Friday 20 October 2017

'No evidence HPAT exam is doing what it was designed for' - study

(Stock photo)
(Stock photo)
Ralph Riegel

Ralph Riegel

A NEW study has found no evidence that a test specifically designed to assist Irish people with strong interpersonal skills and empathy to enter the medical profession is doing what it was designed for.

The examination, the Health Professions Admissions Test (HPAT), was introduced in 2009 in a bid to widen the entry access to medical courses in Ireland.

It was introduced amid concern that the old entry requirements for medical degrees were effectively limiting the profession to the very top Leaving Cert performers - and that some, whose empathy and interpersonal skill levels might make them ideal doctors, were being excluded.

The HPAT was introduced in a bid to identify and assist those students - and those wishing to study medicine must now sit both the HPAT and their Leaving Cert.

The HPAT's own website stressed that it: "Measures a candidate’s logical reasoning and problem solving skills, nonverbal reasoning and the ability to understand the thoughts, behaviour and/or intentions of people."

Entry into various medical degree courses in Dublin, Cork and Galway is assessed on the combined HPAT and Leaving Cert scores.

However, as early as 2012, concerns were raised that the HPAT was not doing what it was introduced for.

In fact, some critics claimed it offered an unfair advantage to students whose families could afford to pay for expensive preparatory and repeat courses, some of which cost close to €1,000.

Now, a new study has further underlined concerns about precisely what the HPAT has achieved.

The study, published in the British Medical Journal Open (BMJO), was conducted at University College Cork (UCC) across 290 medical students.

It found, having assessed the 290 students and their relevant 262 HPAT scores, that there was absolutely no evidence that HPAT scores correlated with physician empathy assessments under the widely-accepted Jefferson Scale.

"This study suggests no clear link between scores on a selection test, the HPAT-Ireland, which is designed to assess several skill domains including interpersonal skills, and scores on a psychometric measure of empathy, at any point during medical education," the study concluded.

The study was conducted by Dr Donnchadh O'Sullivan, Dr Joseph Moran, Dr Paul Corcoran, Dr Siun O'Flynn, Dr Colm O'Tuathaigh and Dr Aoife O'Sullivan.

Only undergraduate students who had recently completed the HPAT were assessed.

"Empathy is an essential skill needed to become a good doctor. It's imperative to have an admissions test that assesses empathy," Dr O'Sullivan said.

The ability to understand the thoughts, behaviour and even intentions of people is in essence empathy.

They study found that, across the HPAT's section one and three elements (logical reasoning, problem solving and non-verbal reasoning), males scored significantly higher than females.

In contrast, females scored better in the HPAT's second section (interpersonal understanding).

Pointedly, under the Jefferson Scale for Empathy (JSE) females scored significantly higher than males - a fact which mirrors international experience.

"These results adds to a growing literature questioning the validity of the HPAT-Ireland test as a selection tool," the study authors wrote.

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