Construct-level predictive validity of educational attainment and intellectual aptitude tests in medical student selection: meta-regression of six UK longitudinal studies

Background: Measures used for medical student selection should predict future performance during training. A problem for any selection study is that predictor-outcome correlations are known only in those who have been selected, whereas selectors need to know how measures would predict in the entire pool of applicants. That problem of interpretation can be solved by calculating construct-level predictive validity, an estimate of true predictor-outcome correlation across the range of applicant abilities. Methods: Construct-level predictive validities were calculated in six cohort studies of medical student selection and training (student entry, 1972 to 2009) for a range of predictors, including A-levels, General Certificates of Secondary Education (GCSEs)/O-levels, and aptitude tests (AH5 and UK Clinical Aptitude Test (UKCAT)). Outcomes included undergraduate basic medical science and finals assessments, as well as postgraduate measures of Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) performance and entry in the Specialist Register. Construct-level predictive validity was calculated with the method of Hunter, Schmidt and Le (2006), adapted to correct for right-censorship of examination results due to grade inflation. Results: Meta-regression analyzed 57 separate predictor-outcome correlations (POCs) and construct-level predictive validities (CLPVs). Mean CLPVs are substantially higher (.450) than mean POCs (.171). Mean CLPVs for first-year examinations, were high for A-levels (.809; CI: .501 to .935), and lower for GCSEs/O-levels (.332; CI: .024 to .583) and UKCAT (mean = .245; CI: .207 to .276). A-levels had higher CLPVs for all undergraduate and postgraduate assessments than did GCSEs/O-levels and intellectual aptitude tests. CLPVs of educational attainment measures decline somewhat during training, but continue to predict postgraduate performance. Intellectual aptitude tests have lower CLPVs than A-levels or GCSEs/O-levels. Conclusions: Educational attainment has strong CLPVs for undergraduate and postgraduate performance, accounting for perhaps 65% of true variance in first year performance. Such CLPVs justify the use of educational attainment measure in selection, but also raise a key theoretical question concerning the remaining 35% of variance (and measurement error, range restriction and right-censorship have been taken into account). Just as in astrophysics, ‘dark matter’ and ‘dark energy’ are posited to balance various theoretical equations, so medical student selection must also have its ‘dark variance’, whose nature is not yet properly characterized, but explains a third of the variation in performance during training. Some variance probably relates to factors which are unpredictable at selection, such as illness or other life events, but some is probably also associated with factors such as personality, motivation or study skills

Learning to perceive: informing pedagogic practice through the empirical study of drawing

This paper is the result of collaboration between psychologists with an interest in the cognitive processes underpinning drawing activity (Chamberlain, McManus and Brunswick), a dyslexia support tutor (Rankin) and an art school lecturer in drawing (Riley). It reports on a small-scale, ‘pilot’ workshop, designed to test the pedagogical strategies specifically designed for dyslexic students, with a cohort of volunteers from across the Royal College of Art, London

Talking the line: inclusive strategies for the teaching of drawing

The article reports on a series of drawing workshops held at the Royal College of Art (RCA), London, which tested an original pedagogical strategy designed to help dyslexic and/or dyspraxic art and design students who had reported difficulties with their abilities to make accurate representational drawings. A group of non-dyslexic/dyspraxic RCA students volunteered as control group, and both cohorts completed three days of workshops in the Drawing Studio of the RCA. Results of recorded interviews eliciting student observations as they drew, and a questionnaire in the form of a Likert scale, administered before and after the workshop, indicate positive shifts in both cohorts’ attitudes towards specific aspects of the stages involved in the production of accurate representational drawings of still-life set-ups, the human skeleton and the clothed life-model. Assessment of the drawings produced indicates positive shifts in the two cohorts in geometric accuracy and other qualitative criteria embedded in the teaching strategy such as control of scale, proportion and illusions of depth. Both cohorts displayed similar positive attitude shifts and both sets of drawings indicated similar positive shifts in visual qualities. An interim conclusion posits that the pedagogical strategy appears to enhance the abilities of both dyslexic/dyspraxic students and non-dyslexic/dyspraxic students to make accurate representational drawings. This result correlates closely with the findings of an earlier, prototype workshop held at the RCA in July 2012. It is suggested that similar pedagogically inclusive strategies might produce positive results in the context of secondary schools as part of a more inclusive curriculum

Scratching the surface: practice, personality, approaches to learning and the acquisition of high level representational drawing ability

Accurate representational drawing is a complex skill which underpins performance in many branches of the visual arts. Research suggests that expertise typically is acquired as a result of deliberate practice and a flexible approach to learning strategies. The current study investigated how, in art students, differences in the acquisition of observational drawing skill could be characterised using domain-general expertise accounts. A cohort of undergraduate and postgraduate art students (n=682) completed questionnaires about self-perceived artistic abilities, personality and approaches to learning. A subset completed tasks of actual drawing ability (n=301), the Rey-Osterrieth Complex Figure (ROCF) test and a performance IQ test. Actual drawing ability related to time spent drawing and drawing techniques, with additional independent predictive effects of both the copying and delayed ROCF test. Effects of personality were mainly mediated via learning styles, with surface learners spending more time drawing, learning fewer techniques and acquiring a lower level of actual skill. Deep learners learned more drawing techniques, and strategic (achieving) learners acquired a higher level of drawing skill overall. The resulting model of drawing ability development has the potential to be generalised over a range of creative and non-creative domains

Drawing on the right side of the brain: a voxel-based morphometry analysis of observational drawing

Structural brain differences in relation to expertise have been demonstrated in a number of domains including visual perception, spatial navigation, complex motor skills and musical ability. However no studies have assessed the structural differences associated with representational skills in visual art. As training artists are inclined to be a heterogeneous group in terms of their subject matter and chosen media, it was of interest to investigate whether there would be any consistent changes in neural structure in response to increasing representational drawing skill. In the current study a cohort of 44 graduate and post-graduate art students and non-art students completed drawing tasks. Scores on these tasks were then correlated with the regional grey and white matter volume in cortical and subcortical structures. An increase in grey matter density in the left anterior cerebellum and the right medial frontal gyrus was observed in relation to observational drawing ability, whereas artistic training (art students vs. non-art students) was correlated with increased grey matter density in the right precuneus. This suggests that observational drawing ability relates to changes in structures pertaining to fine motor control and procedural memory, and that artistic training in addition is associated with enhancement of structures pertaining to visual imagery. The findings corroborate the findings of small-scale fMRI studies and provide insights into the properties of the developing artistic brain

Inclusive Practice: researching the relationships between dyslexia, personality, and art students’ drawing ability.

This paper addresses the conference theme of inclusivity from two standpoints. Firstly, involving collaboration between researchers from fields including psychology, educational study support and studio drawing practice, which has revealed insights into students’ learning difficulties in drawing, which are not easily accessible through mono-disciplinary research practice. Secondly it involves a proposal outlining a strategy for the teaching of drawing which attempts to include students of varying abilities in drawing, and to empower their practice equally. The paper demonstrates the effectiveness of an inclusive, cross-disciplinary approach to exploring the relations between personality factors, perceptual problems, visual memory and drawing skills in art students who report difficulties producing accurate drawn representations of their observational experiences. Results indicate that whilst in general drawing ability seems not to relate to dyslexia, higher drawing ability does appear related to the personality measure of conscientiousness, and also both to sex (in the biological sense, males drawing better than females) and to gender (those who perceive themselves as more masculine drawing better, whether they are male or female). Poor drawers are less good at accurately copying angles and proportions, and their visual memory is less good. These findings inform a proposed inclusive group teaching strategy for drawing which attempts to address these weaknesses without hindering the progress of the more able student

Monitoring HIV pre-exposure prophylaxis (PrEP) uptake in Australia. Issue #6, May 2022

Description This report uses data extracted from every PrEP prescription supplied in Australia through the Pharmaceutical Benefits Scheme (PBS) between 1 April 2018 and 31 December 2021. Data are presented on the total number of people who have ever initiated PBS-subsidised PrEP, as well as the number of people dispensed PrEP within the past 12 months. These data are disaggregated by age, and by state or territory of patient residence. This report also includes a section investigating the effect of COVID-19-related lockdowns on presents monthly dispensing data by jurisdiction since COVID-19-related lockdowns began

Application of neural networks in modelling serviceability deterioration of concrete stormwater pipes

Stormwater pipe systems in Australia are designed to convey water from rainfall and surface runoff only and do not transport sewage. Any blockage can cause flooding events with the probability of subsequent property damage. Proactive maintenance plans that can enhance their serviceability need to be developed based on a sound deterioration model. This paper uses a neural network (NN) approach to model deterioration in serviceability of concrete stormwater pipes, which make up the bulk of the stormwater network in Australia. System condition data was collected using CCTV images. The outcomes of model are the identification of the significant factors influencing the serviceability deterioration and the forecasting of the change of serviceability condition over time for individual pipes based on the pipe attributes. The proposed method is validated and compared with multiple discriminant analysis, a traditionally statistical method. The results show that the NN model can be applied to forecasting serviceability deterioration. However, further improvements in data collection and condition grading schemes should be carried out to increase the prediction accuracy of the NN model.<br /

Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys

Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess. We used national survey data to establish the difference in the prevalence of psychosis between black ethnic groups and the white majority in the British general population. Methods Analysis of the combined datasets (N = 26,091) from the British national mental health surveys of 1993, 2000 and 2007. Cases of psychosis were determined either by the use of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), or from a combination of screening items. We controlled for sex, age, social class, unemployment, design features and other putative confounders, using a Disease Risk Score. Results People from black ethnic minorities had an excess prevalence rate of psychosis compared with the white majority population. The OR, weighted for study design and response rate, was 2.72 (95 % CI 1.3–5.6, p = 0.002). This was marginally increased after controlling for potential confounders (OR = 2.90, 95 % CI 1.4–6.2, p = 0.006). Conclusions The excess of psychosis in black ethnic minority groups was similar to that in two previous British community surveys, and less than that based on clinical studies. Even so it confirms a considerable need for increased mental health service resources in areas with high proportions of black ethnic minority inhabitants

Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation

Background: In the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved. Methods: A cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male) presenting in 2002–2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A) an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory. Results: The most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick. Conclusion: Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of suicide; however, low rates of severe psychiatric illness were detected. These findings suggest that MedNet clients represent both ends of the spectrum of severity, enabling early clinical engagement for a significant proportion of cases that is of importance both in terms of personal health and protecting patient care, and providing a timely intervention for those who are at risk, a group for whom rapid intervention services are in need and an area that requires further investigation in the UK