Evaluating the complementary roles of an SJT and academic assessment for entry into clinical practice

Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the complementary roles of academic and non-academic selection methods in predicting in-role performance. This is an important area of enquiry as despite it being common practice to use both types of methods within a selection system, there is currently no evidence that this approach translates into increased predictive validity of the selection system as a whole, over that achieved by the use of a single selection method. In this preliminary study, the majority of the range of scores achieved by successful applicants to the UK Foundation Programme provided a unique opportunity to address both of these areas of enquiry. Sampling targeted high (>80th percentile) and low (<20th percentile) scorers on the SJT. Supervisors rated 391 trainees' in-role performance, and incidence of remedial action was collected. SJT and academic performance scores correlated with supervisor ratings (r = .31 and .28, respectively). The relationship was stronger between the SJT and in-role performance for the low scoring group (r = .33, high scoring group r = .11), and between academic performance and in-role performance for the high scoring group (r = .29, low scoring group r = .11). Trainees with low SJT scores were almost five times more likely to receive remedial action. Results indicate that an SJT for entry into trainee physicians' first role in clinical practice has good predictive validity of supervisor-rated performance and incidence of remedial action. In addition, an SJT and a measure of academic performance appeared to be complementary to each other. These initial findings suggest that SJTs may be more predictive at the lower end of a scoring distribution, and academic attainment more predictive at the higher end.