Journal of Educational Evaluation for Health Professions

Reviews

Socioeconomic and economic factors affecting access and progression in medical schools: a systematic review and meta-analysis: Arash Arianpoor, Alexia Pena, Annette Mercer, Jennifer Cox, Dimitra Lekkas, Francis Ruel Geronimo, Heidi Waldron, John Randal, Marcus Dabner, Marita Lynagh, Nalini Pather, Nicole Shepherd, Nigel Robb, Rose Berdin, Tim Wilkinson, Wendy Hu, Boaz Shulruf, Pin-Hsiang Huang; J Educ Eval Health Prof. 2026;23:6. Published online April 16, 2026; DOI: https://doi.org/10.3352/jeehp.2026.23.6

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Abstract PDF Supplementary Material: Purpose
Socioeconomic disadvantage remains a major determinant of equitable access to, and progression within, medical education. This systematic review and meta-analysis examines both the impact and the magnitude of financial and economic disadvantage on student selection and progression in medical school.
Methods
Studies were included if they reported associations between socioeconomic indicators (e.g., parental income, occupation, education, geographic deprivation, or premedical debt) and selection or progression outcomes, and were excluded if they lacked clearly defined economic predictors or sufficient data for binary effect sizes. Searches were conducted across PubMed, Scopus, ERIC, Embase, ProQuest, and EBSCO (2005–2025). Study selection employed an active machine-learning screening process. Extracted data included sample characteristics, socioeconomic measures, and outcome types, with risk of bias assessed using the Risk of Bias Instrument. Random-effects meta-analysis was conducted where appropriate.
Results
Thirty-two studies of medical programs were included, yielding 28 effect sizes for selection and 9 for progression. Household economic and educational disadvantage, identified through parental indices, was consistently associated with reduced odds of admission (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.55–0.65) and poorer progression (OR, 0.56; 95% CI, 0.53–0.59). Geographic deprivation also exerted a negative effect, particularly on selection (OR, 0.69; 95% CI, 0.5–0.93).
Conclusion
Socioeconomic disadvantage exerts a pervasive influence across the medical education continuum. Addressing these inequities requires sustained financial, academic, and psychosocial support both before and during their studies. Students’ economic circumstances should therefore be considered in medical school selection policy and curriculum development to further enhance equity within medical schools and the profession.

Insights into undergraduate medical student selection tools: a systematic review and meta-analysis: Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf; J Educ Eval Health Prof. 2024;21:22. Published online September 12, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.22; Correction in: J Educ Eval Health Prof 2024;21(0):41

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Purpose
Evaluating medical school selection tools is vital for evidence-based student selection. With previous reviews revealing knowledge gaps, this meta-analysis offers insights into the effectiveness of these selection tools.
Methods
A systematic review and meta-analysis were conducted applying the following criteria: peer-reviewed articles available in English, published from 2010 and which include empirical data linking performance in selection tools with assessment and dropout outcomes of undergraduate entry medical programs. Systematic reviews, meta-analyses, general opinion pieces, or commentaries were excluded. Effect sizes (ESs) of the predictability of academic and clinical performance within and by the end of the medicine program were extracted, and the pooled ESs were presented.
Results
Sixty-seven out of 2,212 articles were included, which yielded 236 ESs. Previous academic achievement predicted medical program academic performance (Cohen’s d=0.697 in early program; 0.619 in end of program) and clinical exams (0.545 in end of program). Within aptitude tests, verbal reasoning and quantitative reasoning predicted academic achievement in the early program and in the last years (0.704 & 0.643, respectively). Overall aptitude tests predicted academic achievement in both the early and last years (0.550 & 0.371, respectively). Neither panel interviews, multiple mini-interviews, nor situational judgement tests (SJT) yielded statistically significant pooled ES.
Conclusion
Current evidence suggests that learning outcomes are predicted by previous academic achievement and aptitude tests. The predictive value of SJT and topics such as selection algorithms, features of interview (e.g., content of the questions) and the way the interviewers’ reports are used, warrant further research.

Citations

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A Qualitative Study of a New Generation of Irish-Trained Doctors’ Views on Selection for Medicine
Seán Barber, Deirdre Bennett
MedEdPublish.2026; 16: 3. CrossRef
Facilitators and barriers along the pathways from secondary school to medical programmes- results from a national longitudinal study in Aotearoa New Zealand
Sarah Randal, Tim J. Wilkinson, Phillippa Poole, John Randal, Boaz Shulruf
Advances in Health Sciences Education.2026;[Epub] CrossRef
Transparency of Alpha Omega Alpha Selection Processes and Bias Mitigation Across US Medical Schools: A Cross-Sectional Mixed Methods Study
Christine C. Cheston, Neeharika Chanda, Sorraya Jaiprasert, Liam F. Keohane
Journal of General Internal Medicine.2026;[Epub] CrossRef
Predictive Validity of Pre-Clinical Academic Achievements in Comprehensive Basic Science Examination: A Nationwide Cohort of Iranian Medical Students
Farhang Rashidi, Reza Sattarpour, Alipasha Meysamie
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Notice of Retraction and Replacement: Insights into undergraduate medical student selection tools: a systematic review and meta-analysis
Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf
Journal of Educational Evaluation for Health Professions.2024; 21: 41. CrossRef

Research articles

Medical student selection process enhanced by improving selection algorithms and changing the focus of interviews in Australia: a descriptive study: Boaz Shulruf, Gary Mayer Velan, Sean Edward Kennedy; J Educ Eval Health Prof. 2022;19:31. Published online November 28, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.31

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Abstract PDF Supplementary Material

Purpose
The study investigates the efficacy of new features introduced to the selection process for medical school at the University of New South Wales, Australia: (1) considering the relative ranks rather than scores of the Undergraduate Medicine and Health Sciences Admission Test and Australian Tertiary Admission Rank; (2) structured interview focusing on interpersonal interaction and concerns should the applicants become students; and (3) embracing interviewers’ diverse perspectives.
Methods
Data from 5 cohorts of students were analyzed, comparing outcomes of the second year in the medicine program of 4 cohorts of the old selection process and 1 of the new process. The main analysis comprised multiple linear regression models for predicting academic, clinical, and professional outcomes, by section tools and demographic variables.
Results
Selection interview marks from the new interview (512 applicants, 2 interviewers each) were analyzed for inter-rater reliability, which identified a high level of agreement (kappa=0.639). No such analysis was possible for the old interview since it required interviewers to reach a consensus. Multivariate linear regression models utilizing outcomes for 5 cohorts (N=905) revealed that the new selection process was much more effective in predicting academic and clinical achievement in the program (R2=9.4%–17.8% vs. R2=1.5%–8.4%).
Conclusion
The results suggest that the medical student selection process can be significantly enhanced by employing a non-compensatory selection algorithm; and using a structured interview focusing on interpersonal interaction and concerns should the applicants become students; as well as embracing interviewers’ diverse perspectives.

Citations

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Creating Medical Education Enhancement Training for Medical Students
Betty S. Chan, Marian Lee, Lucy S. R. Jo, Boaz Shulruf, Adrienne Torda
The Clinical Teacher.2026;[Epub] CrossRef
Medical student selection interviews: insights into nonverbal observable communications: a cross-sectional study
Pin-Hsiang Huang, Kang-Chen Fan, Alexander Waits, Boaz Shulruf, Yi-Fang Chuang
Korean Journal of Medical Education.2025; 37(2): 153. CrossRef
Insights into undergraduate medical student selection tools: a systematic review and meta-analysis
Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf
Journal of Educational Evaluation for Health Professions.2024; 21: 22. CrossRef

A novel tool for evaluating non-cognitive traits of doctor of physical therapy learners in the United States: Marcus Roll, Lara Canham, Paul Salamh, Kyle Covington, Corey Simon, Chad Cook; J Educ Eval Health Prof. 2018;15:19. Published online August 17, 2018; DOI: https://doi.org/10.3352/jeehp.2018.15.19

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Abstract PDF Supplementary Material

Purpose
The primary aim of this study was to develop a survey addressing an individual’s non-cognitive traits, such as emotional intelligence, interpersonal skills, social intelligence, psychological flexibility, and grit. Such a tool would provide beneficial information for the continued development of admissions standards and would help better capture the full breadth of experience and capabilities of applicants applying to doctor of physical therapy (DPT) programs.
Methods
This was a cross-sectional survey study involving learners in DPT programs at 3 academic institutions in the United States. A survey was developed based on established non-proprietary, non-cognitive measures affiliated with success and resilience. The survey was assessed for face validity, and exploratory factor analysis (EFA) was used to identify subgroups of factors based on responses to the items.
Results
A total of 298 participants (90.3%) completed all elements of the survey. EFA yielded 39 items for dimensional assessment with regression coefficients < 0.4. Within the 39 items, 3 latent constructs were identified: adaptability (16 items), intuitiveness (12 items), and engagement (11 items).
Conclusion
This preliminary non-cognitive assessment survey will be able to play a valuable role in DPT admissions decisions following further examination and refinement.

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Kelly Reynolds, Maggie Horn, Karen Huhn, Steven George
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An exploration of the relationship between grit, reflection-in-learning, and academic performance in entry-level doctor of physical therapy students
Elizabeth M Ardolino, Hazel Anderson, Katherine F Wilford
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Emotional intelligence evaluation tools used in allied health students: A scoping review
Debra Lee, Tracy Burrows, Daphne James, Ross Wilkinson, Yolanda Surjan
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Change in metacognitive traits in Doctor of physical therapy students over the first year of entry-level education
Jason Bartley, Tyler Miller, Ayodeji Famuyide, Jodi L. Young, Rebecca Bliss
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A Systematic Review of Variables Used in Physical Therapist Education Program Admissions Part 2: Noncognitive Variables
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Personal characteristic differences among Doctor of Physical Therapy students with unique sociodemographic factors
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Journal of Physical Therapy Education.2022; 36(3): 225. CrossRef
Grit, Resilience, Mindset, and Academic Success in Physical Therapist Students: A Cross-Sectional, Multicenter Study
Marlena Calo, Belinda Judd, Lucy Chipchase, Felicity Blackstock, Casey L Peiris
Physical Therapy.2022;[Epub] CrossRef
Predicting graduate student performance – A case study
Jinghua Nie, Ashrafee Hossain
Journal of Further and Higher Education.2021; 45(4): 524. CrossRef
Examining Demographic and Preadmission Factors Predictive of First Year and Overall Program Success in a Public Physical Therapist Education Program
Katy Mitchell, Jennifer Ellison, Elke Schaumberg, Peggy Gleeson, Christina Bickley, Anna Naiki, Severin Travis
Journal of Physical Therapy Education.2021; 35(3): 203. CrossRef
Doctor of Physical Therapy Student Grit as a Predictor of Academic Success: A Pilot Study
Rebecca Bliss, Erin Jacobson
Health Professions Education.2020; 6(4): 522. CrossRef
Personality-oriented job analysis to identify non-cognitive factors predictive of performance in a doctor of physical therapy program in the United States
Maureen Conard, Kristin Schweizer
Journal of Educational Evaluation for Health Professions.2018; 15: 34. CrossRef

Research Article

Developing a situational judgment test blueprint for assessing the non-cognitive skills of applicants to the University of Utah School of Medicine, the United States: Jorie M. Colbert-Getz, Karly Pippitt, Benjamin Chan; J Educ Eval Health Prof. 2015;12:51. Published online October 31, 2015; DOI: https://doi.org/10.3352/jeehp.2015.12.51

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Abstract PDF

Purpose
The situational judgment test (SJT) shows promise for assessing the non-cognitive skills of medical school applicants, but has only been used in Europe. Since the admissions processes and education levels of applicants to medical school are different in the United States and in Europe, it is necessary to obtain validity evidence of the SJT based on a sample of United States applicants. Methods: Ninety SJT items were developed and Kane’s validity framework was used to create a test blueprint. A total of 489 applicants selected for assessment/interview day at the University of Utah School of Medicine during the 2014-2015 admissions cycle completed one of five SJTs, which assessed professionalism, coping with pressure, communication, patient focus, and teamwork. Item difficulty, each item’s discrimination index, internal consistency, and the categorization of items by two experts were used to create the test blueprint. Results: The majority of item scores were within an acceptable range of difficulty, as measured by the difficulty index (0.50-0.85) and had fair to good discrimination. However, internal consistency was low for each domain, and 63% of items appeared to assess multiple domains. The concordance of categorization between the two educational experts ranged from 24% to 76% across the five domains. Conclusion: The results of this study will help medical school admissions departments determine how to begin constructing a SJT. Further testing with a more representative sample is needed to determine if the SJT is a useful assessment tool for measuring the non-cognitive skills of medical school applicants.

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Adanna Chukwuma, Uche Obi, Ifunanya Agu, Chinyere Mbachu
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Situational judgment test validity: an exploratory model of the participant response process using cognitive and think-aloud interviews
Michael D. Wolcott, Nikki G. Lobczowski, Jacqueline M. Zeeman, Jacqueline E. McLaughlin
BMC Medical Education.2020;[Epub] CrossRef
Computerized test versus personal interview as admission methods for graduate nursing studies: A retrospective cohort study
Koren Hazut, Pnina Romem, Smadar Malkin, Ilana Livshiz‐Riven
Nursing & Health Sciences.2016; 18(4): 503. CrossRef

Review Article

Imperfect physician assistant and physical therapist admissions processes in the United States: Phillip Eugene Jones, Susan Simpkins, Jennie Alicea Hocking; J Educ Eval Health Prof. 2014;11:11. Published online May 9, 2014; DOI: https://doi.org/10.3352/jeehp.2014.11.11

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Abstract PDF

We compared and contrasted physician assistant and physical therapy profession admissions processes based on the similar number of accredited programs in the United States and the co-existence of many programs in the same school of health professions, because both professions conduct similar centralized application procedures administered by the same organization. Many studies are critical of the fallibility and inadequate scientific rigor of the high-stakes nature of health professions admissions decisions, yet typical admission processes remain very similar. Cognitive variables, most notably undergraduate grade point averages, have been shown to be the best predictors of academic achievement in the health professions. The variability of non-cognitive attributes assessed and the methods used to measure them have come under increasing scrutiny in the literature. The variance in health professions students’ performance in the classroom and on certifying examinations remains unexplained, and cognitive considerations vary considerably between and among programs that describe them. One uncertainty resulting from this review is whether or not desired candidate attributes highly sought after by individual programs are more student-centered or graduate-centered. Based on the findings from the literature, we suggest that student success in the classroom versus the clinic is based on a different set of variables. Given the range of positions and general lack of reliability and validity in studies of non-cognitive admissions attributes, we think that health professions admissions processes remain imperfect works in progress.

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