Theme
9JJ Admission to Medicine and Postgraduate Training Programmes
INSTITUTION
Memorial University of Newfoundland
Memorial University’s medical school is situated on an island in the North Atlantic with distributed learning across the province of Newfoundland and Labrador, and other areas of Canada. The majority of the population in the province live in rural communities, scattered across rugged rocky isolated terrain. The Faculty of Medicine is dedicated to a holistic approach to admissions and has three priority areas: Aboriginal Peoples of Newfoundland and Labrador, students from rural and remote areas, and economically disadvantaged students. Memorial University has historically used a traditional two-person panel interview to assess the personal characteristics of applicants to medical school. Many medical schools have replaced the panel interview with the Multiple Mini Interview, a process consisting of numerous short interview stations, developed by the Michael G DeGroote Faculty of Medicine at McMaster University.1 However concerns have been raised by research that shows that students from rural areas may score lower on the MMIs which is important to Memorial where rural students are a priority area.2
A survey conducted at the Faculty of Medicine at Memorial University with current medical students, medical school applicants, interview committee members, and faculty members showed that the majority of medical students and interviewers felt that changes should be made to the current interview process but, although respondents felt a MMI could increase objectivity and decrease predictability of the interview process, there was opposition to completely adopting the MMI. Based on feedback from this survey it was decided to use a hybrid of the traditional and multiple mini interview.
Research questions:
1. Do students who participate in the medical school interview process at Memorial University perform differently on the MMIs compared to the traditional interview process?
2. Does performance on either of the two interview processes differ based on age, sex, roots (urban or rural), or socioeconomic status?
For the 2013-2014 medical school admissions cycle, Memorial University used a hybrid of both traditional (semi-structured) and MMI (structured) interviews-TaMMI (Traditional and MMI). All 229 interviewed students participated in eight (ten minute) MMI stations with one assessor at each station, and a 30 minute two person panel traditional interview. For each MMI station, students were scored out of ten ranging from one (1) Unsuitable to ten (10) Outstanding (Total score possible 80). The traditional interview was also scored out of 80 total; each interviewer ranked the interviewed applicant out of three for each of ten criteria (for a total of 30) plus an overall impression score out of ten ranging from one (1) Unsuitable to ten (10) Outstanding. After the interviews were completed, all the data was de-identified and linked to postal codes during high school. The postal codes were classified as to socioeconomic status, and to urban or rural region.3
|
|
Characteristic |
Traditional Score |
p-value |
MMI Score |
p-value |
|
Age group <22 23 ~ 26 >27 |
114 (49.78%) 89 (38.86%) 26 (11.35%) |
61.81 + 9.86 62.12 + 10.37 64.00 +12.10 |
0.620 |
50.95 + 8.49 54.26 + 8.26 53.77 + 8.94 |
0.017 |
|
Sex Female Male |
133 (58.08%) 96 (41.92%) |
63.38 + 10.40 60.51 + 9.99 |
0.037 |
52.91 + 8.93 52.06 + 8.06 |
0.462 |
|
Urban/rural Urban Rural |
177 (77.29%) 52 (22.71%) |
61.36 + 10.23 64.96 + 10.17 |
0.027 |
52.09 + 8.50 53.44 + 8.84 |
0.400 |
|
Neighbourhood SES Highest Second highest Middle Second lowest Lowest |
84 (36.68%) 39 (17.03%) 28 (12.23%) 32 (13.97%) 46 (20.09%) |
61.68 + 10.68 63.56 + 9.32 64.11 + 8.58 59.53 +11.59 62.59 + 10.40 |
0.399 |
53.63 + 8.98 52.46 + 7.94 50.64 + 8.09 50.94 + 9.69 52.96 + 7.72 |
0.413 |
Pearson Correlation of Traditional and Multiple Mini Interview
The Pearson correlation between the score on traditional interview and the MMI score was 0.257.
This correlation was significantly not zero (p value<0.0001), but the correlation was not strong.
The mean score on the traditional interview was significantly higher than that of MMI scores (p value<0.0001). The 95% confidence interval for the difference is (8.116, 11.133).
Multiple Regression Results
1. Multiple Mini Interview
After adjusting for other factors, the only significant factor is age groups.
- Age groups (p value: 0.025)
- Compared with the group of ages 27 and above, the young group of ages 22 and below performed worse and the group of ages 23-26 performed better.
- Urban/rural status (p value: 0.622)
- Neighbourhood SES (p value: 0.599)
- Sex (p value: 0.324)
2. Traditional interview:
After adjusting for other factors, the significant factors are sex and urban/rural status.
- Sex (p value: 0.028)
- Females performed better than males.
- Urban/rural status (p value: 0.042)
- Students from urban background performed worse.
- Age Groups (p value: 0.458)
- Neighbourhood SES (p value: 0.419)
The mean score on the traditional interview was higher than that on the MMI. Rural students and females scored higher on the traditional interview. Students aged 23-26 scored higher on the MMI than aged 27 and above. Students aged 22 and younger performed worse than the other age groups. Sex and Urban/rural living status were not significantly related with students' performance on MMI.
We must remember that the interview is only one part of an inclusive, holistic approach that is used by the Admissions Committee to select the best-qualified applicants in order to provide a diverse medical student body that takes personal characteristics, as well as academic history, into consideration in the selection process.
We did an anonymous survey of the students after the interview and seventy-two percent preferred the combination of traditional and multiple mini interview format to either the MMI (14%) or the traditional (14%) interview alone. To give students every opportunity to shine in the interview, we will continue to use a hybrid of traditional and multiple mini interviews (TaMMI) rather than one or the other. We will continue to follow the students' performance in medical school and on licensing exams to futher evaluate the interview method.
- Eva KW, Reiter HI, Trinh K, Wasi P, Rosenfeld J, Norman GR. Predictive validity to the multiple mini-interview for undergraduate and postgraduate admissions decision. Medical Education 43:767-785.
- Raghavan M, Martin BD, Burnett M, Aoki F, Christensen H, Mackalski B, Young DG, Ripstein I. Multiple mini-interview scores of medical school applicants with and without rural attributes. Rural Remote Health. 2013 Apr-Jun;13(2).
- Russell Wilkins, Paul A Peters. PCCF+ Version 5K* User’s Guide. Automated Geographic Coding Based on the Statistics Canada Postal Code Conversion Files, Including Postal Codes through May 2011. Catalogue 82F0086-XDB. Health Analysis Division, Statistics Canada, Ottawa, July 2012.
- Statistics Canada, Census Metropolitan Area and Census Agglomeration definitions. http://www.statcan.gc.ca/pub/92-195-x/2011001/geo/cma-rmr/def-eng.htm.
The authors wish to thank Dr. Kien Trinh and Ms. Wendy Edge from the Michael G. DeGroote Faculty of Medicine at McMaster University for their advice and expertise.
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