Non-cognitive selected students do not outperform lottery-admitted students in the pre-clinical stage of medical school

Lucieer, Susanna M.; Stegers‐Jager, Karen M.; Rikers, Remy M. J. P.; Themmen, Axel P. N.

doi:10.1007/s10459-015-9610-4

Cited by 19 publications

(29 citation statements)

References 41 publications

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“…In a subsequent study we compared students selected (exclusively) on non‐academic criteria and students selected (exclusively) on academic criteria with lottery‐admitted students. Contrary to our expectations, students selected on non‐academic criteria did not outperform lottery‐admitted students in pre‐clinical training, whereas those selected on academic criteria did . This led us to conclude that apparently the use of non‐academic selection criteria is not sufficient to select the best academically performing students, probably because a minimum academic level is required to succeed in medical school.…”

Section: Non‐grades‐based Selection In the Netherlandscontrasting

confidence: 94%

Lessons learned from 15 years of non-grades-based selection for medical school

Stegers‐Jager

2017

Med Educ

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ContextThirty years ago, it was suggested in the Edinburgh Declaration that medical school applicants should be selected not only on academic, but also on non‐academic, attributes. The main rationale behind extending medical school selection procedures with the evaluation of (non‐academic) personal qualities is that this will lead to the selection of students who will perform better as a doctor than those who are selected on the basis of academic measures only. A second rationale is the expectation that this will lead to a representative health workforce as a result of reduced adverse impact. The aims of this paper are (i) to describe what can be learned about the use of selection criteria other than grades from over 15 years of Dutch experience and (ii) to summarise current knowledge on the issue of adverse impact in relation to non‐grades‐based selection.MethodsA narrative review was undertaken of the (published) evidence that has resulted from non‐grades‐based school‐specific selection procedures in the Netherlands and from recent explorations of the effect of the use of non‐grades‐based selection criteria on student diversity.ResultsThe Dutch evidence is grouped into five key themes: the effect of participation in voluntary selection procedures, the assessment of pre‐university extracurricular activities, the use of work samples, Dutch experiences with situational judgement tests and the effects of changing circumstances. This is followed by several lessons learned for medical schools that aim to increase their student diversity.ConclusionOver the last 30 years, important steps towards reliable and valid methods for measuring non‐academic abilities have been taken. The current paper describes several lessons that can be learned from the steps taken in the Dutch context. The importance of sharing evidence gathered around the globe and building on this evidence to reach our goal of predicting who will be a good doctor is acknowledged.

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Section: Non‐grades‐based Selection In the Netherlandscontrasting

confidence: 94%

Lessons learned from 15 years of non-grades-based selection for medical school

Stegers‐Jager

2017

Med Educ

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“…The single-institution nature of previous research has resulted in a relative lack of studies comparing different selection procedures. A study comparing students selected using cognitive criteria and students selected using non-cognitive criteria within one medical school, showed no differences with regard to dropout and performance during the pre-clinical and clinical phases of medical study (Lucieer et al 2015). The present study includes multiple institutions applying different selection procedures, enabling comparisons across medical schools.…”

Section: Introductionmentioning

confidence: 80%

“…Whenever performance differences are found, however small they are, applying a selection procedure seems favourable over applying weighted lottery (de Visser et al 2016;Lucieer et al 2015;Schripsema et al 2014;Urlings-Strop et al 2009. However, the differences are often not statistically significant (de Visser et al 2016;Hulsman et al 2007;Lucieer et al 2015;Schripsema et al 2014;Stegers-Jager et al 2015;Urlings-Strop et al 2009).…”

Section: Introductionmentioning

confidence: 99%

A multi-site study on medical school selection, performance, motivation and engagement

Wouters

Croiset

Schripsema

et al. 2017

Adv in Health Sci Educ

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Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a weighted lottery procedure, which includes direct admission based on top pre-university grade point averages (C8 out of 10; top-pu-GPA). We also considered whether students had participated in selection, prior to being admitted through weighted lottery. Year-1 (pre-clinical) and Year-4 (clinical) students completed standard validated questionnaires measuring quality of motivation (Academic Self-regulation Questionnaire), strength of motivation (Strength of Motivation for Medical School-Revised) and engagement (Utrecht Work Engagement Scale-Student). Performance data comprised GPA and course credits in Year-1 and clerkship performance in Year-4. Regression analyses were performed. The response rate was 35% (387 Year-1 and 273 Year-4 students). Top-pu-GPA students outperformed selected students. Selected Year-1 students reported higher strength of motivation than top-pu-GPA students. Selected students did not outperform or show better quality of motivation and engagement than lotteryadmitted students. Participation in selection was associated with higher engagement and better clerkship performance in Year-4. GPA, course credits and strength of motivation in Year-1 differed between students admitted through different selection procedures. Top-pu- GPA students perform best in the medical study. The few and small differences found raise questions about the added value of an extensive selection procedure compared to a weighted lottery procedure. Findings have to be interpreted with caution because of a low response rate and small group sizes.

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“…This might have been particularly so in the first years of our selection procedure when applicants were less aware of the requirements for admission. As described by Lucieer et al (2016) it might be that in more recent years-since the requirements for admission have become more transparent-applicants invest time in extracurricular activities just because they want to enter medical school. Possible differences in regulatory focus between lottery-admitted and selected students and their relation with clerkship grades may be an interesting area for further research.…”

Section: Participation In Msecasmentioning

confidence: 99%

“…However, it might still be that selfselection instigated by the use of puECAs as a criterion in the selection procedure is stronger for non-traditional applicants than for traditional applicants at other medical schools. Additionally, as suggested above, there is a risk that when requirements of puECA participation for admission become more transparent, applicants may choose to participate in puECAs because they feel they have to do so to have a chance to enter medical school, and not because they want to [Lucieer et al 2016 and Higgins' regulatory focus theory (Higgins 1997(Higgins , 1998]. Therefore it would be interesting to search for tools to assess the underlying students traits that lead to persistent msECAs associated with better clinical achievement.…”

Section: Participation In Msecasmentioning

confidence: 99%

The relationship between extracurricular activities assessed during selection and during medical school and performance

Urlings‐Strop

Themmen

Stegers‐Jager

2016

Adv in Health Sci Educ

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Several medical schools include candidates' extracurricular activities in their selection procedure, with promising results regarding their predictive value for achievement during the clinical years of medical school. This study aims to reveal whether the better achievement in clinical training of students selected on the basis of their extracurricular activities could be explained by persistent participation in extracurricular activities during medical school (msECAs). Lottery-admitted and selected student admission groups were compared on their participation in three types of msECAs: (1) research master, (2) important board positions or (3) additional degree programme. Logistic regression was used to measure the effect of admission group on participation in any msECA, adjusted for pre-university GPA. Two-way ANCOVA was used to examine the inter-relationships between admission group, participation in msECAs and clerkship grade, with pre-university GPA as covariate. Significantly more selected students compared to lottery-admitted students participated in any msECA. Participation in msECAs was associated with a higher pre-university GPA for lottery-admitted students only, whereas participation in msECAs was associated with higher clerkship grades for selected students only. These results suggest that persistent participation in extracurricular activities of selected students favours better clinical achievement, supporting the inclusion of ECAs in the selection procedure. More insight in the rationale behind participation in extracurricular activities during medical school may explain differences found between lottery-admitted and selected students.

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Non-cognitive selected students do not outperform lottery-admitted students in the pre-clinical stage of medical school

Cited by 19 publications

References 41 publications

Lessons learned from 15 years of non-grades-based selection for medical school

Lessons learned from 15 years of non-grades-based selection for medical school

A multi-site study on medical school selection, performance, motivation and engagement

The relationship between extracurricular activities assessed during selection and during medical school and performance

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