties. This study had two objectives: 1) identification and evaluation of personality traits which are essential for performing anesthesiology and 2) establishment of a job specification for anesthesiology.

METHODS

We performed a survey among German anesthesiologists using an online questionnaire. This questionnaire collected demographic data, such as age, gender, level of postgraduate education and 28 personality traits from 5 categories: cognition, psychomotor, physical, sensory and social interactive properties. The participants were asked to rate the personality traits on a 5-point Likert scale. Statistical analysis was performed using an ANOVA.

RESULTS

A total of 714 questionnaires were analyzed. Social interactive skills and cognitive personality traits were considered as most important for a clinical career in anesthesiology. The three personality traits rated highest were a high decision-making ability, stress tolerance and speed of perception. Furthermore, a high apprehension, affability and patient-oriented behavior are needed.

CONCLUSION

A job specification describing important personality traits can be useful to advise both undergraduates and postgraduates on their medical career and for medical team simulation tasks. For the clinical practice in anesthesiology, for example, high social interactive and cognitive personality traits are required.

Assessing competencies of healthcare professionals caring for parents with cancer: The development of an innovative assessment tool

OBJECTIVE

This paper describes the development of an assessment tool capturing competencies of healthcare professionals (HCPs) in caring for cancer patients with minor children.

METHODS

We combined the methods of clinical case vignettes and situational judgement tests (SJTs). Scenarios were created based on literature and interviews with patients, HCPs, and experts. We pretested the instrument by conducting cognitive interviews with n = 6 HCPs, who gave feedback on realism, clarity, and difficulty of the scenarios.

RESULTS

The developed assessment tool measures the following competencies: HCPs' (1) application of knowledge, (2) behavioural responses to clinical scenarios, (3) attitudes regarding the relevance of integrating the parental role in cancer care, and (4) empathic behaviour towards affected parents. Results of the cognitive interviews indicate that the scenarios are perceived as realistic and clear.

CONCLUSIONS

We provide an innovative approach by methodologically combining clinical case vignettes and SJTs. Next, the assessment tool will be applied in the context of a pilot evaluation of a newly developed training for HCPs that aims at enhancing their competencies in caring for cancer patients with minor children.

Exam performance of different admission quotas in the first part of the state examination in medicine: a cross-sectional study

BACKGROUND

Most medical students in Germany are admitted via selection procedures, which are adjusted to the demands of the universities. At Lübeck medical school, scores from interviews that measure non-academic skills and pre-university GPAs are summed to arrive at an admission decision. This article seeks to illuminate the effectiveness of this selection procedure in comparison to other non-selected student groups.

METHODS

Quota information and exam results from the first federal exam were linked for students admitted to Lübeck medical school between 2012 and 2015 (N = 655). Five different student groups (university-specific selection quota, pre-university GPA quota, waiting time quota, ex-ante quota and foreign students) were compared regarding exam attempts, written and oral grades, temporal continuity and examination success in the standard study period.

RESULTS

While the pre-university GPA quota outperformed all other quotas regarding written and oral grades, it did not differ from the selection quota regarding exam attempts, temporal continuity and examination success in the standard study period. Students in the waiting time and ex-ante quotas performed inferior by comparison. The results of foreign students were the most problematic.

CONCLUSION

Students selected by the university show high temporal continuity and examination success. These results, and possible advantages in physician eligibility, argue for the utilisation of non-academic skills for admission.

The Hamburg integrated medical degree program iMED

The integrated medical degree program (iMED) was established in winter semester 2012/2013 at the Faculty of Medicine of Universität Hamburg with the aim of improving medical education. The main features of the iMED medical degree program include the close integration of theoretical knowledge and practical skills, scientific orientation and the teaching of psychosocial and communication skills. All these features are commonly found in the modular compulsory core curriculum and elective courses ("2nd Tracks"): The compulsory core curriculum comprises 19 modules which are arranged thematically in seven module groups and cover three stages of a "learning spiral". By comprehensively coordinating the teaching content and the learning objectives of the participating theoretical and clinical subjects, theoretical content is taught on the basis of real patient's medical histories from the first stage of the learning spiral. The elective courses enable students to learn and apply scientific work in a structured curriculum according to their own interests. Relevant practical skills for students future professional routines are taught in the longitudinal training course "Clinical Examination Methods plus Communication" (KUMplusKOM), which runs through the entire curriculum up to the final practical year. Accompanying, extra-curricular projects such as crash courses in the natural sciences or using the iMED Textbook as an online learning platform increase the attractiveness of the iMED degree program. Results of the evaluation show that the introduction and the accompanying optimization of iMED were very successful.

Longitudinal development of different dimensions of perfectionism in undergraduate medical students with respect to their medical school admission procedure

Objective: The concept of perfectionism comprises high standards of performance as needed in medicine, but also concerns about making mistakes and dealing with social reactions about not being perfect. Perfectionism is associated with motivation and deep learning strategies but high expression of perfectionism has been found to be associated with symptoms of stress and anxiety in students. We aim to gain insights into the longitudinal development of different dimensions of perfectionism in medical students with respect to their way of medical school admission. Methods: At the Medical Faculty of Hamburg University, 167 undergraduate medical students completed validated questionnaires (MPS-H and MPS-F) of different dimensions of perfectionism and sociodemographic data including medical school admission procedures, personality traits (BSI-10 and GSE), and symptoms of depression and anxiety (PHQ-9 and GAD-7) at the start of their first year and at half term of their second year. Results: On average, after controlling for baseline and age, a significant decrease (p≤0.05) in Self-Oriented Perfectionism was found during the first two years in students who were admitted after a waiting period (M: -12.57; 95% CI: [-21.94 - -3.35]), by other ways of medical school entrance (M: -6.36; 95% CI: [-12.71 - -0.02]), by multiple mini-interviews (HAM-Int) (M: -5.52; 95% CI: [-9.90 - -1.14]), and by a natural science test (HAM-Nat) (M: -3.41; 95% CI: [-6.71 - -0.11]. Waiting period students also showed a significant longitudinal decline in the scale Personal Standards (M: -4.62; 95% CI: [-8.04 - -1.21]. Conclusions: Since medical students from all admission groups except from the high school degree group showed a significant longitudinal decrease in Self-Oriented Perfectionism, high levels of aspects of perfectionism associated with intrinsic motivation or deep learning strategies could be included medical school admission processes. Additionally, particular attention needs to be paid not to induce a loss of intrinsic motivation or deep learning strategies during undergraduate medical education.

Leisten fachspezifische Studierfähigkeitstests im deutschsprachigen Raum eine valide Studienerfolgsprognose?

Zusammenfassung. Fachspezifische Studierfähigkeitstests werden in mehreren zulassungsbeschränkten Studiengängen als Auswahlinstrument eingesetzt. Eine Metaanalyse von Hell, Trapmann und Schuler (2007) ermittelte eine hohe prognostische Validität solcher Tests. Seitdem hat es allerdings umfassende Veränderungen des Bildungssystems (z. B. Bologna-Prozess, Änderungen der Schulsysteme) sowie eine stete Weiterentwicklung der Testverfahren gegeben. Zur Klärung der Frage, ob fachspezifische Studierfähigkeitstests nach wie vor eine gute Erfolgsprognose liefern, schreibt die vorliegende Arbeit die Metaanalyse von Hell et al. (2007) fort. Die prognostische Validität im deutschsprachigen Raum ist stabil geblieben (ρ = .427, K = 54 Stichproben, N = 8410 Personen). Es fanden sich höhere Validitäten bei neueren Studien, Zeitschriftenartikeln mit Peer-Review, universitären Stichproben sowie bei kürzerem Abstand zwischen Test und Studiennotenerfassung. Zudem zeigten sich Fachunterschiede bezüglich der prognostischen Validität beispielsweise zugunsten von Sozialwissenschaften (ρ = .510). Die Studierfähigkeitstests besitzen außerdem eine inkrementelle Validität über die Abiturnote hinaus (Δ R² = .081, k = 31, n = 3999). Die Befunde sprechen dafür, dass die Testverfahren einen hilfreichen Beitrag zur erfolgreichen Studierendenauswahl liefern (als Alternative oder Ergänzung zur Abiturnote).

From HAM-Nat to the "Physikum" - Analysis of the study success parameters before and after the introduction of a science test in the approval procedure

Background/Objectives: For the winter semester 2012/13, the Medical School of Otto-von-Guericke University Magdeburg introduced the HAM-Nat test (Hamburg Assessment Test for Medical Degrees - Natural Sciences Section) for the selection of its study applicants with the aim of improving the academic success of their students in the pre-clinical part which has a heavy emphasis on natural sciences. The study examines the extent to which the new University Selection Procedure (AdH) influences two criteria for measuring students' success, compliance with the standard period of study up until the first part of the medical state exam (M1) and its result. Methodology: A comparison of above-mentioned parameters for measuring student success for the matriculation years 2008-2011 (no HAM-Nat test, Pre-Matriculation) and those of the matriculation years 2012-2014 (Nat-Matriculation), whose students have passed the HAM-Nat test in the selection process of the university. In addition, it was taken into account the number of course certificates gained within the standard time period. In the Nat-Matriculation, the HAM-Nat results were merged with the associated M1 exam results. Results: The proportion of AdH students who were admitted to the Physikum (first part of the medical state exam (M1)) within the standard period of study only increased slightly in the period studied. Within the AdH group, 70% of the Pre-Matriculation group gained entry to the second phase of studies without delay, rising to 78% in the AdH-group of the Nat-Matriculation. For all admission groups taken together, the overall grades for the first section of the medical state exam 2010-2016 show a positive trend, regardless of the selection procedure. The proportion of correctly answered questions in the nationwide M1 increased accordingly in the period studied. The better those matriculating had performed in the HAM-Nat test, the better their results were in the written and oral parts of the first part of the medical state exam. Conclusion: Although a significant proportion of students in the AdH group had obtained their place of study only on the basis of their test result and the score in the HAM-Nat test only weakly correlated with the school leaving grade (Abitur), the quantifiable study success parameters to date - in an albeit short observation period before and after introduction of the test - improved slightly. The number of Nat-Matriculations is too low to be able to assess the effect of the HAM-Nat test bearing in mind natural fluctuations. Nevertheless, the HAM-Nat test as an instrument of selection also made it possible for candidates with originally insufficient Abitur grades to gain admission without negative effects on the study success of the AdH cohort.