2018 Ottawa consensus statement: Selection and recruitment to the healthcare professions

Abstract

Selection and recruitment into healthcare education and practice is a major area of endeavor for health professional educators. Key insights have emerged to guide further inquiry and influence future policy and practice since the last Ottawa consensus statement on selection (Prideaux et al., 2011). However, much remains to be done, not only in refining the science of selection, but also in considering the opportunities and challenges of translating current research understandings into established practice. This updated consensus statement is based on strong theoretical research evidence and was developed using a multi-stage process. First, a group of international researchers with expertise in selection and recruitment, assessment, curriculum, and educational theory was specially convened to critically appraise the literature and develop a draft consensus statement. Second, the group shared the draft statement with the wider community via a workshop and symposium at the 2018 Ottawa-ICME Joint Conference on the Assessment of Competence in Medicine and the Healthcare Professions, and at the Second International Conference of Selection into the Health Professions. Colleagues from diverse countries and regions actively engaged with these activities face-to-face and through social media. Finally, the statement was refined on the basis of feedback, questions and comments, sent for independent peer review, and further revised. Reflecting the state of the science at the time, the previous consensus (Prideaux et al., 2011) characterised selection as an assessment system and focussed on the quality of different selection methods. In this updated statement, we present the latest research findings on selection methods and, reflecting progression within the field, we also consider potentially more complex issues including: selection policies; methodological concerns (beyond psychometric issues); social accountability, diversity and fairness, workforce shortages in some specialities (e.g. General Practice and Psychiatry) and in certain contexts (e.g. remote and rural working, and emerging countries), globalisation issues, developments in theory, and evaluation frameworks. We conclude with a synthesis of the key issues and a series of recommendations to guide future research and practice and encourage debate between colleagues across the globe. Our findings are

Selection in context: The importance of clarity, transparency and evidence in achieving widening participation goals

“…Reflecting local historical, legal and social contexts and priorities, countries differ in the goals they prioritise and the groups they target. 3,4 For example, former colonies such as Canada and Australia have a strong focus on increasing participation amongst indigenous peoples to redress inequalities and create a diverse workforce, whereas in the UK the focus is on social mobility. Even within the UK, however, medical schools vary in their widening participation goals and how clearly they state them.…”

“…The stated goals of widening access are several and include: utilising the full talent pool of applicants; producing a diverse and representative workforce; improving social mobility; redressing inequalities; social justice, and boosting economic growth. Reflecting local historical, legal and social contexts and priorities, countries differ in the goals they prioritise and the groups they target . For example, former colonies such as Canada and Australia have a strong focus on increasing participation amongst indigenous peoples to redress inequalities and create a diverse workforce, whereas in the UK the focus is on social mobility.…”

Who is allowed to study medicine? – regulations and evidence

“…Complementary interview techniques on different levels of standardization are also often included as components of selection procedures [6]. While unstructured interviews do not add to the prediction of study success highly structured communication situations as in multiple mini-interviews [7], [8] predict non-cognitive study performance.…”

“…Eligible criteria are the results of SATs or professional experience in health care professions. The application of SATs is based on good evidence, while the evidence for the benefit of professional experience is missing [4], [8], [16]. …”

Getting to know our non-traditional and rejected medical school applicants

“…Designing admissions policies to meet academic and non-academic selection aims while ensuring fair access proves challenging [1,2]. Cleland et al have previously described medical school admissions as a wicked problem, recognizing its complexity, describing selection as dynamic rather than a static solution [3].…”