CJEM Debate Series: #BetterSelection – Medical school acceptance tests select the wrong doctors: We need fewer memorizers and more thinkers and communicators in modern medicine

[...]just as we should be selecting for students with the capacity and courage to learn from their mistakes, students with resilience, 9 curiosity, 10 and an ability to adapt to uncertainty and complexity, we must rise to the challenge of continuing to learn, research, and evolve with the patients and populations whom we serve, in selecting for and supporting the development of good doctors.[...]one of the biggest problems in evaluating selection processes is that it is hard to test the tests, to establish “what works,” because there has not been a consensus on defining exactly what “what works” means. 14 How do we define success in the selection process?[...]the stage theory of critical thinking 19 suggests that a comfort with “both/and” thinking over “either/or” thinking 20 is a marker of cognitive development. 21 What is the best way to evaluate cognitive development in our selection process?Perhaps one of the most promising areas to consider for more emphasis is the science and practice of developmental psychology. 25 While including these methodologies in a medical school selection bundle is rare, it has been suggested before that we should include testing of moral reasoning. 26 An interesting study in one Canadian medical school used similar methodology in testing first-year medical students and final-year medical students, and found that there was no difference between those groups on a six-point scale, but that the average stage of development in this domain was only moderate on admission. 27 Along with moral reasoning, there are similar models and standardized tests for other domains of development (emotional intelligence, reflective judgment, empathy, and so forth) with varying degrees of evidence.