Mwandigha Lazaro M, Tiffin Paul A, Paton Lewis W, Kasim Adetayo S, Böhnke Jan R
Department of Health Sciences, University of York, Heslington, UK.
Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton-on-Tees, UK.
BMJ Open. 2018 May 23;8(5):e020291. doi: 10.1136/bmjopen-2017-020291.
University academic achievement may be inversely related to the performance of the secondary (high) school an entrant attended. Indeed, some medical schools already offer 'grade discounts' to applicants from less well-performing schools. However, evidence to guide such policies is lacking. In this study, we analyse a national dataset in order to understand the relationship between the two main predictors of medical school admission in the UK (prior educational attainment (PEA) and performance on the United Kingdom Clinical Aptitude Test (UKCAT)) and subsequent undergraduate knowledge and skills-related outcomes analysed separately.
The study was based on national selection data and linked medical school outcomes for knowledge and skills-based tests during the first five years of medical school. UKCAT scores and PEA grades were available for 2107 students enrolled at 18 medical schools. Models were developed to investigate the potential mediating role played by a student's previous secondary school's performance. Multilevel models were created to explore the influence of students' secondary schools on undergraduate achievement in medical school.
The ability of the UKCAT scores to predict undergraduate academic performance was significantly mediated by PEA in all five years of medical school. Undergraduate achievement was inversely related to secondary school-level performance. This effect waned over time and was less marked for skills, compared with undergraduate knowledge-based outcomes. Thus, the predictive value of secondary school grades was generally dependent on the secondary school in which they were obtained.
The UKCAT scores added some value, above and beyond secondary school achievement, in predicting undergraduate performance, especially in the later years of study. Importantly, the findings suggest that the academic entry criteria should be relaxed for candidates applying from the least well performing secondary schools. In the UK, this would translate into a decrease of approximately one to two A-level grades.
大学学业成绩可能与学生入学前就读的中学表现呈负相关。事实上，一些医学院已经对来自表现较差学校的申请者给予“成绩折扣”。然而，缺乏指导此类政策的证据。在本研究中，我们分析了一个全国性数据集，以了解英国医学院入学的两个主要预测因素（先前教育成就（PEA）和英国临床能力倾向测试（UKCAT）成绩）与随后分别分析的本科知识和技能相关结果之间的关系。
该研究基于全国选拔数据以及医学院前五年基于知识和技能测试的相关医学院校结果。有18所医学院的2107名学生的UKCAT成绩和PEA等级数据。建立模型以研究学生之前中学表现可能起到的中介作用。创建多层次模型以探讨学生所在中学对医学院本科成绩的影响。
在医学院的所有五年中，PEA显著介导了UKCAT成绩预测本科学习成绩的能力。本科成绩与中学阶段表现呈负相关。这种影响会随着时间减弱，与基于知识的本科成绩相比，对技能的影响不那么明显。因此，中学成绩的预测价值通常取决于取得成绩的中学。
UKCAT成绩在预测本科表现方面，除了中学成绩之外还增加了一些价值，尤其是在学习后期。重要的是，研究结果表明，对于来自表现最差中学的申请者，学术入学标准应该放宽。在英国，这将转化为A-level成绩下降大约一到两个等级。
