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Incorporating a non-cognitive selection method in the residency program: the complexities of effective situational
Diantha Soemantri1, Syntia Nusanti1,2, Natalia Widiasih Raharjanti1,3
1Department of Medical Education, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Frontiers in Medicine
|April 6, 2026
Summary
This study examined the Situational Judgment Test (SJT) item writing process for Indonesian medical residency selection. Findings highlight the need for structured faculty development and continuous feedback to improve SJT validity and inclusivity.
Area of Science:
- Medical Education
- Psychometrics
- Healthcare Workforce Development
Background:
- Medical residency programs are increasingly adopting non-cognitive selection methods.
- Situational Judgment Tests (SJTs) offer a more inclusive approach to candidate assessment.
- Indonesia's accelerating residency training program necessitates refined selection tools.
Purpose of the Study:
- To map the content and characteristics of SJT items used in Indonesian medical residency selection.
- To identify potential biases and limitations in the SJT item writing process.
- To provide recommendations for improving SJT development for residency selection.
Main Methods:
- Twenty-one subject matter experts from 11 residency programs participated as item writers.
- Item writers developed 106 SJT scenarios and response options using a template after test specification development.
- Analysis included domain/content identification and assessment of potential gender, language, and sensitivity biases.
Main Results:
- Commitment to professionalism was the dominant domain in the 106 developed SJT scenarios.
- Scenarios were designed for neutrality regarding language, gender, and sensitivity, with lengths varying from 21 to 145 words.
- Identified drawbacks included an overemphasis on clinical decision-making, specific medical contexts, and insufficient scenario details.
Conclusions:
- Pitfalls such as construct irrelevance and lack of contextual detail were identified in the SJT writing process.
- Structured faculty development is essential to address nuances that could compromise test validity.
- Continuous support and feedback for item writers are crucial for the sustained development and adoption of SJTs in selection.
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