Medics’ test may misread empathy

A test used to help select medical students may not be properly predicting the levels of empathy it intends to identify in applicants, a study has found.

Medics’ test may misread empathy

Research at University College Cork raised questions about the Health Professions Admissions Test (HPAT).

It was introduced in 2009 as an additional factor to Leaving Certificate results when picking entrants to the five main undergraduate medical schools, including the one at UCC which admits around 100 school leavers every year.

The Central Applications Office (CAO) combines HPAT results and points from Leaving Certificate grades to rank applicants to each undergraduate medicine degree.

As well as aiming to broaden access and rely on more than just academic strengths, HPAT was intended to identify characteristics sought in prospective doctors, such as good bedside manner and communication.

The three main test sections are designed to measure logical reasoning and problem-solving, interpersonal understanding, and non-verbal reasoning.

The UCC study set out to assess if performance in any of the HPAT sections, particularly that of interpersonal understanding, would co-relate with self-reported empathy levels in undergraduate medical students. The results and analysis have now been published in the British Medical Journal.

The HPAT scores of 263 students were compared with their responses to questionnaires measuring empathy, completed during the 2014/15 academic year. There were even numbers of male and female students, and between 45% and 71% of students took part from each year of the five-year undergraduate medicine degree course.

The responses to the questionnaire were assessed with the widely used Jefferson Scale of Physician Empathy, for studying empathy in clinicians and medical students. These scores were comparable among recent entrants and those near graduation at UCC’s medical school, and disagreed with previous studies that point to empathy levels diminishing during medical studies.

Crucially, the study failed to show any association between HPAT scores, including measurement of interpersonal understanding, and individual variation on the Jefferson scale.

“These results... add to a growing literature questioning the validity of the HPAT-Ireland test as a selection tool,” wrote Donnchadh O’Sullivan and co-authors from the UCC school of medicine, and its departments of general practice, and epidemiology and public health.

A previous study by Irish researchers in 2012 found there was no relationship between HPAT scores and those on tests for communication and clinical skills with first-year medical students.

The other authors of the journal article from UCC are Joseph Moran (general practice department), Paul Corcoran (epidemiology), and Siun O’Flynn, Colm O’Tuathaigh, and Aoife O’Sullivan of the school of medicine.

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