A new evaluation tool for admissionsJoanna Bates, Vera Frinton & Don Voaklander

Context and setting A Canadian province, 4 times thesize of the UK, has only 1 medical school. Thenorthern and rural areas of the province are under-served medically, with difficulties in doctor recruit-ment and retention. In 2004, the medical schoolopened a northern campus for undergraduatemedical education in partnership with a northernuniversity. The programme’s mission is to admit andtrain future doctors who are more likely to locatetheir clinical practice in northern and rural settings,requiring changes to the admissions process.Why the idea was necessary The standard admissionsprocess for the main school is based 50% on cognitiveand 50% on non-cognitive criteria, but no assessmentis made on the student’s background. Other schoolshave looked at geographical origin, race or the resultsof personality testing. However, we found no existingadmissions process to meet the needs of this pro-gramme, namely to admit students who fit well in anorthern programme site.What was done The partners developed an admis-sions tool, the Rural and Remote Suitability Score(RRSS) to evaluate applicants’ suitability for educa-tion in the north. Predictors of eventual rural ornorthern practice location were developed by aliterature review and focus groups, resulting in thedevelopment of admission criteria and a markingscheme. The instrument was piloted with northernstudents currently studying medicine, students inurban settings, and postgraduate trainees who hadchosen a northern site for further training. Only 1question was added to the admissions form, whichalready included an autobiographical essay anddocumentation of non-academic activities. Using thissubmitted material, the tool develops a score in 3domains (northern background or experience, self-reliance, and recreational preferences) to develop anoverall RRSS score out of 100. For example, experi-ence of working in a rural community, participationin typical, rural outdoor activities such as fishing andhunting, and travelling independently or working injobs requiring independent decision making wouldall score specific points in the RRSS score.

The instrument was used to score applications in2004 (n ¼ 1308); interrater reliability alpha was 0Æ90,and RRSS scores were used in admissions decisions tothe northern programme.Evaluation of results and impact Review of theapplicant RRSS scores ensured an adequate pool ofpotential candidates for interview for the northernprogramme. Weighted use of the RRSS score in

admissions decisions ensured that selected applicantswere likely to fit well into this educational environ-ment. In comparison to grade point average, inter-view scores and other admission criteria, the RRSSwas the single significant predictor of the applicant’sfirst choice of education location. All but 1 studentselected for the northern programme had placed thenorthern programme in the top 2 out of 3 possibleoptions.

Most importantly, 25 students are happily studyingon a northern campus, embraced by a communitythat feels they are the ‘right’ students for their siteand programme.

Correspondence: Dr Joanna Bates, Senior Associate Dean, Education,Dean’s Office, UBC Faculty of Medicine, 317-2194 Health SciencesMall, Vancouver, B.C. V6T 1Z3. Tel: 604 822 7833; Fax: 604 822-6061;E-mail: jbates@interchange.ubc.ca

doi: 10.1111/j.1365-2929.2005.02308.x

Introduction of problem-solving activities duringconventional lectures

Farah Khaliq

Context and setting The first-year medical studentsat University College of Medical Sciences, Delhi areexposed to 3 hours of constant lecturing, i.e. from 8a.m. to 11 a.m. (1 hour each for anatomy, physiologyand biochemistry). During this period there are nodiscussion or problem-solving sessions, etc. to breakthe monotony. This teaching intervention targetedthese 100 students in the department of physiology.Why the change was necessary As per our ownexperience and also as reported by the students, it isvery difficult to concentrate in lectures for more than45 minutes at a stretch, but the present teachingsystem compels students to attend lectures for3 hours continuously. We decided to tackle thisproblem by introducing some group activities in theform of problem-solving or case histories to break themonotony of the class. We hypothesised that theintroduction of such activities will help the studentsto be more attentive during lectures. Although ourprevious problem-based learning (PBL) programmealso had a similar type of approach, i.e. discussing aclinical problem in small batches followed by aninteractive resource session, there were some draw-backs to it, notably the varying approach by differenttutors that leads to non-uniformity.What was done A pre-test was given to the studentsfor assessing all the teaching learning aspects of theconventional lectures. This was followed by a series of

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� Blackwell Publishing Ltd 2005. MEDICAL EDUCATION 2005; 39: 1143–1172