The academic backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

Background: Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades. Methods: Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register. Results: Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on measures of educational attainment, undergraduate, and post-graduate performance. Women performed better in assessments but were less likely to be on the Specialist Register. Non-white participants generally underperformed in undergraduate and post-graduate assessments, but were equally likely to be on the Specialist Register. There was a suggestion of smaller ethnicity effects in earlier studies. Conclusions: The existence of the Academic Backbone concept is strongly supported, with attainment at secondary school predicting performance in undergraduate and post-graduate medical assessments, and the effects spanning many years. The Academic Backbone is conceptualized in terms of the development of more sophisticated underlying structures of knowledge ('cognitive capital’ and 'medical capital’). The Academic Backbone provides strong support for using measures of educational attainment, particularly A-levels, in student selection

A monochrome view of colour

Saunders & van Brakel's criticism of Berlin & Kay's methodology misunderstands the fact that scientific hypotheses are tested by generating new, replicable data with novel explanatory power. Thus, although Berlin and Kay studied differences in colour words between language, the same patterns are also present in colour word usage within languages, in a range of literary and other textual databases

Construct-level predictive validity of educational attainment and intellectual aptitude tests in medical student selection: meta-regression of six UK longitudinal studies

Background: Measures used for medical student selection should predict future performance during training. A problem for any selection study is that predictor-outcome correlations are known only in those who have been selected, whereas selectors need to know how measures would predict in the entire pool of applicants. That problem of interpretation can be solved by calculating construct-level predictive validity, an estimate of true predictor-outcome correlation across the range of applicant abilities. Methods: Construct-level predictive validities were calculated in six cohort studies of medical student selection and training (student entry, 1972 to 2009) for a range of predictors, including A-levels, General Certificates of Secondary Education (GCSEs)/O-levels, and aptitude tests (AH5 and UK Clinical Aptitude Test (UKCAT)). Outcomes included undergraduate basic medical science and finals assessments, as well as postgraduate measures of Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) performance and entry in the Specialist Register. Construct-level predictive validity was calculated with the method of Hunter, Schmidt and Le (2006), adapted to correct for right-censorship of examination results due to grade inflation. Results: Meta-regression analyzed 57 separate predictor-outcome correlations (POCs) and construct-level predictive validities (CLPVs). Mean CLPVs are substantially higher (.450) than mean POCs (.171). Mean CLPVs for first-year examinations, were high for A-levels (.809; CI: .501 to .935), and lower for GCSEs/O-levels (.332; CI: .024 to .583) and UKCAT (mean = .245; CI: .207 to .276). A-levels had higher CLPVs for all undergraduate and postgraduate assessments than did GCSEs/O-levels and intellectual aptitude tests. CLPVs of educational attainment measures decline somewhat during training, but continue to predict postgraduate performance. Intellectual aptitude tests have lower CLPVs than A-levels or GCSEs/O-levels. Conclusions: Educational attainment has strong CLPVs for undergraduate and postgraduate performance, accounting for perhaps 65% of true variance in first year performance. Such CLPVs justify the use of educational attainment measure in selection, but also raise a key theoretical question concerning the remaining 35% of variance (and measurement error, range restriction and right-censorship have been taken into account). Just as in astrophysics, ‘dark matter’ and ‘dark energy’ are posited to balance various theoretical equations, so medical student selection must also have its ‘dark variance’, whose nature is not yet properly characterized, but explains a third of the variation in performance during training. Some variance probably relates to factors which are unpredictable at selection, such as illness or other life events, but some is probably also associated with factors such as personality, motivation or study skills

Unity in the wild variety of nature, or just variety?

Although there are some common underlying mechanisms for many nonhuman behavioural asymmetries, the evidence at present is not compelling for commonalities in cerebral organisation across vertebrates. Phylogenetic analysis of detour behaviour in fish suggests that more closely related species are not particularly similar in the direction of turning; contingency and demands of ecological niches may better explain such asymmetries

Colour word usage within languages follows the Berlin and Kay ordering

Colour word usage within languages follows the same ordering as that proposed by Berlin and Kay between languages. This provides additional validation and support for Berlin and Kay's schema

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates

The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students

Changes in standard of candidates taking the MRCP(UK) Part 1 examination, 1985 to 2002: Analysis of marker questions

The maintenance of standards is a problem for postgraduate medical examinations, particularly if they use norm-referencing as the sole method of standard setting. In each of its diets, the MRCP(UK) Part 1 Examination includes a number of marker questions, which are unchanged from their use in a previous diet. This paper describes two complementary studies of marker questions for 52 diets of the MRCP(UK) Part 1 Examination over the years 1985 to 2001 to assess whether standards have changed

Would changing the selection process for GP trainees stem the workforce crisis? A cohort study using multiple-imputation and simulation

BACKGROUND: There is currently a shortage of qualified GPs in the UK and not all of the training posts available each year are filled. Changing the way in which GP trainees are selected could help increase the training post fill rate and the number of new entrants to the GP Register. The aim of this study was to model the impact of changing the selection process for GP training on the number of trainees obtaining GP Registration, either with or without extensions. METHOD: This was a cohort study using UK applications for GP training in 2011-14. Application data were linked using GMC numbers to training outcome data where available, and imputed using multiple imputation where missing. The number of trainees appointed and GP Registrations within three and five years' full-time-equivalent were estimated for four different selection processes. RESULTS: The cut scores used in the actual 2015 selection process makes it impossible to fill all training posts. Random selection is the worst option, but the difference between this and other processes modelled falls as more trainees are selected. There are large marginal effects on outcomes: those with the highest selection scores are more likely to obtain GP Registration than those with the lowest scores. CONCLUSIONS: Changing the selection process alone would have a small impact on the number of GP Registrations; reducing/removing cut scores would have a much larger impact. This would also increase the number of trainees requiring extensions and being released from training which would have adverse consequences for the profession

The Tapley and Bryden test of performance differences between the hands: the original data, newer data, and the relation to pegboard and other tasks

Tapley and Bryden (T&B)’s 1985 circle-marking task is a group-administered task assessing performance differences between the hands. The bimodal distribution clearly separates self-described right- and left-handers. Using Phil's original datafiles we analyse the test in more detail, providing raw scores for each hands which are useful forensically, and we provide reliability estimates. Van Horn's unpublished 1992 PhD thesis studied T&B tasks and Annett pegboards varying in difficulty. A striking finding, that Phil Bryden called “the Van Horn problem,” was that hand differences (R − L) were unrelated to task difficulty. That result was the starting point for Pamela Bryden's 1998 thesis, firstly replicating Van Horn, but then showing that task difficulty did relate to hand differences for Grooved pegboards. Pamela Bryden's model for those effects is presented here. Comparing across tasks, the T&B and pegboard tasks showed almost complete consistency for direction of handedness. Likewise, within each task, degree of handedness intercorrelated strongly across variants. In strong contrast, degree of handedness for T&B tasks showed minimal correlation with degree of handedness for pegboards. At the highest level, therefore, direction of handedness is consistent within individuals (conventional right and left handedness), but there are separable processes determining dominant–non-dominant hands differences for each particular task

Do Events on One Day Influence the Perception of Stuttering on Subsequent Days?

OBJECTIVE: The reaction of children and adolescents who stutter to their own speech and their perception about how others reacted to them were examined over time. Day-to-day changes in perception of own-speech and emotional impact of others on their stuttering were assessed using the new Daily Questionnaire. DESIGN: Nineteen participants (mean age13.10 years, SD=2.8 years) who attended an intensive stuttering treatment completed the Daily Questionnaire on 19 successive days. RESULTS: The Daily Questionnaire assessed day-to-day experiences of the participants and the influence these experiences had on the participant's life. Significant cross-lagged panel correlations between the impact of other people's behavior on the previous day with perception of general speaking abilities on the current day were found and between the emotions reported on the previous day and the perception of their own speaking abilities on the current day. CONCLUSIONS: The experiences of children and adolescents who stutter fluctuated over time because of the perception of their own and other people's behavior. These perceived experiences affected how the participants perceived their speech on subsequent days