Recruiting for values in healthcare: a preliminary review of the evidence.

Displaying compassion, benevolence and respect, and preserving the dignity of patients are important for any healthcare professional to ensure the provision of high quality care and patient outcomes. This paper presents a structured search and thematic review of the research evidence relating to values-based recruitment within healthcare. Several different databases, journals and government reports were searched to retrieve studies relating to values-based recruitment published between 1998 and 2013, both in healthcare settings and other occupational contexts. There is limited published research related to values-based recruitment directly, so the available theoretical context of values is explored alongside an analysis of the impact of value congruence. The implications for the design of selection methods to measure values is explored beyond the scope of the initial literature search. Research suggests some selection methods may be appropriate for values-based recruitment, such as situational judgment tests (SJTs), structured interviews and multiple-mini interviews (MMIs). Personality tests were also identified as having the potential to compliment other methods (e.g. structured interviews), as part of a values-based recruitment agenda. Methods including personal statements, references and unstructured/'traditional' interviews were identified as inappropriate for values-based recruitment. Practical implications are discussed in the context of values-based recruitment in the healthcare context. Theoretical implications of our findings imply that prosocial implicit trait policies, which could be measured by selection tools such as SJTs and MMIs, may be linked to individuals' values via the behaviours individuals consider to be effective in given situations. Further research is required to state this conclusively however, and methods for values-based recruitment represent an exciting and relatively unchartered territory for further research.

Development of competency models for assessors and simulators in high-stakes selection processes.

BACKGROUND: Selection for entry into UK medical specialty training is a high-stakes, high-volume process. For selection into General Practice, a large number of assessors and simulators are involved in the delivery of the selection centre, which represents the final stage of selection. AIM: In order to standardize and quality-assure assessor and simulator involvement in the process, we developed two competency models outlining the knowledge, skills and attributes associated with each role using a previously validated job analysis methodology. RESULTS: The final qualitative analysis resulted in two competency models, each encompassing eight competency domains. In general, results from a validation questionnaire demonstrated positive feedback from various regional recruitment leads in the UK (n = 14). CONCLUSION: Both models are currently being used in practice for quality assurance and training purposes. We conclude that the competency models can be used in three ways: (1) recruiting assessors/simulators; (2) in measuring performance of assessors/simulators and highlighting areas for potential development; and (3) they can be used for training assessors/simulators.

Evaluating cognitive ability, knowledge tests and situational judgement tests for postgraduate selection.

OBJECTIVES: This study aimed to evaluate the validity and utility of and candidate reactions towards cognitive ability tests, and current selection methods, including a clinical problem-solving test (CPST) and a situational judgement test (SJT), for postgraduate selection. METHODS; This was an exploratory, longitudinal study to evaluate the validities of two cognitive ability tests (measuring general intelligence) compared with current selection tests, including a CPST and an SJT, in predicting performance at a subsequent selection centre (SC). Candidate reactions were evaluated immediately after test administration to examine face validity. Data were collected from candidates applying for entry into training in UK general practice (GP) during the 2009 recruitment process. Participants were junior doctors (n = 260). The mean age of participants was 30.9 years and 53.1% were female. Outcome measures were participants' scores on three job simulation exercises at the SC. RESULTS: Findings indicate that all tests measure overlapping constructs. Both the CPST and SJT independently predicted more variance than the cognitive ability test measuring non-verbal mental ability. The other cognitive ability test (measuring verbal, numerical and diagrammatic reasoning) had a predictive value similar to that of the CPST and added significant incremental validity in predicting performance on job simulations in an SC. The best single predictor of performance at the SC was the SJT. Candidate reactions were more positive towards the CPST and SJT than the cognitive ability tests. CONCLUSIONS: In terms of operational validity and candidate acceptance, the combination of the current CPST and SJT proved to be the most effective administration of tests in predicting selection outcomes. In terms of construct validity, the SJT measures procedural knowledge in addition to aspects of declarative knowledge and fluid abilities and is the best single predictor of performance in the SC. Further research should consider the validity of the tests in this study in predicting subsequent performance in training.

Evaluations of situational judgement tests to assess non-academic attributes in selection.

OBJECTIVES: This paper presents a systematic review of the emerging international research evidence for the use of situational judgement tests (SJTs) for testing important non-academic attributes (such as empathy, integrity and resilience) in selection processes. METHODS: Several databases (e.g. MEDLINE, PsycINFO, Web of Science) were searched to retrieve empirical studies relating to SJTs published between 1990 and 2010. Personal contact with experts in the field was made to identify any unpublished research or work in progress to obtain the most current material. Finally, reference lists were checked to access other relevant journal articles and further research. All research studies were required to meet specific inclusion criteria selected by two independent reviewers. RESULTS: Over 1000 citations were identified during the initial literature search; following the review of abstracts, full-text copies of 76 articles were retrieved and evaluated. A total of 39 articles that adequately met the inclusion criteria were included in the final review. The research evidence shows that, compared with personality and IQ tests, SJTs have good levels of reliability, predictive validity and incremental validity for testing a range of professional attributes, such as empathy and integrity. CONCLUSIONS: SJTs can be designed to test a broad range of non-academic constructs depending on the selection context. As a relatively low-fidelity assessment, SJTs are a cost-efficient methodology compared with high-fidelity assessments of non-academic attributes, such as those used in objective structured clinical examinations. In general, SJTs are found to demonstrate less adverse impact than IQ tests and are positively received by candidates. Further research is required to explore theoretical developments and the underlying construct validity of SJTs.

'Care about my animal, know your stuff and take me seriously': United Kingdom and Australian clients' views on the capabilities most important in their veterinarians.

Success in veterinary practice requires careful balancing of stakeholder needs. The aim of this study was to investigate the current expectations and needs of veterinary clients across a range of practice types. Interviews and focus groups were undertaken with veterinary clients to identify the capabilities of veterinarians that result in the best client experience, generating a 'Veterinary Capability Framework'. This comprised six main capabilities each containing 4-10 behavioural indicators: client relationships; professionalism; communication skills; decision-making and problem solving; commitment to animal welfare; and commitment to quality and the profession. An online survey was then conducted to validate the importance of these capabilities, which was completed by 1446 mostly UK and Australian clients. The data have allowed us to develop a 'Client Hierarchy of Needs' which emphasises the fundamental importance of commitment to animal welfare and veterinary capabilities to the client experience. This study is part of the VetSet2Go project, a collaborative international project to define the capabilities most important for employability and success in the veterinary profession today.

Developing national selection processes for entry into postgraduate specialty training: the case of trauma and orthopedics in the United Kingdom.

A large body of international research has been done investigating best practice selection across many occupational groups, but there is relatively little research on developing selection methodology for entry to postgraduate training. Hitherto, various selection processes have been used, some of which relied heavily on patronage. Developments in Medical Education, including curriculum design, formal work-based place assessment, alongside the introduction of MMC (Modernizing Medical Careers) paved the way for significant change. Trauma and orthopedics in England is the last surgical specialty to adopt National Selection and did so first in 2013. This paper sets out that journey, the implementation of National selection in 2013, what has been learned, and our goals for the future.

The predictive validity of selection for entry into postgraduate training in general practice: evidence from three longitudinal studies.

BACKGROUND: The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study AIM: To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. DESIGN AND SETTING: A three-part longitudinal predictive validity study of selection into training for UK general practice. METHOD: In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). RESULTS: Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. CONCLUSION: In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered.

A new competency model for general practice: implications for selection, training, and careers.

BACKGROUND: Recent structural and policy changes in the UK health service have significantly changed the job responsibilities for the GP role. AIM: To replicate a previous job analysis study to examine the relevance of current competency domains and selection criteria for doctors entering training. DESIGN AND METHOD: A multisource, multimethod approach comprising three phases: (1) stakeholder consultation (n = 205) using interviews, focus groups and behavioural observation of practising GPs; (2) a validation questionnaire based on results from phase 1 (n = 1082); followed by (3) an expert panel (n = 6) to review and confirm the final competency domains. RESULTS: Eleven competency domains were identified, which extends previous research findings. A new domain was identified called Leading for Continuing Improvement. Results show that, Empathy and Perspective Taking, Communication Skills, Clinical Knowledge and Expertise, and Professional Integrity are currently rated the most important domains. Results indicate a significant increase in ratings of importance for each domain in the future (P<0.001), except for Communication Skills and Empathy and Perspective Taking, which consistently remain high. CONCLUSION: The breadth of competencies required for GPs has increased significantly. GPs are now required to resolve competing tensions to be effective in their role, such as maintaining a patient focus while overseeing commissioning, with a potential ethical conflict between these aspects. Selection criteria remain largely unchanged but with increased priority in some domains (for example, Effective Teamworking). However, there is an urgent need to review the training provision arrangements to reflect the greater breadth of competencies now required.