The ability of ‘non-cognitive’ traits to predict undergraduate performance in medical schools: a national linkage study

Gabrielle M. Finn, Lazaro Mwandigha, Lewis W. Paton, Paul A. Tiffin

In addition to the evaluation of educational attainment and intellectual ability there has been interest in the potential to select medical school applicants on non-academic qualities. Consequently, a battery of self-report measures concerned with assessing 'non-cognitive' traits was piloted as part of the UK Clinical Aptitude Test (UKCAT) administration to evaluate their potential to be used in selection. The four non-cognitive instruments piloted were: 1) the Libertarian-communitarian scale, (2) The NACE (narcissism, aloofness, confidence and empathy, (3) the MEARS (Managing emotions and resilience scale; self-esteem, optimism, control, self-discipline, emotional-nondefensiveness and faking, and (4) an abridged version of instruments (1) and (2) combined. Non-cognitive scores and sociodemographic characteristics were available for 14,387 applicants. A series of univariable and multivariable analyses were conducted in order to assess the ability of the non-cognitive scores to predict knowledge and skills-based performance, as well as the odds of passing each academic year at first attempt. Non-cognitive scores and medical performance were standardised within cohorts. The scores on the non-cognitive scales showed only very small (magnitude of standardised betas< 0.2), though sometimes statistically significant (p < 0.01) univariable associations with subsequent performance on knowledge or skills-based assessments. The only statistically significant association between the non-cognitive scores and the probability of passing an academic year at first attempt was the narcissism score from one the abridged tests (OR 0.84,95% confidence intervals 0.71 to 0.97, p = 0.02). Our findings are consistent with previously published research. The tests had a very limited ability to predict undergraduate academic performance, though further research on identifying narcissism in medical students may be warranted. However, the validity of such self-report tools in high-stakes settings may be affected, making such instruments unlikely to add value within the selection process.