Yamada Toru, Sato Juichi, Yoshimura Hiroshi, Okubo Tomoya, Hiraoka Eiji, Shiga Takashi, Kubota Tadao, Fujitani Shigeki, Machi Junji, Ban Nobutaro
Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan.
BMC Med Educ. 2017 Mar 16;17(1):57. doi: 10.1186/s12909-017-0898-z.
The multiple mini-interview (MMI) is increasingly used for postgraduate medical admissions and in undergraduate settings. MMIs use mostly Situational Questions (SQs) rather than Past-Behavioural Questions (PBQs). A previous study of MMIs in this setting, where PBQs and SQs were asked in the same order, reported that the reliability of PBQs was non-inferior to SQs and that SQs were more acceptable to candidates. The order in which the questions are asked may affect reliability and acceptability of an MMI. This study investigated the reliability of an MMI using both PBQs and SQs, minimising question order bias. Acceptability of PBQs and SQs was also assessed.
Forty candidates applying for a postgraduate medical admission for 2016-2017 were included; 24 examiners were used. The MMI consisted of six stations with one examiner per station; a PBQ and a SQ were asked at every station, and the order of questions was alternated between stations. Reliability was analysed for scores obtained for PBQs or SQs separately, and for both questions. A post-MMI survey was used to assess the acceptability of PBQs and SQs.
The generalisability (G) coefficients for PBQs only, SQs only, and both questions were 0.87, 0.96, and 0.80, respectively. Decision studies suggested that a four-station MMI would also be sufficiently reliable (G-coefficients 0.82 and 0.94 for PBQs and SQs, respectively). In total, 83% of participants were satisfied with the MMI. In terms of face validity, PBQs were more acceptable than SQs for candidates (p = 0.01), but equally acceptable for examiners (88% vs. 83% positive responses for PBQs vs. SQs; p = 0.377). Candidates preferred PBQs to SQs when asked to choose one, though this difference was not significant (p = 0.081); examiners showed a clear preference for PBQs (p = 0.007).
Reliability and acceptability of six-station MMI were good among 40 postgraduate candidates; modelling suggested that four stations would also be reliable. SQs were more reliable than PBQs. Candidates found PBQs more acceptable than SQs and examiners preferred PBQs when they had to choose between the two. Our findings suggest that it is better to ask both PBQs and SQs during an MMI to maximise acceptability.
多重迷你面试（MMI）越来越多地用于研究生医学招生和本科阶段。MMI大多使用情境问题（SQ）而非过去行为问题（PBQ）。此前在这种情境下对MMI的一项研究中，PBQ和SQ按相同顺序提问，结果显示PBQ的可靠性不低于SQ，且候选人对SQ的接受度更高。问题的提问顺序可能会影响MMI的可靠性和接受度。本研究调查了同时使用PBQ和SQ的MMI的可靠性，将问题顺序偏差降至最低。还评估了PBQ和SQ的接受度。
纳入40名申请2016 - 2017年研究生医学入学的候选人；使用24名考官。MMI由六个站点组成，每个站点有一名考官；每个站点提出一个PBQ和一个SQ，问题顺序在各站点交替。分别分析PBQ或SQ以及两个问题的得分的可靠性。MMI后调查用于评估PBQ和SQ的接受度。
仅PBQ、仅SQ以及两个问题的概化（G）系数分别为0.87、0.96和0.80。决策研究表明，四站点的MMI也将具有足够的可靠性（PBQ和SQ的G系数分别为0.82和0.94）。总体而言，83%的参与者对MMI感到满意。在表面效度方面，候选人认为PBQ比SQ更可接受（p = 0.01），但考官认为两者同样可接受（PBQ和SQ的积极回应率分别为88%和83%；p = 0.377）。当被要求选择一个时，候选人更喜欢PBQ而非SQ，不过这种差异不显著（p = 0.081）；考官对PBQ表现出明显偏好（p = 0.007）。
40名研究生候选人中，六站点MMI的可靠性和接受度良好；模型显示四站点也将可靠。SQ比PBQ更可靠。候选人发现PBQ比SQ更可接受，且当考官必须在两者之间选择时，他们更喜欢PBQ。我们的研究结果表明，在MMI期间同时提出PBQ和SQ以最大化接受度更好。
