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

Background: 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. Methods: 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. Results: 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). Conclusions: 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.