The academic backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

Background: Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades. Methods: Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register. Results: Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on measures of educational attainment, undergraduate, and post-graduate performance. Women performed better in assessments but were less likely to be on the Specialist Register. Non-white participants generally underperformed in undergraduate and post-graduate assessments, but were equally likely to be on the Specialist Register. There was a suggestion of smaller ethnicity effects in earlier studies. Conclusions: The existence of the Academic Backbone concept is strongly supported, with attainment at secondary school predicting performance in undergraduate and post-graduate medical assessments, and the effects spanning many years. The Academic Backbone is conceptualized in terms of the development of more sophisticated underlying structures of knowledge ('cognitive capital’ and 'medical capital’). The Academic Backbone provides strong support for using measures of educational attainment, particularly A-levels, in student selection

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

Unity in the wild variety of nature, or just variety?

Although there are some common underlying mechanisms for many nonhuman behavioural asymmetries, the evidence at present is not compelling for commonalities in cerebral organisation across vertebrates. Phylogenetic analysis of detour behaviour in fish suggests that more closely related species are not particularly similar in the direction of turning; contingency and demands of ecological niches may better explain such asymmetries

Colour word usage within languages follows the Berlin and Kay ordering

Colour word usage within languages follows the same ordering as that proposed by Berlin and Kay between languages. This provides additional validation and support for Berlin and Kay's schema

A monochrome view of colour

Saunders & van Brakel's criticism of Berlin & Kay's methodology misunderstands the fact that scientific hypotheses are tested by generating new, replicable data with novel explanatory power. Thus, although Berlin and Kay studied differences in colour words between language, the same patterns are also present in colour word usage within languages, in a range of literary and other textual databases

Architects need environmental feedback

The role of environmental feedback within architects' offices is examined as a fundamental ingredient of sustainability. Three case study buildings are examined using a feedback exercise encompassing the whole building process from early key design decisions to occupation. Results show that sometimes design decisions are taken for aesthetic reasons without certainty on their environmental impact. Improvements are possible especially in energy consumption, glare, the usability of controls, the communication of strategies and comfort conditions. The architects report the feedback lessons relevant for their work. A systematic approach to project feedback is proposed with emphasis in feeding forward to new projects and recording decision-making. To close the information loop, briefs need explicitly to mention performance targets for energy use, management expectations, control requirements and to promote feedback itself

THE ROLE OF PREVIOUS ANTERIOR CRUCIATE LIGAMENT INJURY ON THE VARIABILITY OF JOINT KINEMATICS AND COORDINATION DURING A MATCH SPECIFIC LAND-CUT TASK

This study compared the movement and coordination variability of the previously injured leg of ACL injured subjects (ACLr, n=9), against their non-injured leg and a control (nACL, n=9) leg. The variability of lower limb joint angles and couplings were calculated during a land-cut task (n=20). The previously injured leg had less variability than the noninjured leg in the knee rotation–knee abd-adduction coupling, and more variability than the nACL leg in frontal and transverse knee joint angles and hip rotation–knee abdadduction coupling. Reduced coordination variability could produce a more repetitive loading pattern linked to cartilage degeneration. Increased movement and coordination variability may stem from proprioceptive deficits on the previously injured leg and decrease the ability to adapt to perturbations

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates

The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students

Compositional analysis of archaeological glasses

At CoDaWork'03 we presented work on the analysis of archaeological glass composi- tional data. Such data typically consist of geochemical compositions involving 10-12 variables and approximates completely compositional data if the main component, sil- ica, is included. We suggested that what has been termed `crude' principal component analysis (PCA) of standardized data often identi ed interpretable pattern in the data more readily than analyses based on log-ratio transformed data (LRA). The funda- mental problem is that, in LRA, minor oxides with high relative variation, that may not be structure carrying, can dominate an analysis and obscure pattern associated with variables present at higher absolute levels. We investigate this further using sub- compositional data relating to archaeological glasses found on Israeli sites. A simple model for glass-making is that it is based on a `recipe' consisting of two `ingredients', sand and a source of soda. Our analysis focuses on the sub-composition of components associated with the sand source. A `crude' PCA of standardized data shows two clear compositional groups that can be interpreted in terms of di erent recipes being used at di erent periods, re ected in absolute di erences in the composition. LRA analysis can be undertaken either by normalizing the data or de ning a `residual'. In either case, after some `tuning', these groups are recovered. The results from the normalized LRA are di erently interpreted as showing that the source of sand used to make the glass di ered. These results are complementary. One relates to the recipe used. The other relates to the composition (and presumed sources) of one of the ingredients. It seems to be axiomatic in some expositions of LRA that statistical analysis of compositional data should focus on relative variation via the use of ratios. Our analysis suggests that absolute di erences can also be informativeGeologische Vereinigung; Institut d’Estadística de Catalunya; International Association for Mathematical Geology; Patronat de l’Escola Politècnica Superior de la Universitat de Girona; Fundació privada: Girona, Universitat i Futur; Càtedra Lluís Santaló d’Aplicacions de la Matemàtica; Consell Social de la Universitat de Girona; Ministerio de Ciencia i Tecnología

A linear algebraic method for pricing temporary life annuities and insurance policies

We recast the valuation of annuities and life insurance contracts under mortality and interest rates, both of which are stochastic, as a problem of solving a system of linear equations with random perturbations. A sequence of uniform approximations is developed which allows for fast and accurate computation of expected values. Our reformulation of the valuation problem provides a general framework which can be employed to find insurance premiums and annuity values covering a wide class of stochastic models for mortality and interest rate processes. The proposed approach provides a computationally efficient alternative to Monte Carlo based valuation in pricing mortality-linked contingent claims