Elam, C.L., Stratton, T.D. Wilson, J.F. & Scott, K.L. (2002). How Admission Committees Decide: Influence of Committee Members' Experience and Applicants' Academic Characteristics. Academic Medicine, 77, S26-S28.

PURPOSE: At our institution, admission committee members are expected to review the materials of all interviewed applicants prior to group consideration of the files. Members formulate an overall impression of each applicant's suitability for medicine and for admission to our institution, and are prepared to discuss each application at the committee meeting. Thus, they formulate two consecutive impressions -the first following preliminary review of the file, and the second after committee deliberation. This study focused on vote-changing behavior as one tangible outcome of a deliberative process; we did not seek to evaluate the content or efficacy of that process. Instead, we were curious whether committee members' background characteristics were associated with their propensities to change votes in a context that allowed for deliberation about applicants. Conversely, we also wondered whether academic characteristics of applicants were linked to members' vote-changing behaviors. We posited the following research questions: (1) What background characteristics distinguish committee members who are more (or less) likely to change votes? (2) Is unanimity of voting after preliminary file review related to the likelihood of vote changing after committee deliberation? (3) Are low interview scores, science or non-science GPAs, and MCAT scores associated with a greater likelihood of vote change following committee deliberation?

METHOD: Application files for 608 applicants receiving interviews during the 1999 and 2000 application cycles were examined. Complete data were available for 597 applicants. The following data were examined for each applicant: undergraduate science and non-science GPAs, MCAT score (defined as lowest Verbal Reasoning, Biological Science, or Physical Science score on a 1-15 scale), and interview rating (defined as lowest of two interview scores on a 1-10 scale). Lowest MCAT and interview scores were used to better represent committee cues or flags. The committee members' backgrounds (faculty, student, administrator/community member) and years of committee service (five years) were also recorded. Simple univariate statistics were used to describe the committee characteristics, frequency, and nature of committee members' vote-changing behaviors. Multiple regression analysis was used to examine the relationship between committee members' characteristics and vote-changing behaviors, and logistic regression was used to examine the association between "low" academic indicators and the probability of vote change following deliberation. Analyses were performed on the two combined applicant cohorts, with year as a control variable.

RESULTS: Using multiple regression analysis, we examined the influences of length of committee service and background of committee member on vote-changing frequency. The two dependent variables for the regression analysis were: (1) percentage of times a committee member's vote changed in a negative direction (from accept to hold/reject, or from hold to reject); and (2) the percentage of times a committee member's vote changed in a positive direction (from reject to hold/accept or hold to accept). Negative vote changes occurred equally among the three categories (i.e., faculty, student, and administrative/community members). However, students were more likely than faculty members and administrator/community members to change in a positive direction. Similarly, faculty members were more likely than administrative/community members to change in a positive direction. More experienced committee members, with five or more years of service, were also significantly more likely to change votes in a positive direction than were less experienced committee members, but equally likely to change votes in a negative direction. Second, we compared the unanimity of members' votes after preliminary review of the file with that following committee deliberation. We defined substantial vote change as more than one committee member's changing votes from after review to after deliberation. This occurred for 46% of the applicants (275/597). Deliberation plays a much more important role when there is less consensus regarding applicants' overall suitability after the file review. Finally, we used logistic regression to examine the likelihood of substantial vote change following deliberation when an applicant had one low interview score, one low MCAT subscore (<8, 23.2%), or a low science or non-science GPA (<3.25, 24.0%). The likelihood of a substantial (>1) vote change was significantly more likely when a candidate had a low interview score. Low GPAs and low MCAT scores were not statistically significant predictors of substantial vote change.

CONCLUSION: The findings suggest that experienced committee members-as well as faculty and student members-are more likely to change their votes in a positive direction following deliberation. Committee factors were not associated with likelihood of negative vote change. We believe deliberation may provide an opportunity for the expression of individual committee members' concerns about applicants, ultimately leading to more informed decisions. The observation that experienced committee members (>five years) were more fluid in their votes than were their less experienced counter-parts (less than five years) supports this contention. However, we also believe that vote change following discussion reflects a cultivated group atmosphere values diverse interpretations of information from applicants' dossiers. In sense, could be considered one indication well-functioning group

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