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Predictive validity of the UKCAT for medical school undergraduate performance: a national prospective cohort study

Tiffin, P.A.; Mwandigha, L.M.; Paton, L.W.; Hesselgreaves, H.; McLachlan, J.C.; Finn, G.M.; Kasim, A.S.

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Authors

P.A. Tiffin

L.M. Mwandigha

L.W. Paton

H. Hesselgreaves

J.C. McLachlan

G.M. Finn

A.S. Kasim



Abstract

Background: The UK Clinical Aptitude Test (UKCAT) has been shown to have a modest but statistically significant ability to predict aspects of academic performance throughout medical school. Previously, this ability has been shown to be incremental to conventional measures of educational performance for the first year of medical school. This study evaluates whether this predictive ability extends throughout the whole of undergraduate medical study and explores the potential impact of using the test as a selection screening tool. Methods: This was an observational prospective study, linking UKCAT scores, prior educational attainment and sociodemographic variables with subsequent academic outcomes during the 5 years of UK medical undergraduate training. The participants were 6812 entrants to UK medical schools in 2007–8 using the UKCAT. The main outcome was academic performance at each year of medical school. A receiver operating characteristic (ROC) curve analysis was also conducted, treating the UKCAT as a screening test for a negative academic outcome (failing at least 1 year at first attempt). Results: All four of the UKCAT scale scores significantly predicted performance in theory- and skills-based exams. After adjustment for prior educational achievement, the UKCAT scale scores remained significantly predictive for most years. Findings from the ROC analysis suggested that, if used as a sole screening test, with the mean applicant UKCAT score as the cut-off, the test could be used to reject candidates at high risk of failing at least 1 year at first attempt. However, the ‘number needed to reject’ value would be high (at 1.18), with roughly one candidate who would have been likely to pass all years at first sitting being rejected for every higher risk candidate potentially declined entry on this basis. Conclusions: The UKCAT scores demonstrate a statistically significant but modest degree of incremental predictive validity throughout undergraduate training. Whilst the UKCAT could be considered a fairly crude screening tool for future academic performance, it may offer added value when used in conjunction with other selection measures. Future work should focus on the optimum role of such tests within the selection process and the prediction of post-graduate performance.

Citation

Tiffin, P., Mwandigha, L., Paton, L., Hesselgreaves, H., McLachlan, J., Finn, G., & Kasim, A. (2016). Predictive validity of the UKCAT for medical school undergraduate performance: a national prospective cohort study. BMC Medicine, 14(1), Article 140. https://doi.org/10.1186/s12916-016-0682-7

Journal Article Type Article
Acceptance Date Aug 31, 2016
Online Publication Date Sep 17, 2016
Publication Date Sep 17, 2016
Deposit Date Jun 8, 2017
Publicly Available Date Mar 29, 2024
Journal BMC Medicine
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 14
Issue 1
Article Number 140
DOI https://doi.org/10.1186/s12916-016-0682-7

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.





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