Kelly Maureen E, Dowell Jon, Husbands Adrian, Newell John, O'Flynn Siun, Kropmans Thomas, Dunne Fidelma P, Murphy Andrew W
The Medical School, National University of Ireland Galway, (NUI Galway), Galway, Ireland.
School of Medicine, University of Dundee, Dundee, Scotland.
BMC Med Educ. 2014 Dec 21;14:267. doi: 10.1186/s12909-014-0267-0.
International medical students, those attending medical school outside of their country of citizenship, account for a growing proportion of medical undergraduates worldwide. This study aimed to establish the fairness, predictive validity and acceptability of Multiple Mini Interview (MMI) in an internationally diverse student population.
This was an explanatory sequential, mixed methods study. All students in First Year Medicine, National University of Ireland Galway 2012 were eligible to sit a previously validated 10 station MMI. Quantitative data comprised: demographics, selection tool scores and First Year Assessment scores. Qualitative data comprised separate focus groups with MMI Assessors, EU and Non-EU students.
109 students participated (45% of class). Of this 41.3% (n = 45) were Non-EU and 35.8% (n = 39) did not have English as first language. Age, gender and socioeconomic class did not impact on MMI scores. Non-EU students and those for whom English was not a first language achieved significantly lower scores on MMI than their EU and English speaking counterparts (difference in mean 11.9% and 12.2% respectively, P<0.001). MMI score was associated with English language proficiency (IELTS) (r = 0.5, P<0.01). Correlations emerged between First Year results and IELTS (r = 0.44; p = 0.006; n = 38) and EU school exit exam (r = 0.52; p<0.001; n = 56). MMI predicted EU student OSCE performance (r = 0.27; p = 0.03; n = 64). In the analysis of focus group data two overarching themes emerged: Authenticity and Cultural Awareness. MMI was considered a highly authentic assessment that offered a deeper understanding of the applicant than traditional tools, with an immediate relevance to clinical practice. Cultural specificity of some stations and English language proficiency were seen to disadvantage international students. Recommendations included cultural awareness training for MMI assessors, designing and piloting culturally neutral stations, lengthening station duration and providing high quality advance information to candidates.
MMI is a welcome addition to assessment armamentarium for selection, particularly with regard to stakeholder acceptability. Understanding the mediating and moderating influences for differences in performance of international candidates is essential to ensure that MMI complies with the metrics of good assessment practice and principles of both distributive and procedural justice for all applicants, irrespective of nationality and cultural background.
国际医学生，即在其公民国籍所属国家以外的医学院校就读的学生，在全球医学本科学生中所占比例日益增加。本研究旨在确定多重迷你面试（MMI）在国际多元化学生群体中的公平性、预测效度和可接受性。
这是一项解释性序列混合方法研究。爱尔兰国立高威大学2012级医学一年级的所有学生都有资格参加先前验证过的10站式MMI。定量数据包括：人口统计学数据、选拔工具分数和一年级评估分数。定性数据包括分别与MMI评估者、欧盟和非欧盟学生进行的焦点小组讨论。
109名学生参与（占班级的45%）。其中41.3%（n = 45）是非欧盟学生，35.8%（n = 39）的第一语言不是英语。年龄、性别和社会经济阶层对MMI分数没有影响。非欧盟学生和第一语言不是英语的学生在MMI上的得分明显低于他们的欧盟和说英语的同龄人（平均差异分别为11.9%和12.2%，P<0.001）。MMI分数与英语语言能力（雅思）相关（r = 0.5，P<0.01）。一年级成绩与雅思（r = 0.44；p = 0.006；n = 38）和欧盟学校毕业考试（r = 0.52；p<0.001；n = 56）之间存在相关性。MMI预测了欧盟学生的客观结构化临床考试表现（r = 0.27；p = 0.03；n = 64）。在焦点小组数据分析中出现了两个总体主题：真实性和文化意识。MMI被认为是一种高度真实的评估，与传统工具相比，能更深入地了解申请人，且与临床实践直接相关。一些站点的文化特异性和英语语言能力被认为对国际学生不利。建议包括对MMI评估者进行文化意识培训、设计和试点文化中立的站点、延长站点时长以及向考生提供高质量的提前信息。
MMI是选拔评估手段中一项受欢迎的补充，特别是在利益相关者可接受性方面。了解国际考生成绩差异的中介和调节影响对于确保MMI符合良好评估实践的标准以及所有申请人（无论国籍和文化背景）的分配正义和程序正义原则至关重要。
