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MCAT Communication Skills Test Development FAQWhat is the MCAT Communication Skills project? The MCAT Communication Skills Project is an attempt by the AAMC to assess the feasibility of measuring the communication skills of medical school applicants. Using input from medical school students, residents and faculty, AAMC researchers have identified assessment objectives for such a test. They have also developed video scenarios that portray various aspects of interpersonal communication situations, as well as test questions written to the assessment objectives and based on the scenarios. What are some of the assessment objectives? The preliminary test material is centered on three broad objectives: extracting, processing, and responding to information. Some specific assessment objectives include:
Who determined there was a need for this testing? The AAMC's interest in measuring personal characteristics dates back to the 1960s. A concern among medical professionals at that time was that throughout the medical education process, the measurement of "non-intellectual" characteristics was not recognized as being just as critical as the measurement of intellectual ability. By the 1970s, medical schools were attempting to measure non-intellectual characteristics, by then referred to as "non-cognitives," and AAMC was able to identify a common set of non-cognitives of interest to most of the schools. AAMC research slowed in the early 1980s. More recently, in the context of the growing commitment to professionalism and humanism in medical education, the medical education community has once again appealed to schools to balance the strong message it sends about "the importance of grades and test scores with more visible evidence of our co-equal interest in humanistic attributes." Aware of the shortcomings of admissions interviews, which sometimes yield vague impressions of applicants' personal characteristics, and unconvinced that the present "crude measures" are the ultimate evaluation tools, former AAMC president Jordan Cohen directed staff to try to devise better tools for evaluating applicants' personal characteristics, and has extended an invitation to medical schools to help create these new tools. The proposed communication skills project is aligned with the objectives of the Medical School Objectives Project (MSOP), which were defined with input from medical school deans and faculty across the U.S. Why Communication Skills? In keeping with the role of the MCAT—as a predictor of medical school grades and GPAs—AAMC thought it prudent to choose, as a starting focal point, a personal characteristic that seemed more easily measurable than some of the other characteristics under consideration, and also one that might yield scores that could be aligned with related medical school outcome measures not covered by the current MCAT. With the growing emphasis on humanism and professionalism in medicine, and the influence of the MSOP, 126 schools currently teach and assess communication skills in the first two years of medical school, either as separate required courses or as part of a required course. Performance on the MCAT communication skills component might also be a good correlate of success on the NBME clinical skills examination. What would this test look like? It would be a computer-based test, administered as a set of video scenarios followed by questions in a number of different question formats. The scenarios would be staged in a medical/teaching hospital setting, but questions would not require any specific medical knowledge of examinees. Examinees would indicate their responses using rating scales, rank ordering formats, multiple choice formats, and/or true-false formats. The MCAT communication skills component would be no more than 60 minutes long. What skills would an applicant have to have before medical school, and what might be learned during medical school? MCAT examinees would be expected to have communication skills that fall within the broad objectives of extracting information, processing information, and responding to information. Like the MCAT science content that is the basis of basic science in the first two years of medical school, the content specified by the MCAT communication skills objectives would precede the content defined by the objectives of medical school communication skills courses, for example, "developing an appreciation of the interpersonal and situational dynamics of medical encounters," as described by the MSOP. So this would assess examinees' skills. Doesn't that make the term "non-cogs" a misnomer? Yes, indeed. AAMC staff have abandoned the term "non-cognitives" and adopted instead, "personal characteristics," which appears to be a more positive descriptive term. How is AAMC seeking input from constituent groups? The AAMC established an MCAT Test Development Advisory Committee (TDAC) in 2001 to advise on the development of a test of communication skills. The seven-member committee includes representatives of various AAMC constituent groups: medical students, admissions officers, medical school faculty, practicing physicians, as well as undergraduate health professions advisors and expert pychometricians. In addition, staff have hosted focus groups aimed at getting feedback on preliminary test material. In these focus groups, pre-medical and medical school students, as well as residents, admissions officers and undergraduate health professions advisors have offered valuable suggestions for improving the preliminary test material. The TDAC and staff plan on hosting several other focus groups with constituent groups, at various stages of test development. How would this test help the admissions process? A standardized test that identifies students with poor or exceptional communication skills would be a valuable tool for medical school admission committees. The goal is to provide medical schools with a means of identifying applicants who either satisfy the traditional academic criteria, but show no "aptitude" for medical school communications courses; or those with just average performance in traditional academic subjects but with remarkable aptitude for medical school communications courses. How would this new component affect the cost of the MCAT? Would this create an additional barrier for certain applicants? The AAMC has been working on other changes to the MCAT that, if supported by research, would result in a substantial shortening of the current multiple choice and writing sections. Implementing these changes would then facilitate the inclusion of the communication skills component. The cost to examinees is still an unknown, but a determination of that cost, in relation to benefit, would be one of the factors that would influence a decision to implement the test. How might short-term test preparation, such as that offered by commercial companies, affect performance on the communication skills test? We have no idea at this point, but this is one of the threats to test validity that would have to be assessed. A communication skills test would have to meet the same high reliability and validity standards that distinguish the current MCAT. Who would decide whether to implement this form of assessment? Throughout the test development process, AAMC will continue to consult with constituent groups. If all test development issues are resolved and the project has sufficient support from all relevant stakeholder groups, MCAT staff would make a formal recommendation to the AAMC president to proceed. He, in concert with the Executive Council, would give final approval. Where can I find more information about AAMC's interest in pursuing communications skills testing? Sources include: Cohen, J., "Leadership for Medicine's Promising Future," Acad Med 1999; 73: 132-137 Cohen, J., "Our Compact with Tomorrow's Doctors," Acad Med 2002; 77: 475-480 Medical School Objectives Project
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