Prideaux Centre for Research in Health Professions Education, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
Sydney Medical School - Northern, The University of Sydney, Sydney, Australia.
Adv Health Sci Educ Theory Pract. 2018 Aug;23(3):533-546. doi: 10.1007/s10459-018-9811-8. Epub 2018 Jan 31.
Written tests for selection into medicine have demonstrated reliability and there is accumulating evidence regarding their validity, but we know little about the broader impacts or consequences of medical school selection tests from the perspectives of key stakeholders. In this first Australian study of its kind, we use consequential validity as a theoretical lens to examine how medical school students and applicants view and experience the Graduate Medical Schools Admission Test (GAMSAT), and the consequences of testing. Participants (n = 447) were recruited from five graduate-entry medical schools across Australia and a publicly available online test preparation forum. An online survey was used to gather demographic information, and quantitative and qualitative data. Quantitative data were analysed via descriptive statistics and qualitative data were thematically analysed. The findings showed there was a considerable financial burden associated with preparing for and sitting the GAMSAT and moderate agreement regarding the GAMSAT as a fair selection method. The main unintended consequences of using the GAMSAT as a selection tool included barriers related to test affordability and language, and socialisation into the hidden curriculum of medicine. Selection tools such as the GAMSAT have some limitations when the goals are to support equitable participation in medicine and professional identity development. Our study highlights the value interpretive and theoretically-informed research in contributing to the evidence base on medical school selection.
医学选拔的书面考试已经证明了其可靠性，并且关于其有效性的证据也在不断增加，但我们对从关键利益相关者的角度来看，医学院选拔考试的更广泛影响或后果知之甚少。在澳大利亚此类的第一项研究中，我们使用后果有效性作为理论视角，来考察医学院学生和申请人如何看待和体验研究生医学院入学考试（GAMSAT），以及考试的后果。参与者（n=447）是从澳大利亚五所研究生入学医学学校和一个公开的在线考试准备论坛招募的。我们使用在线调查收集人口统计信息、定量和定性数据。定量数据通过描述性统计进行分析，定性数据通过主题分析进行分析。研究结果表明，准备和参加 GAMSAT 考试会带来相当大的经济负担，并且对于 GAMSAT 作为公平的选拔方法，有一定程度的共识。使用 GAMSAT 作为选拔工具的主要意外后果包括与考试负担能力和语言相关的障碍，以及被医学的隐性课程同化。当目标是支持公平参与医学和专业身份发展时，像 GAMSAT 这样的选拔工具存在一些局限性。我们的研究强调了解释性和理论性研究在为医学院校选拔提供证据基础方面的价值。
