Talk about multi-competency assessment of professional qualifications . . . medical schools way ahead of us, again

Worth checking out:  “New for Aspiring Doctors, the People Skills Test“.   Eight US and 13 Canadian medical schools, including Stanford and UCLA, have adopted the “multiple mini interview,” or M.M.I.  This technique seeks to “test” medical school applicants for ethical and problem-solving acumen and even more importantly, ability to collaborate.   The schools invite applicants to engage in an admissions equivalent of speed-dating: a series of nine brief interviews that require them to demonstrate whether they have the social skills to navigate a health care system in which quality communication has become critical.   The interviewers are trained health care providers and community members who meet briefly with and assess certain attributes of the applicants.

On a Saturday, candidates for admission stand opposite a number of small rooms.  When a bell sounds, the applicants read a sheet of paper taped to each door that describes an ethical problem.  Two minutes later, the bell sounds again and the applicants rush into the rooms to find waiting interviewers.  The candidates have eight minutes to discuss that room’s situation.  Then the bell rings again and they move to the next room, the next surprise issue, and the next interviewer.  Interviewers score each applicant with a number and sometimes a brief note.

“[A]dministrators said they created questions that assessed how well candidates think on their feet and how willing they are to work in teams.  The most important part of the interviews are often not candidates’ initial responses — there are no right or wrong answers — but how well they respond when someone disagrees with them, something that happens when working in teams.  Candidates who jump to improper conclusions, fail to listen or are overly opinionated fare poorly because such behavior undermines teams.  Those who respond appropriately to the emotional tenor of the interviewer or ask for more information do well in the new admissions process because such tendencies are helpful not only with colleagues but also with patients.  ‘We are trying to weed out the students who look great on paper but haven’t developed the people or communication skills we think are important. . . .’  A survey by the Joint Commission, a hospital accreditation group, found communication woes to be among the leading causes of medical errors, which cause as many as 98,000 deaths each year. “

“The system grew out of research that found that interviewers rarely change their scores after the first five minutes, that using multiple interviewers removes random bias, and that situational interviews rather than personal ones are more likely to reveal character flaws,” said Dr. Harold Reiter, the professor at McMaster University in Hamilton, Ontario, who developed the system.  “In fact, candidate scores on multiple mini interviews have proved highly predictive of scores on medical licensing exams three to five years later that test doctors’ decision-making, patient interactions and cultural competency,” Dr. Reiter said.

Most law schools have eliminated admissions interviews, even by alums, or very rarely use them, I believe.  I’ve heard it said that law schools have no resources for such a time-consuming process.  It seems more than a little bizarre that law school  faculty refuse to devote substantial time to the recruitment and selection of their incoming students — what, exactly, is more important for and predictive of the law school’s success? — but now the medical schools appear to have made it feasible to meaningfully augment the admissions process without the participation of large numbers of faculty and staff.   We could imagine refinements of this method that would similarly ask law school applicants to show us, rather than tell us about, their approaches to communication, collaboration, and problem-solving.  In an era when some law schools like to claim that, despite the US News pressures,  the LSAT and GPA are not the sole determinants  of readiness for the legal profession, here is an opportunity to objectively and systematically incorporate other attributes into the admissions rubric.  Are any law schools already on board?

2 Responses

  1. This is very interesting, esp the multiple interviews idea and the coping with being challenged stuff. Isn’t the counter-argument that cognitive ability (which is broadly measured by aptitude tests or exam performance or similar) is a good – the best on studies I have seen – predictor of most work place performance including communication and it is cheap. I see these interviews are good predictors of certain aspects of performance, but don’t we need good evidence that they are better predictors than (cheaper) techniques?

    • Of course cost is a valid and important consideration — somewhat addressed apparently in this context by recruiting “friends of the school” to work as volunteers or cheap. I also have to disagree that there is any good evidence that establishes that, e.g., the LSAT is a predictor of any aspect of workplace performance — every study I’ve seen has shown no correlation with anything other than academic success in the first year of law school — the first year only. First year success, in turn, has not been shown to correlate with anything but higher income immediately after law school — which, I think we could agree, does not necessarily correlate with professional competence.

      In any event, aside from a potentially larger debate about what really constitutes proof of cognitive ability (i.e. cognition purely in theory, demonstrated via pen ‘n paper, or cognition in action, demonstrated via executing judgments in reality), I guess the answer to this question depends in part on whether you see the attributes measured by this technique as not merely luxury items, nice to have if you can get them cheaply, but essential components of professional competence.

      Moreover, pen ‘n paper testing is actually very expensive when you add in all the costs of preparation courses, tutoring, materials, and in fact the administration of the large-scale tests. It’s just that professional schools have managed to transfer the costs of these tests to the would-be students — a clever trick, that. I suppose that schools could choose to do the same with these techniques – could even choose to outsource the entire admissions process to specialized contractors which undoubtedly would spring up to accommodate them. That might even enhance the consistency and efficiency of this approach. However, one thing I like about this model is its very local, homegrown, and easily adjustable nature. A school can really focus on particular issues important to that school.

      I don’t see these alternative models as panaceas, but am interested in learning more about whether they can usefully supplement and amplify what is plainly now an inadequate and incomplete process (unless one believes that the quality and functioning of the current American bar is near-ideal).

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