Despite their widespread use, medical school admission interviews often are unstructured and lack reliability. This report describes the development of a structured admission interview designed to eliminate bias and provide valid information for selecting medical students, with preliminary information about the interview's reliability and validity.
After screening applications, 490 applicants to a public medical school residency program were interviewed by two faculty members using a structured interview format. Interview scores were compiled and correlated with undergraduate grade-point averages (GPAs); Medical College Admission Test (MCAT) scores; Iowa Evaluation Form (IEF) scores, an in-house evaluation of applicants' noncognitive abilities; and eventual admissions status.
Interrater agreement was good; the percentages of rater pairs whose scores differed by one point or less ranged from 87% to 98%. Scores on the structured interview revealed low to moderate correlations with other admission criteria:.10 (p <.05) for cumulative GPA,.18 (p <.01) for MCAT Biological Science,.08 (p >.05) MCAT Physical Science, and .10 (p <.05) MCAT Verbal Reasoning. None of the correlations between the overall interview scores and the IEF scores reached statistical significance (p =.05). Higher overall scores on the structured interview did predict a greater likelihood of being accepted into the medical school and the interview score accounted for 20% of the incremental variance in admission status beyond GPA, MCAT, and IEF scores.
The moderate-to-low correlations with other admission criteria suggest that the interview provided information about candidate credentials not obtained from other sources and accounted for a substantial proportion of the variance in admission status. This finding supports the considerable time and resources required to develop a structured interview for medical student admissions. Final judgment on the validity and utility of this interview should be made after follow-up performance data have been obtained and analyzed.
At the time of the study, Dr. Patrick and Dr. Ugolini were doctoral students in the Counseling Psychology Program, Division of Psychological and Quantitative Foundations, College of Education, University of Iowa, Iowa City. Dr. Altmaier is professor, Division of Psychological and Quantitative Foundations, College of Education and Center for Health Policy and Research, College of Public Health, and Dr. Kuperman is associate professor, Department of Psychiatry, College of Medicine, both at the University of Iowa. Dr. Patrick is now a psychology intern, Portland VA Medical Center; Dr. Ugolini is now staff psychologist, North-west Occupational Medicine Center, Portland, Oregon.
Correspondence and requests for reprints should be addressed to Dr. Altmeir, 360 Lindquist Center, University of Iowa, Iowa City, IA 52242.