| THE SELECTION PROBLEMInternationally, selection into healthcare remains competitive, and as such, selection processes can be highly resource intensive. A risk of litigation exists if selection methods are viewed as unfair by applicants and/or key stakeholders. 1 In addition, with an increased emphasis on widening access and increasing diversity in the healthcare professions, 2 selection is considered "high-stakes" from various key stakeholders (including applicants, recruiters, regulatory bodies and government) and therefore should be based on good-quality research evidence.Traditionally, previous academic attainment has been used as a basis for selection into healthcare roles and is usually assessed early in the selection process. 3 Academic attainment is often used for shortlisting decisions (frequently in combination with references or personal statements) and may be followed by an interview or selection centre as a final stage of selection. However, emerging evidence clearly shows that whilst academic ability is important, it is not the only requirement for healthcare practitioners to become competent clinicians. 4 For example, in medicine, Trost and colleagues 5 found that academic attainment only partially predicted performance in undergraduate medical training (23% of the variance) and was much less predictive for postgraduate performance (6%) as trainees enter clinical practice.
| THE RESEARCH PROBLEMThere is increasing recognition and emerging evidence that to be a competent clinician, one must excel academically but also have important personal attributes and values (such as compassion, integrity, resilience and other interpersonal skills). 6-8 Therefore, healthcare professionals should be selected based on both academic and (socalled) "non-academic" attributes. However, the research examining methods used to select for non-academic attributes is in its infancy compared to cognitive and academic assessments, which have over 100 years of research evidence. 9-11 It has only been in the last few decades that a clinician's "softer" skills have been recognised as important to examine during recruitment processes. It is plausible that some academically able people are less suited to a healthcare career than others based on their personal attributes. This proposal is in line with findings from UK government enquiries 12,13 which highlighted major concerns about the level of compassionate care from healthcare professionals.Nevertheless, it is important that the research examining these so-called softer skills is appropriately conducted. Single-site studies should not be used to draw firm conclusions about selection methods as erroneous conclusions can be made when original studies are not carefully conducted. For example, authors should always cite evaluation evidence of the selection method in question, as opposed to, for example, suggesting an admissions interview is valid simply because it is structured (see a recent paper by Lambe and colleagues). 14 Whilst we agree that structured interviews have signifi...