The predictive validity of multiple mini interviews (MMIs) in nursing and midwifery programmes: year three findings from a cross-discipline cohort study

Education literature worldwide is replete with studies evaluating the effectiveness of Multiple Mini Interviews (MMIs) in admissions to medicine but <1% of published studies have been conducted in selection to nursing and midwifery programmes. To examine the predictive validity of MMIs using end of programme clinical and academic performance indicators of pre-registration adult, child, and mental health nursing and midwifery students. A cross-sectional cohort study at one university in the United Kingdom. A non-probability consecutive sampling strategy whereby all applicants to the September 2015 pre-registration adult, child, mental health nursing and midwifery programmes were invited to participate. Of the 354 students who commenced year one, 225 (64%) completed their three-year programme and agreed to take part (adult 120, child 32, mental health nursing 30 and midwifery 43). All applicants were interviewed using MMIs with six and seven station, four-minute models deployed in nursing and midwifery student selection respectively. Associations between MMI scores and the cross-discipline programme performance indicators available for each student at this university at the end of year three: clinical practice (assessed by mentors) and academic attainment (dissertation mark) were explored using multiple linear regression adjusting for applicant age, academic entry level, discipline and number of MMI stations. In the adjusted models, students with higher admissions MMI score (at six and seven stations) performed better in clinical practice (p < 0.001) but not in academic attainment (p = 0.122) at the end of their three-year programme. These findings provide the first report of the predictive validity of MMIs for performance in clinical practice using six and seven station models in nursing and midwifery programmes. Further evidence is required from both clinical and academic perspectives from larger, multi-site evaluations. [Abstract copyright: Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.

Values, situational judgement, and the clinical practice environment: A study of adult nursing students.

Background: In England, a Values Based Recruitment (VBR) policy intends to ensure that healthcare students’ individual values align with the values of the National Health Service (NHS) Constitution. However, students’ values may become compromised with increased clinical experience, due to, for instance, distress, negative role models and hidden curricula. Aim: To explore potential differences in values between first, second, and third year students of adult nursing, in order to theorise whether and how such students’ values may change over the duration of their programme, upon exposure to clinical practice environments. Objectives: 1. To develop an instrument (Situational Judgement Test, SJT) that assesses students’ congruence with the NHS Constitution values, and whether these are prioritised. 2. To establish whether the values (assessed using the SJT) of students with differing levels of experience (years one, two, and three – particularly clinical practice experience) vary. 3. To generate insights into the considerations and reflections that students have regarding SJT items, and determine whether these vary between the different year groups. 4. To verify and gain a deeper understanding of these findings in the context of students’ (practice) learning, as well as input for recommendations, through adult nursing Practice Liaison Tutors within the university. Methods: This research was granted a Favourable Ethical Opinion by the University of Surrey Ethics Committee. An SJT was developed (objective 1), and reliability and validity were determined with a pilot sample of 47 volunteers. Subsequently, first (n=13), second (n=15) and third (n=9) year students (total N=37) completed the SJT and participated in discussion sessions (objectives 2 and 3). Analysis took place using inferential statistics and thematic methods. Afterwards, six tutors were presented with the findings and interviewed (objective 4). Findings: SJT scores were highest in year one and lowest in year three (significant difference between first and third year group, F=7.28, p=.002). First year students expressed idealism. Second and third year students, however, experienced organisational hierarchy and difficulty speaking up against poor practice on their placements, at times de-prioritising the NHS Constitution values in response. Tutors could relate to these findings and suggested strategies to support students. Discussion: Despite the VBR policy, students’ congruence with the NHS Constitution values may become compromised with increased clinical experience. Recommendations are made for education and placement organisations to prepare students for clinical practice, address hierarchy, and provide a safe and ethical learning environment