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Abstract Background Knowledge in natural sciences generally predicts study performance in the first two years of the medical curriculum. In order to reduce delay and dropout in the preclinical years, Hamburg Medical School decided to develop a natural science test (HAM-Nat) for student selection. In the present study, two different approaches to scale construction are presented: a unidimensional scale and a scale composed of three subject specific dimensions. Their psychometric properties and relations to academic success are compared. Methods 334 first year medical students of the 2006 cohort responded to 52 multiple choice items from biology, physics, and chemistry. For the construction of scales we generated two random subsamples, one for development and one for validation. In the development sample, unidimensional item sets were extracted from the item pool by means of weighted least squares (WLS) factor analysis, and subsequently fitted to the Rasch model. In the validation sample, the scales were subjected to confirmatory factor analysis and, again, Rasch modelling. The outcome measure was academic success after two years. Results Although the correlational structure within the item set is weak, a unidimensional scale could be fitted to the Rasch model. However, psychometric properties of this scale deteriorated in the validation sample. A model with three highly correlated subject specific factors performed better. All summary scales predicted academic success with an odds ratio of about 2.0. Prediction was independent of high school grades and there was a slight tendency for prediction to be better in females than in males. Conclusions A model separating biology, physics, and chemistry into different Rasch scales seems to be more suitable for item bank development than a unidimensional model, even when these scales are highly correlated and enter into a global score. When such a combination scale is used to select the upper quartile of applicants, the proportion of successful completion of the curriculum after two years is expected to rise substantially.

BACKGROUND: The aims of this study were to examine the level of dissociative symptoms in patients with different substance related disorders (alcohol dependence, drug dependence, and combined alcohol and drug dependence), and to investigate the influence of potentially traumatic events in childhood, age, gender, and posttraumatic stress disorder on the relationship between dissociative symptoms and type of substance abuse. METHODS: Of the 459 participants (59.7% male) 182 (39.7%) were alcohol-dependent (A), 154 (33.6%) were drug-dependent (D), and 123 (26.8%) were dependent on both, alcohol and drugs (AD) based on the DSM-IV criteria for a current diagnosis. Participants completed the Childhood Trauma Questionnaire (CTQ) and the Dissociative Experiences Scale (DES). The International Diagnostics Checklist (IDCL) was administered to diagnose PTSD. RESULTS: Higher levels of dissociation were observed in patients with drug dependence as compared to patients with mere alcohol dependence (mean DES group A: 9.9+/-8.8; group D: 12.9+/-11.7; group AD: 15.1+/-11.3). However, when severity of potentially traumatic events in childhood, PTSD, age and gender were included in the analysis, the influence of the type of substance abuse did not prove to be statistically significant. The variable most strongly related to dissociative symptoms was severity of potentially traumatic events in childhood, in particular emotional abuse, even after controlling for PTSD and other potential confounders. CONCLUSIONS: It seems appropriate to screen SUD patients for dissociative symptoms, especially those with a more complex risk profile including (additional) drug abuse, female gender, younger age and most importantly a history of childhood trauma. [ABSTRACT FROM AUTHOR]

Situational Judgement Tests (SJTs) are popular to screen for social skills during undergraduate medical admission as they have been shown to predict relevant study outcomes. Two different types of SJTs can be distinguished: Traditional SJTs, which measure general effective behavior, and construct-driven SJTs which are designed to measure specific constructs. To date, there has been no comparison of the predictive validity of these two types of SJTs in medical admission. With the present research, we examine whether the HAM-SJT, a traditional SJT, and the CD-SJT, a construct-driven SJT with an agentic and a communal scale, administered during undergraduate medical admission can predict OSCE (i.e., objective structured clinical examination) performance in a low-stakes (n LS = 159) and a high-stakes (n HS = 160) sample of medical students. Results showed a moderate positive relation between the communal scale of the CD-SJT and performance in OSCE stations with trained patients in the high-stakes sample (r =.20, p =.009). This SJT had also an incremental value in predicting the OSCE performance above and beyond GPA (i.e., grade point average), a science test (i.e., HAM-Nat), and gender (ß = 0.18, 95% CI [0.03; 0.33], p =.020). That is, individuals who chose more communal behavioral responses in the SJT were rated more favorably in interactions with trained patients in the OSCE. A comparable correlation coefficient was observed for the HAM-SJT when controlling for range restriction due to admission (r raw = 0.14 vs. r controlled = 0.20). Our research provides a first indication for the predictive validity of construct-driven SJTs in high-stakes undergraduate medical admission., (© 2024. The Author(s).)

As a component of many intelligence test batteries, figural matrices tests are an effective way to assess reasoning, which is considered a core ability of intelligence. Traditionally, the sum of correct items is used as a performance indicator (total solution procedure). However, recent advances in the development of computer-based figural matrices tests allow additional indicators to be considered for scoring. In two studies, we focused on the added value of a partial solution procedure employing log file analyses from a computer-based figural matrices test. In the first study ( n = 198), we explored the internal validity of this procedure by applying both an exploratory bottom-up approach (using sequence analyses) and a complementary top-down approach (using rule jumps, an indicator taken from relevant studies). Both approaches confirmed that higher scores in the partial solution procedure were associated with higher structuredness in participants' response behavior. In the second study ( n = 169), we examined the external validity by correlating the partial solution procedure in addition to the total solution procedure with a Grade Point Average (GPA) criterion. The partial solution procedure showed an advantage over the total solution procedure in predicting GPA, especially at lower ability levels. The implications of the results and their applicability to other tests are discussed.

Background: Student selection at Hamburg medical school is based on the combination of a natural science knowledge test (HAM-Nat) and pre-university educational attainment., Method: Of the 1565 medical students enrolled in Hamburg from 2012 to 2015 about half were admitted by an entrance test, half by quotas. First, we analysed sociodemographic determinants of entrance test performance. Then, we used regression analysis to describe the interplay of variables in the prediction of study outcome, the role of sociodemographic factors, and differences in the calibration of educational attainment specific to German federal states., Results: Better performance in the entrance test was associated with age over 21, male gender, German nationality, first language German and both parents holding an academic degree - effect sizes were small. No differences were found for the birthplaces of parents (a proxy for migration background). Study outcome differed considerably among admission paths: Students admitted by entrance test or the quota for excellent pre-university educational attainment performed markedly better during the first 3 terms than students admitted by the waiting list quota and the quota for foreign students. Gender differences in study outcome were slight with better performance by males. The relation of pre-university educational attainment to study outcome was moderated by the federal state in which secondary schooling took place. Methods for the equating of state-specific grades are explored. The predictive validity of the HAM-Nat after correction for range restriction was r = .31. The relatively low value of this coefficient may be attributed to 3 factors: 1. self-selection of applicants which leads to a validity-enhancing effect that is not revealed by the predictor-outcome correlation, 2. reduction of variance due to a high selection ratio, and 3. high test difficulty, exceeding the demands of the medical curriculum., Conclusion: The HAM-Nat achieves a small amount of incremental validity over pre-university educational attainment. This effect, obtained from correlational analysis, underestimates the validity of the test, because it does not reflect the role of self-selection and other validity enhancing features of the selection process.

The German Constitutional Court is currently reviewing whether the actual study admission process in medicine is compatible with the constitutional right of freedom of profession, since applicants without an excellent GPA usually have to wait for seven years. If the admission system is changed, politicians would like to increase the influence of psychosocial criteria on selection as specified by the Masterplan Medizinstudium 2020.What experiences have been made with the actual selection procedures? How could Situational Judgement Tests contribute to the validity of future selection procedures to German medical schools?High school GPA is the best predictor of study performance, but is more and more under discussion due to the lack of comparability between states and schools and the growing number of applicants with top grades. Aptitude and knowledge tests, especially in the natural sciences, show incremental validity in predicting study performance. The measurement of psychosocial competencies with traditional interviews shows rather low reliability and validity. The more reliable multiple mini-interviews are superior in predicting practical study performance. Situational judgement tests (SJTs) used abroad are regarded as reliable and valid; the correlation of a German SJT piloted in Hamburg with the multiple mini-interview is cautiously encouraging.A model proposed by the Medizinischer Fakultätentag and the Bundesvertretung der Medizinstudierenden considers these results. Student selection is proposed to be based on a combination of high school GPA (40%) and a cognitive test (40%) as well as an SJT (10%) and job experience (10%). Furthermore, the faculties still have the option to carry out specific selection procedures.

Objectives: Increasing numbers of educational institutions in the medical field choose to replace their conventional admissions interviews with a multiple mini-interview (MMI) format because the latter has superior reliability values and reduces interviewer bias. As the MMI format can be adapted to the conditions of each institution, the question of under which circumstances an MMI is most expedient remains unresolved. This article systematically reviews the existing MMI literature to identify the aspects of MMI design that have impact on the reliability, validity and cost-efficiency of the format., Methods: Three electronic databases (OVID, PubMed, Web of Science) were searched for any publications in which MMIs and related approaches were discussed. Sixty-six publications were included in the analysis., Results: Forty studies reported reliability values. Generally, raising the number of stations has more impact on reliability than raising the number of raters per station. Other factors with positive influence include the exclusion of stations that are too easy, and the use of normative anchored rating scales or skills-based rater training. Data on criterion-related validities and analyses of dimensionality were found in 31 studies. Irrespective of design differences, the relationship between MMI results and academic measures is small to zero. The McMaster University MMI predicts in-programme and licensing examination performance. Construct validity analyses are mostly exploratory and their results are inconclusive. Seven publications gave information on required resources or provided suggestions on how to save costs. The most relevant cost factors that are additional to those of conventional interviews are the costs of station development and actor payments., Conclusions: The MMI literature provides useful recommendations for reliable and cost-efficient MMI designs, but some important aspects have not yet been fully explored. More theory-driven research is needed concerning dimensionality and construct validity, the predictive validity of MMIs other than those of McMaster University, the comparison of station types, and a cost-efficient station development process., (© 2014 John Wiley & Sons Ltd.)

Although some recent studies concluded that dexterity is not a reliable predictor of performance in preclinical laboratory courses in dentistry, they could not disprove earlier findings which confirmed the worth of manual dexterity tests in dental admission. We developed a wire bending test (HAM-Man) which was administered during dental freshmen's first week in 2008, 2009, and 2010. The purpose of our study was to evaluate if the HAM-Man is a useful selection criterion additional to the high school grade point average (GPA) in dental admission. Regression analysis revealed that GPA only accounted for a maximum of 9% of students' performance in preclinical laboratory courses, in six out of eight models the explained variance was below 2%. The HAM-Man incrementally explained up to 20.5% of preclinical practical performance over GPA. In line with findings from earlier studies the HAM-Man test of manual dexterity showed satisfactory incremental validity. While GPA has a focus on cognitive abilities, the HAM-Man reflects learning of unfamiliar psychomotor skills, spatial relationships, and dental techniques needed in preclinical laboratory courses. The wire bending test HAM-Man is a valuable additional selection instrument for applicants of dental schools.

Introduction: The present study examines the question whether the selection of dental students should be based solely on average school-leaving grades (GPA) or whether it could be improved by using a subject-specific aptitude test., Methods: The HAM-Nat Natural Sciences Test was piloted with freshmen during their first study week in 2006 and 2007. In 2009 and 2010 it was used in the dental student selection process. The sample size in the regression models varies between 32 and 55 students., Results: Used as a supplement to the German GPA, the HAM-Nat test explained up to 12% of the variance in preclinical examination performance. We confirmed the prognostic validity of GPA reported in earlier studies in some, but not all of the individual preclinical examination results., Conclusion: The HAM-Nat test is a reliable selection tool for dental students. Use of the HAM-Nat yielded a significant improvement in prediction of preclinical academic success in dentistry.

Aims: Tests with natural-scientific content are predictive of the success in the first semesters of medical studies. Some universities in the German speaking countries use the 'Test for medical studies' (TMS) for student selection. One of its test modules, namely "medical and scientific comprehension", measures the ability for deductive reasoning. In contrast, the Hamburg Assessment Test for Medicine, Natural Sciences (HAM-Nat) evaluates knowledge in natural sciences. In this study the predictive power of the HAM-Nat test will be compared to that of the NatDenk test, which is similar to the TMS module "medical and scientific comprehension" in content and structure., Methods: 162 medical school beginners volunteered to complete either the HAM-Nat (N=77) or the NatDenk test (N=85) in 2007. Until spring 2011, 84.2% of these successfully completed the first part of the medical state examination in Hamburg. Via different logistic regression models we tested the predictive power of high school grade point average (GPA or "Abiturnote") and the test results (HAM-Nat and NatDenk) with regard to the study success criterion "first part of the medical state examination passed successfully up to the end of the 7(th) semester" (Success7Sem). The Odds Ratios (OR) for study success are reported., Results: For both test groups a significant correlation existed between test results and study success (HAM-Nat: OR=2.07; NatDenk: OR=2.58). If both admission criteria are estimated in one model, the main effects (GPA: OR=2.45; test: OR=2.32) and their interaction effect (OR=1.80) are significant in the HAM-Nat test group, whereas in the NatDenk test group only the test result (OR=2.21) significantly contributes to the variance explained., Conclusions: On their own both HAM-Nat and NatDenk have predictive power for study success, but only the HAM-Nat explains additional variance if combined with GPA. The selection according to HAM-Nat and GPA has under the current circumstances of medical school selection (many good applicants and only a limited number of available spaces) the highest predictive power of all models.

Repetitive, intrusive cognitive phenomena are central both to obsessive-compulsive patients - typically as obsessive thoughts - and to depressed patients - typically as ruminative thoughts. The objective of the present study is to compare obsessive and ruminative thoughts in non-depressed obsessive-compulsive and depressed patients. Thirty-four patients diagnosed with obsessive-compulsive disorder and 34 patients diagnosed with major depression disorder were asked to identify both a personally relevant obsessive and a personally relevant ruminative thought and to subsequently evaluate these thoughts on a modified version of the Cognitive Intrusions Questionnaire (CIQ) developed by Freeston, Ladouceur, Thibodeau, and Gagnon (1991). The CIQ assesses general descriptors, emotional reactions, appraisal and coping strategies on a nine-point Likert scale. A mixed-model ANOVA demonstrated that obsessive and ruminative thoughts are distinct cognitive processes, clearly distinguishable in form, appraisal and temporal orientation across disorders. In obsessive-compulsive patients, ruminative thoughts were more common and more emotionally distressing than predicted. In depressed patients, obsessive thoughts occurred infrequently and were not associated with high negative emotions. Clarifying similarities and differences between ruminative and obsessive thoughts and understanding their interaction might ultimately help to expand on the role of cognitive vulnerability factors in obsessive-compulsive and major depression disorder., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Relatively few studies have examined how patients with schizophrenia and depression view psychiatric research and what influences their readiness to participate., Methods: A total of 763 patients (48% schizophrenia, 52% depression) from 7 European countries were examined using a specifically designed self-report questionnaire ["Hamburg Attitudes to Psychiatric Research Questionnaire" (HAPRQ)]., Results: Most patients (98%) approved of psychiatric research, in general, at least "a little". There was a tendency to approve psychosocial rather than biological research topics (e.g. research on the role of the family by 91% of patients compared to 79% in genetics). Reasons to participate were mainly altruistic. Only a minority (28%) considered monetary incentives important. Patients wanted extensive background information and a feedback of the results; both were significantly more expressed by schizophrenia as compared to depressive patients, although these findings need to be interpreted with care because of age and gender differences between the diagnostic groups., Conclusion: While patients expressed discerning views of psychiatric research, only few differences were apparent between the two diagnostic groups. Patients' research priorities are not the same as those of many professionals and funding bodies. Their demonstrated critical appraisal should inform future research ensuring an increased patient role in the research process.

Objective: The University Hospital in Hamburg (UKE) started to develop a test of knowledge in natural sciences for admission to medical school in 2005 (Hamburger Auswahlverfahren für Medizinische Studiengänge, Naturwissenschaftsteil, HAM-Nat). This study is a step towards establishing the HAM-Nat. We are investigating parallel forms reliability, the effect of a crash course in chemistry on test results, and correlations of HAM-Nat test results with a test of scientific reasoning (similar to a subtest of the "Test for Medical Studies", TMS)., Methods: 316 first-year students participated in the study in 2007. They completed different versions of the HAM-Nat test which consisted of items that had already been used (HN2006) and new items (HN2007). Four weeks later half of the participants were tested on the HN2007 version of the HAM-Nat again, while the other half completed the test of scientific reasoning. Within this four week interval students were offered a five day chemistry course., Results: Parallel forms reliability for four different test versions ranged from r(tt)=.53 to r(tt)=.67. The retest reliabilities of the HN2007 halves were r(tt)=.54 and r(tt )=.61. Correlations of the two HAM-Nat versions with the test of scientific reasoning were r=.34 und r=.21. The crash course in chemistry had no effect on HAM-Nat scores., Conclusions: The results suggest that further versions of the test of natural sciences will not easily conform to the standards of internal consistency, parallel-forms reliability and retest reliability. Much care has to be taken in order to assemble items which could be used interchangeably for the construction of new test versions. The test of scientific reasoning and the HAM-Nat are tapping different constructs. Participation in a chemistry course did not improve students' achievement, probably because the content of the course was not coordinated with the test and many students lacked of motivation to do well in the second test.