Annette Mercer - Academia.edu (original) (raw)

Papers by Annette Mercer

Research paper thumbnail of RESEARCH ARTICLE Open Access

Medical student selection criteria and socio-demographic factors as predictors of ultimately work... more Medical student selection criteria and socio-demographic factors as predictors of ultimately working rurally after graduation

Research paper thumbnail of Who gets in and who doesn't : Selecting medical students : An Australian Case Study

Education research and perspectives, 2009

Research paper thumbnail of Selecting medical students: an Australian case study

The recognition that medical practitioners require more than simply a high level of academic abil... more The recognition that medical practitioners require more than simply a high level of academic ability to function successfully in their profession, together with a sharp increase in the number of academically qualified applicants to medical courses, has led to new ways of selecting medical students. Consequently the selection of students into the high-stakes course of medicine has become an area of considerable interest and research activity. The issues involved in selection are now prominent in the medical and medical education literature published in the UK, the USA, Australia, New Zealand and Canada, and in some European countries. At the same time as the introduction of new selection procedures, and independently of it, due to advances in pedagogy the nature of the medical curriculum has also changed. Changes have been characterised by the use of problem-based learning, and an emphasis on self-directed learning, as well as an increase in interaction between the students in classe...

Research paper thumbnail of Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study

Research paper thumbnail of Rediscovering nursing: A study of overseas nurses working in Western Australia

Nursing & Health Sciences, 2011

The shortage of nurses worldwide has taken its toll on the Australian healthcare system and, as a... more The shortage of nurses worldwide has taken its toll on the Australian healthcare system and, as a result, there is an increased migration of overseas-qualified nurses, some of them with a non-English-speaking background. Despite Australia's regulations that assess the eligibility for nursing registration, many migrant nurses who have been successful in gaining their nursing license feel only partially prepared to work. This article presents the findings of a study, based on Husserlian phenomenology, that describes the work experience of 13 female nurses who were working in Western Australia, Australia. The participants, who could recognize the core components of nursing, were taken aback by the way that nursing is practised in Western Australia. The major differences that they encountered were related to clinical skills, holistic care, the work dynamic with doctors and patients, and the overall societal status of the nursing profession. As a result, they had to adjust their practice to conform to the new work environment. In this study, the participants elaborated on some positive and some not-so-positive aspects of their experiences in their endeavor to integrate into the Western Australian metropolitan hospital setting.

Research paper thumbnail of Selecting medical students: an Australian case study

The recognition that medical practitioners require more than simply a high level of academic abil... more The recognition that medical practitioners require more than simply a high level of academic ability to function successfully in their profession, together with a sharp increase in the number of academically qualified applicants to medical courses, has led to new ways of selecting medical students. Consequently the selection of students into the high-stakes course of medicine has become an area of considerable interest and research activity. The issues involved in selection are now prominent in the medical and medical education literature published in the UK, the USA, Australia, New Zealand and Canada, and in some European countries. At the same time as the introduction of new selection procedures, and independently of it, due to advances in pedagogy the nature of the medical curriculum has also changed. Changes have been characterised by the use of problem-based learning, and an emphasis on self-directed learning, as well as an increase in interaction between the students in classe...

Research paper thumbnail of Medical student selection criteria and socio-demographic factors as predictors of ultimately working rurally after graduation

BMC Medical Education, 2015

We have previously demonstrated that both coming from a rural background and spending a year-long... more We have previously demonstrated that both coming from a rural background and spending a year-long clinical rotation in our Rural Clinical School (RCS) have independent and additive effects to increase the likelihood of medical students practicing rurally following graduation. The current study assesses the extent to which medical school selection criteria and/or the socio-demographic profile of medical students may further facilitate or hamper the selection of students ultimately destined for the rural medical workforce. Methods: The study comprised 729 students, admitted from secondary school since 1999 and having graduated by 2011, whose actual workplace location in 2014 was classified as either urban or rural using the Australian Health Practitioner Regulation Agency database. Selection factors on entry (score from a standardised interview, percentile scores for the 3 components of the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance as assessed by the Australian Tertiary Admissions Rank) together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD)), were examined in relation to ultimate rural destination of practice.

Research paper thumbnail of Is midwifery competence affected by working in a Western Australian rural area

Women and Birth, 2013

To describe Western Australian (WA) midwives' perceptions of competence and continuing competence... more To describe Western Australian (WA) midwives' perceptions of competence and continuing competence and contrast these perceptions for midwives practicing in rural and low risk urban settings.

Research paper thumbnail of Relationship of selection criteria to subsequent academic performance in an Australian undergraduate dental school

European Journal of Dental Education, 2013

In 1998, in addition to previous academic achievement, an aptitude test (UMAT) and a structured i... more In 1998, in addition to previous academic achievement, an aptitude test (UMAT) and a structured interview were introduced into selection for the Bachelor of Dental Science (BDSc), the undergraduate dental course at the University of Western Australia. The aim of this study was to determine the relationship between the combination of school-leaver dental students' entry scores, some demographic characteristics and subsequent student performance in the undergraduate course. Three hundred and ninety-eight school-leavers who enrolled in the BDSc from 1999 through 2011 were studied. Regression models were constructed comprising entry scores, gender and age as predictors in relation to subsequent academic performance. The main outcome measure was the weighted average mark (WAM) for each of five academic year levels as well as results in specific units, defined as either 'knowledge' based or 'clinically' based. Of the variables studied, previous academic performance and female gender had the strongest relationship with yearly WAM for Years 1 through 4 and for both 'knowledge' based and 'clinically' based units. The interview score showed a strong relationship in the major clinical years and in a range of 'clinically' based units. UMAT scores were less consistent in relationship to WAM. These results support assessment through a highly structured interview together with prior academic achievement as an evidence-based approach to selection of students for this undergraduate dental course.

Research paper thumbnail of The positive impact of structured teaching in the operating room

The Australian & New Zealand journal of obstetrics & gynaecology, Jan 19, 2015

A survey of obstetric and gynaecology trainees in Australia found the trainee's opinion of th... more A survey of obstetric and gynaecology trainees in Australia found the trainee's opinion of the consultants' teaching ability for laparoscopic procedures and procedures dealing with complications as 'poor' in 21.2% and 23.4% of responses, respectively (Aust NZ J Obstet Gynaecol 2009; 49: 84). Surgical caseload per trainee is falling for a variety of reasons. Strategies need to be adopted to enhance the surgical learning experience of trainees in the operating room. We describe the use of a structured encounter template to facilitate the teaching of surgery in the operating room and report the response of the trainees to this intervention. Trainees attached to a gynaecologic surgery unit all underwent surgical training using a set format based on the surgical encounter template, including briefing, goal setting and intra-operative teaching aims as well as debriefing. Data on the trainees' experience and perception of their learning experience were then collected an...

Research paper thumbnail of Medical student selection criteria as predictors of intended rural practice following graduation

BMC Medical Education, 2014

Background: Recruiting medical students from a rural background, together with offering them oppo... more Background: Recruiting medical students from a rural background, together with offering them opportunities for prolonged immersion in rural clinical training environments, both lead to increased participation in the rural workforce after graduation. We have now assessed the extent to which medical students' intentions to practice rurally may also be predicted by either medical school selection criteria and/or student socio-demographic profiles. Methods: The study cohort included 538 secondary school-leaver entrants to The University of Western Australia Medical School from 2006 to 2011. On entry they completed a questionnaire indicating intention for either urban or rural practice following graduation. Selection factors (standardised interview score, percentile score from the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance (Australian Tertiary Admissions Rank), together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and an index of rurality) were examined in relation to intended rural or urban destination of practice.

Research paper thumbnail of Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study

Physiotherapy, 2014

The purpose of this study was to determine if there is an association between admission interview... more The purpose of this study was to determine if there is an association between admission interview score and subsequent academic and clinical performance, in a four-year undergraduate physiotherapy course. Retrospective observational study. 141 physiotherapy students enrolled in two entry year groups. Individual student performance in all course units, practical examinations, clinical placements as well as year level and overall Grade Point Average. Predictor variables included admission interview scores, admission academic scores and demographic data (gender, age and entry level). Interview score demonstrated a significant association with performance in three of six clinical placements through the course. This association was stronger than for any other admission criterion although effect sizes were small to moderate. Further, it was the only admission score to have a significant association with overall Clinical Grade Point Average for the two year groups analysed (r=0.322). By contrast, academic scores on entry showed significant associations with all year level Grade Point Averages except Year 4, the clinical year. This is the first study to review the predictive validity of an admission interview for entry into a physiotherapy course in Australia. The results show that performance in this admission interview is associated with overall performance in clinical placements through the course, while academic admission scoring is not. These findings suggest that there is a role for both academic and non-academic selection processes for entry into physiotherapy.

Research paper thumbnail of Admission selection criteria as predictors of outcomes in an undergraduate medical course: A prospective study

Medical Teacher, 2011

In 1998, a new selection process which utilised an aptitude test and an interview in addition to ... more In 1998, a new selection process which utilised an aptitude test and an interview in addition to previous academic achievement was introduced into an Australian undergraduate medical course. To test the outcomes of the selection criteria over an 11-year period. 1174 students who entered the course from secondary school and who enrolled in the MBBS from 1999 through 2009 were studied in relation to specific course outcomes. Regression analyses using entry scores, sex and age as independent variables were tested for their relative value in predicting subsequent academic performance in the 6-year course. The main outcome measures were assessed by weighted average mark for each academic year level; together with results in specific units, defined as either 'knowledge'-based or 'clinically' based. Previous academic performance and female sex were the major independent positive predictors of performance in the course. The interview score showed positive predictive power during the latter years of the course and in a range of 'clinically' based units. This relationship was mediated predominantly by the score for communication skills. Results support combining prior academic achievement with the assessment of communication skills in a structured interview as selection criteria into this undergraduate medical course.

Research paper thumbnail of Practice effects in medical school entrance testing with the undergraduate medicine and health sciences admission test (UMAT)

BMC Medical Education, 2014

Background: The UMAT is widely used for selection into undergraduate medical and dental courses i... more Background: The UMAT is widely used for selection into undergraduate medical and dental courses in Australia and New Zealand (NZ). It tests aptitudes thought to be especially relevant to medical studies and consists of 3 sectionslogical reasoning and problem solving (UMAT-1), understanding people (UMAT-2) and non-verbal reasoning (UMAT-3). A substantial proportion of all candidates re-sit the UMAT. Re-sitting raises the issue as to what might be the precise magnitude and determinants of any practice effects on the UMAT and their implications for equity in subsequent selection processes. Methods: Between 2000 and 2012, 158,909 UMAT assessments were completed. From these, 135,833 cases were identified where a candidate had sat once or more during that period with 117,505 cases (86.5%) having sat once, 14,739 having sat twice (10.9%), 2,752 thrice (2%) and 837, 4 or more times (0.6%). Subsequent analyses determined predictors of multiple re-sits as well as the magnitude and socio-demographic determinants of any practice effects.

Research paper thumbnail of Predicting academic outcomes in an Australian graduate entry medical programme

BMC Medical Education, 2014

Predictive validity studies for selection criteria into graduate entry courses in Australia have ... more Predictive validity studies for selection criteria into graduate entry courses in Australia have been inconsistent in their outcomes. One of the reasons for this inconsistency may have been failure to have adequately considered background disciplines of the graduates as well as other potential confounding socio-demographic variables that may influence academic performance. Graduate entrants into the MBBS at The University of Western Australia between 2005 and 2012 were studied (N = 421). They undertook a 6-month bridging course, before joining the undergraduate-entry students for Years 3 through 6 of the medical course. Students were selected using their undergraduate Grade Point Average (GPA), Graduate Australian Medical School Admissions Test scores (GAMSAT) and a score from a standardised interview. Students could apply from any background discipline and could also be selected through an alternative rural entry pathway again utilising these 3 entry scores. Entry scores, together with age, gender, discipline background, rural entry status and a socioeconomic indicator were entered into linear regression models to determine the relative influence of each predictor on subsequent academic performance in the course. Background discipline, age, gender and selection through the rural pathway were variously related to each of the 3 entry criteria. Their subsequent inclusion in linear regression models identified GPA at entry, being from a health/allied health background and total GAMSAT score as consistent independent predictors of stronger academic performance as measured by the weighted average mark for the core units completed throughout the course. The Interview score only weakly predicted performance later in the course and mainly in clinically-based units. The association of total GAMSAT score with academic performance was predominantly dictated by the score in GAMSAT Section 3 (Reasoning in the biological and physical sciences) with Section 1 (Reasoning in the humanities and social sciences) and Section 2 (Written communication) also contributing either later or early in the course respectively. Being from a more disadvantaged socioeconomic background predicted weaker academic performance early in the course. Being an older student at entry or from a humanities background also predicted weaker academic performance. This study confirms that both GPA at entry and the GAMSAT score together predict outcomes not only in the early stages of a graduate-entry medical programme but throughout the course. It also indicates that a comprehensive evaluation of the predictive validity of GAMSAT scores, interview scores and undergraduate academic performance as valid selection processes for graduate entry into medical school needs to simultaneously consider the potential confounding influence of graduate discipline background and other socio-demographic factors on both the initial selection parameters themselves as well as subsequent academic performance.

Research paper thumbnail of Potential influence of selection criteria on the demographic composition of students in an Australian medical school

BMC Medical Education, 2011

Background: Prior to 1999 students entering our MBBS course were selected on academic performance... more Background: Prior to 1999 students entering our MBBS course were selected on academic performance alone. We have now evaluated the impact on the demographics of subsequent cohorts of our standard entry students (those entering directly from high school) of the addition to the selection process of an aptitude test (UMAT), a highly structured interview and a rural incentive program. Methods: Students entering from 1985 to 1998, selected on academic performance alone (N = 1402), were compared to those from 1999 to 2011, selected on the basis of a combination of academic performance, interview score, and UMAT score together with the progressive introduction of a rural special entry pathway (N = 1437).

Research paper thumbnail of A seven-year retrospective analysis of students entering medicine via a Rural Student Recruitment program in Western Australia

Australian Journal of Rural Health, 2009

This research aimed to evaluate the effectiveness of the Rural Student Recruitment (RSR) program.... more This research aimed to evaluate the effectiveness of the Rural Student Recruitment (RSR) program. This program was an initiative to address the low number of rural students enrolled in medicine at the University of Western Australia. RSR identifies students throughout rural and remote areas of Australia interested in pursuing a career in medicine. The program provides support to these students through the various stages of the selection process and subsequently through the course. Medical School, the University of Western Australia. Rural students enrolled in medicine at the University of Western Australia. Of the 1591 participants in the RSR program, 11.6% have been successful in being offered a place. Participation was consistently higher for women, although men were proportionately more successful at gaining entry (14.5% versus 10.4%). It was found that the distribution of successful students in the RSR program generally reflects population density across rural Western Australia, with the majority of students coming from the South West, and the minority from the Pilbara and Kimberley. However, over the last three years (2006-2008) an increase in access from very remote regions was noted. This has been associated with a modification to the entry process that now includes a remoteness weighting for the secondary school attended. The conclusion from this analysis was that the RSR program in concert with refinements in entry criteria has been effective in increasing the number of medical students from a rural background.

Research paper thumbnail of GAMSAT: A 10-year retrospective overview, with detailed analysis of candidates’ performance in 2014

BMC Medical Education, 2015

The Graduate Australian Medical Schools Admission Test (GAMSAT) is undertaken annually in centres... more The Graduate Australian Medical Schools Admission Test (GAMSAT) is undertaken annually in centres around Australia and a small number of overseas locations. Most Australian graduate entry medical schools also use Grade Point Average and interview score for selection. The aim of this study was to review the performance of the GAMSAT over the last 10 years; the study provides an analysis of the impact of candidates' gender, age, language background, level of academic qualification and background discipline on performance; and details on the performance of higher-scoring candidates. These analyses were undertaken on the 2014 data; and trends in the data over the 10-year period are noted. In reviewing performance, the main variables considered were: - Overall GAMSAT score and scores for Section 1, Reasoning in Humanities and Social Sciences, Section 2, Written Communication, and Section 3, Reasoning in Biological and Physical Sciences. - Proportions of candidates achieving a Typical Entry Score. - Impact of gender, age, language background, level of academic qualification and undergraduate course (i.e. subject discipline) on test scores. Descriptive statistics and tests of significance were applied to determine the impact of demographic variables on performance. The number of candidates is increasing. Test reliability is consistently high. Higher scores overall are more likely for candidates who are male; are less than 24 years old; have an English-speaking background; have an Honours degree or a doctorate; and have completed a degree which is not health-related. Performance of the GAMSAT exam over the last 10 years has been stable with high reliability. There are significant variations in candidate performance related to age, gender, level and discipline of previous academic study and language background.

Research paper thumbnail of RESEARCH ARTICLE Open Access

Medical student selection criteria and socio-demographic factors as predictors of ultimately work... more Medical student selection criteria and socio-demographic factors as predictors of ultimately working rurally after graduation

Research paper thumbnail of Who gets in and who doesn't : Selecting medical students : An Australian Case Study

Education research and perspectives, 2009

Research paper thumbnail of Selecting medical students: an Australian case study

The recognition that medical practitioners require more than simply a high level of academic abil... more The recognition that medical practitioners require more than simply a high level of academic ability to function successfully in their profession, together with a sharp increase in the number of academically qualified applicants to medical courses, has led to new ways of selecting medical students. Consequently the selection of students into the high-stakes course of medicine has become an area of considerable interest and research activity. The issues involved in selection are now prominent in the medical and medical education literature published in the UK, the USA, Australia, New Zealand and Canada, and in some European countries. At the same time as the introduction of new selection procedures, and independently of it, due to advances in pedagogy the nature of the medical curriculum has also changed. Changes have been characterised by the use of problem-based learning, and an emphasis on self-directed learning, as well as an increase in interaction between the students in classe...

Research paper thumbnail of Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study

Research paper thumbnail of Rediscovering nursing: A study of overseas nurses working in Western Australia

Nursing & Health Sciences, 2011

The shortage of nurses worldwide has taken its toll on the Australian healthcare system and, as a... more The shortage of nurses worldwide has taken its toll on the Australian healthcare system and, as a result, there is an increased migration of overseas-qualified nurses, some of them with a non-English-speaking background. Despite Australia's regulations that assess the eligibility for nursing registration, many migrant nurses who have been successful in gaining their nursing license feel only partially prepared to work. This article presents the findings of a study, based on Husserlian phenomenology, that describes the work experience of 13 female nurses who were working in Western Australia, Australia. The participants, who could recognize the core components of nursing, were taken aback by the way that nursing is practised in Western Australia. The major differences that they encountered were related to clinical skills, holistic care, the work dynamic with doctors and patients, and the overall societal status of the nursing profession. As a result, they had to adjust their practice to conform to the new work environment. In this study, the participants elaborated on some positive and some not-so-positive aspects of their experiences in their endeavor to integrate into the Western Australian metropolitan hospital setting.

Research paper thumbnail of Selecting medical students: an Australian case study

The recognition that medical practitioners require more than simply a high level of academic abil... more The recognition that medical practitioners require more than simply a high level of academic ability to function successfully in their profession, together with a sharp increase in the number of academically qualified applicants to medical courses, has led to new ways of selecting medical students. Consequently the selection of students into the high-stakes course of medicine has become an area of considerable interest and research activity. The issues involved in selection are now prominent in the medical and medical education literature published in the UK, the USA, Australia, New Zealand and Canada, and in some European countries. At the same time as the introduction of new selection procedures, and independently of it, due to advances in pedagogy the nature of the medical curriculum has also changed. Changes have been characterised by the use of problem-based learning, and an emphasis on self-directed learning, as well as an increase in interaction between the students in classe...

Research paper thumbnail of Medical student selection criteria and socio-demographic factors as predictors of ultimately working rurally after graduation

BMC Medical Education, 2015

We have previously demonstrated that both coming from a rural background and spending a year-long... more We have previously demonstrated that both coming from a rural background and spending a year-long clinical rotation in our Rural Clinical School (RCS) have independent and additive effects to increase the likelihood of medical students practicing rurally following graduation. The current study assesses the extent to which medical school selection criteria and/or the socio-demographic profile of medical students may further facilitate or hamper the selection of students ultimately destined for the rural medical workforce. Methods: The study comprised 729 students, admitted from secondary school since 1999 and having graduated by 2011, whose actual workplace location in 2014 was classified as either urban or rural using the Australian Health Practitioner Regulation Agency database. Selection factors on entry (score from a standardised interview, percentile scores for the 3 components of the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance as assessed by the Australian Tertiary Admissions Rank) together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD)), were examined in relation to ultimate rural destination of practice.

Research paper thumbnail of Is midwifery competence affected by working in a Western Australian rural area

Women and Birth, 2013

To describe Western Australian (WA) midwives' perceptions of competence and continuing competence... more To describe Western Australian (WA) midwives' perceptions of competence and continuing competence and contrast these perceptions for midwives practicing in rural and low risk urban settings.

Research paper thumbnail of Relationship of selection criteria to subsequent academic performance in an Australian undergraduate dental school

European Journal of Dental Education, 2013

In 1998, in addition to previous academic achievement, an aptitude test (UMAT) and a structured i... more In 1998, in addition to previous academic achievement, an aptitude test (UMAT) and a structured interview were introduced into selection for the Bachelor of Dental Science (BDSc), the undergraduate dental course at the University of Western Australia. The aim of this study was to determine the relationship between the combination of school-leaver dental students' entry scores, some demographic characteristics and subsequent student performance in the undergraduate course. Three hundred and ninety-eight school-leavers who enrolled in the BDSc from 1999 through 2011 were studied. Regression models were constructed comprising entry scores, gender and age as predictors in relation to subsequent academic performance. The main outcome measure was the weighted average mark (WAM) for each of five academic year levels as well as results in specific units, defined as either 'knowledge' based or 'clinically' based. Of the variables studied, previous academic performance and female gender had the strongest relationship with yearly WAM for Years 1 through 4 and for both 'knowledge' based and 'clinically' based units. The interview score showed a strong relationship in the major clinical years and in a range of 'clinically' based units. UMAT scores were less consistent in relationship to WAM. These results support assessment through a highly structured interview together with prior academic achievement as an evidence-based approach to selection of students for this undergraduate dental course.

Research paper thumbnail of The positive impact of structured teaching in the operating room

The Australian & New Zealand journal of obstetrics & gynaecology, Jan 19, 2015

A survey of obstetric and gynaecology trainees in Australia found the trainee's opinion of th... more A survey of obstetric and gynaecology trainees in Australia found the trainee's opinion of the consultants' teaching ability for laparoscopic procedures and procedures dealing with complications as 'poor' in 21.2% and 23.4% of responses, respectively (Aust NZ J Obstet Gynaecol 2009; 49: 84). Surgical caseload per trainee is falling for a variety of reasons. Strategies need to be adopted to enhance the surgical learning experience of trainees in the operating room. We describe the use of a structured encounter template to facilitate the teaching of surgery in the operating room and report the response of the trainees to this intervention. Trainees attached to a gynaecologic surgery unit all underwent surgical training using a set format based on the surgical encounter template, including briefing, goal setting and intra-operative teaching aims as well as debriefing. Data on the trainees' experience and perception of their learning experience were then collected an...

Research paper thumbnail of Medical student selection criteria as predictors of intended rural practice following graduation

BMC Medical Education, 2014

Background: Recruiting medical students from a rural background, together with offering them oppo... more Background: Recruiting medical students from a rural background, together with offering them opportunities for prolonged immersion in rural clinical training environments, both lead to increased participation in the rural workforce after graduation. We have now assessed the extent to which medical students' intentions to practice rurally may also be predicted by either medical school selection criteria and/or student socio-demographic profiles. Methods: The study cohort included 538 secondary school-leaver entrants to The University of Western Australia Medical School from 2006 to 2011. On entry they completed a questionnaire indicating intention for either urban or rural practice following graduation. Selection factors (standardised interview score, percentile score from the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance (Australian Tertiary Admissions Rank), together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and an index of rurality) were examined in relation to intended rural or urban destination of practice.

Research paper thumbnail of Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study

Physiotherapy, 2014

The purpose of this study was to determine if there is an association between admission interview... more The purpose of this study was to determine if there is an association between admission interview score and subsequent academic and clinical performance, in a four-year undergraduate physiotherapy course. Retrospective observational study. 141 physiotherapy students enrolled in two entry year groups. Individual student performance in all course units, practical examinations, clinical placements as well as year level and overall Grade Point Average. Predictor variables included admission interview scores, admission academic scores and demographic data (gender, age and entry level). Interview score demonstrated a significant association with performance in three of six clinical placements through the course. This association was stronger than for any other admission criterion although effect sizes were small to moderate. Further, it was the only admission score to have a significant association with overall Clinical Grade Point Average for the two year groups analysed (r=0.322). By contrast, academic scores on entry showed significant associations with all year level Grade Point Averages except Year 4, the clinical year. This is the first study to review the predictive validity of an admission interview for entry into a physiotherapy course in Australia. The results show that performance in this admission interview is associated with overall performance in clinical placements through the course, while academic admission scoring is not. These findings suggest that there is a role for both academic and non-academic selection processes for entry into physiotherapy.

Research paper thumbnail of Admission selection criteria as predictors of outcomes in an undergraduate medical course: A prospective study

Medical Teacher, 2011

In 1998, a new selection process which utilised an aptitude test and an interview in addition to ... more In 1998, a new selection process which utilised an aptitude test and an interview in addition to previous academic achievement was introduced into an Australian undergraduate medical course. To test the outcomes of the selection criteria over an 11-year period. 1174 students who entered the course from secondary school and who enrolled in the MBBS from 1999 through 2009 were studied in relation to specific course outcomes. Regression analyses using entry scores, sex and age as independent variables were tested for their relative value in predicting subsequent academic performance in the 6-year course. The main outcome measures were assessed by weighted average mark for each academic year level; together with results in specific units, defined as either 'knowledge'-based or 'clinically' based. Previous academic performance and female sex were the major independent positive predictors of performance in the course. The interview score showed positive predictive power during the latter years of the course and in a range of 'clinically' based units. This relationship was mediated predominantly by the score for communication skills. Results support combining prior academic achievement with the assessment of communication skills in a structured interview as selection criteria into this undergraduate medical course.

Research paper thumbnail of Practice effects in medical school entrance testing with the undergraduate medicine and health sciences admission test (UMAT)

BMC Medical Education, 2014

Background: The UMAT is widely used for selection into undergraduate medical and dental courses i... more Background: The UMAT is widely used for selection into undergraduate medical and dental courses in Australia and New Zealand (NZ). It tests aptitudes thought to be especially relevant to medical studies and consists of 3 sectionslogical reasoning and problem solving (UMAT-1), understanding people (UMAT-2) and non-verbal reasoning (UMAT-3). A substantial proportion of all candidates re-sit the UMAT. Re-sitting raises the issue as to what might be the precise magnitude and determinants of any practice effects on the UMAT and their implications for equity in subsequent selection processes. Methods: Between 2000 and 2012, 158,909 UMAT assessments were completed. From these, 135,833 cases were identified where a candidate had sat once or more during that period with 117,505 cases (86.5%) having sat once, 14,739 having sat twice (10.9%), 2,752 thrice (2%) and 837, 4 or more times (0.6%). Subsequent analyses determined predictors of multiple re-sits as well as the magnitude and socio-demographic determinants of any practice effects.

Research paper thumbnail of Predicting academic outcomes in an Australian graduate entry medical programme

BMC Medical Education, 2014

Predictive validity studies for selection criteria into graduate entry courses in Australia have ... more Predictive validity studies for selection criteria into graduate entry courses in Australia have been inconsistent in their outcomes. One of the reasons for this inconsistency may have been failure to have adequately considered background disciplines of the graduates as well as other potential confounding socio-demographic variables that may influence academic performance. Graduate entrants into the MBBS at The University of Western Australia between 2005 and 2012 were studied (N = 421). They undertook a 6-month bridging course, before joining the undergraduate-entry students for Years 3 through 6 of the medical course. Students were selected using their undergraduate Grade Point Average (GPA), Graduate Australian Medical School Admissions Test scores (GAMSAT) and a score from a standardised interview. Students could apply from any background discipline and could also be selected through an alternative rural entry pathway again utilising these 3 entry scores. Entry scores, together with age, gender, discipline background, rural entry status and a socioeconomic indicator were entered into linear regression models to determine the relative influence of each predictor on subsequent academic performance in the course. Background discipline, age, gender and selection through the rural pathway were variously related to each of the 3 entry criteria. Their subsequent inclusion in linear regression models identified GPA at entry, being from a health/allied health background and total GAMSAT score as consistent independent predictors of stronger academic performance as measured by the weighted average mark for the core units completed throughout the course. The Interview score only weakly predicted performance later in the course and mainly in clinically-based units. The association of total GAMSAT score with academic performance was predominantly dictated by the score in GAMSAT Section 3 (Reasoning in the biological and physical sciences) with Section 1 (Reasoning in the humanities and social sciences) and Section 2 (Written communication) also contributing either later or early in the course respectively. Being from a more disadvantaged socioeconomic background predicted weaker academic performance early in the course. Being an older student at entry or from a humanities background also predicted weaker academic performance. This study confirms that both GPA at entry and the GAMSAT score together predict outcomes not only in the early stages of a graduate-entry medical programme but throughout the course. It also indicates that a comprehensive evaluation of the predictive validity of GAMSAT scores, interview scores and undergraduate academic performance as valid selection processes for graduate entry into medical school needs to simultaneously consider the potential confounding influence of graduate discipline background and other socio-demographic factors on both the initial selection parameters themselves as well as subsequent academic performance.

Research paper thumbnail of Potential influence of selection criteria on the demographic composition of students in an Australian medical school

BMC Medical Education, 2011

Background: Prior to 1999 students entering our MBBS course were selected on academic performance... more Background: Prior to 1999 students entering our MBBS course were selected on academic performance alone. We have now evaluated the impact on the demographics of subsequent cohorts of our standard entry students (those entering directly from high school) of the addition to the selection process of an aptitude test (UMAT), a highly structured interview and a rural incentive program. Methods: Students entering from 1985 to 1998, selected on academic performance alone (N = 1402), were compared to those from 1999 to 2011, selected on the basis of a combination of academic performance, interview score, and UMAT score together with the progressive introduction of a rural special entry pathway (N = 1437).

Research paper thumbnail of A seven-year retrospective analysis of students entering medicine via a Rural Student Recruitment program in Western Australia

Australian Journal of Rural Health, 2009

This research aimed to evaluate the effectiveness of the Rural Student Recruitment (RSR) program.... more This research aimed to evaluate the effectiveness of the Rural Student Recruitment (RSR) program. This program was an initiative to address the low number of rural students enrolled in medicine at the University of Western Australia. RSR identifies students throughout rural and remote areas of Australia interested in pursuing a career in medicine. The program provides support to these students through the various stages of the selection process and subsequently through the course. Medical School, the University of Western Australia. Rural students enrolled in medicine at the University of Western Australia. Of the 1591 participants in the RSR program, 11.6% have been successful in being offered a place. Participation was consistently higher for women, although men were proportionately more successful at gaining entry (14.5% versus 10.4%). It was found that the distribution of successful students in the RSR program generally reflects population density across rural Western Australia, with the majority of students coming from the South West, and the minority from the Pilbara and Kimberley. However, over the last three years (2006-2008) an increase in access from very remote regions was noted. This has been associated with a modification to the entry process that now includes a remoteness weighting for the secondary school attended. The conclusion from this analysis was that the RSR program in concert with refinements in entry criteria has been effective in increasing the number of medical students from a rural background.

Research paper thumbnail of GAMSAT: A 10-year retrospective overview, with detailed analysis of candidates’ performance in 2014

BMC Medical Education, 2015

The Graduate Australian Medical Schools Admission Test (GAMSAT) is undertaken annually in centres... more The Graduate Australian Medical Schools Admission Test (GAMSAT) is undertaken annually in centres around Australia and a small number of overseas locations. Most Australian graduate entry medical schools also use Grade Point Average and interview score for selection. The aim of this study was to review the performance of the GAMSAT over the last 10 years; the study provides an analysis of the impact of candidates' gender, age, language background, level of academic qualification and background discipline on performance; and details on the performance of higher-scoring candidates. These analyses were undertaken on the 2014 data; and trends in the data over the 10-year period are noted. In reviewing performance, the main variables considered were: - Overall GAMSAT score and scores for Section 1, Reasoning in Humanities and Social Sciences, Section 2, Written Communication, and Section 3, Reasoning in Biological and Physical Sciences. - Proportions of candidates achieving a Typical Entry Score. - Impact of gender, age, language background, level of academic qualification and undergraduate course (i.e. subject discipline) on test scores. Descriptive statistics and tests of significance were applied to determine the impact of demographic variables on performance. The number of candidates is increasing. Test reliability is consistently high. Higher scores overall are more likely for candidates who are male; are less than 24 years old; have an English-speaking background; have an Honours degree or a doctorate; and have completed a degree which is not health-related. Performance of the GAMSAT exam over the last 10 years has been stable with high reliability. There are significant variations in candidate performance related to age, gender, level and discipline of previous academic study and language background.