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

Flood- and Weather-Damaged Homes and Mental Health: An Analysis Using England's Mental Health Survey

There is increasing evidence that exposure to weather-related hazards like storms and floods adversely affects mental health. However, evidence of treated and untreated mental disorders based on diagnostic criteria for the general population is limited. We analysed the Adult Psychiatric Morbidity Survey, a large probability sample survey of adults in England (n = 7525), that provides the only national data on the prevalence of mental disorders assessed to diagnostic criteria. The most recent survey (2014–2015) asked participants if they had experienced damage to their home (due to wind, rain, snow or flood) in the six months prior to interview, a period that included months of unprecedented population exposure to flooding, particularly in Southern England. One in twenty (4.5%) reported living in a storm- or flood-damaged home in the previous six months. Social advantage (home ownership, higher household income) increased the odds of exposure to storm or flood damage. Exposure predicted having a common mental disorder over and above the effects of other known predictors of poor mental health. With climate change increasing the frequency and severity of storms and flooding, improving community resilience and disaster preparedness is a priority. Evidence on the mental health of exposed populations is key to building this capacity

A systematic review of lesbian, gay, bisexual and transgender health in the West Midlands region of the UK compared to published UK research

It is estimated that approximately 3-8% of the UK population identify as lesbian, gay, bisexual or trans (LGBT). Until now, most health research on gay and bisexual men has been around HIV, AIDS and sexually transmitted diseases and for trans people has been on the transitioning process only. However, it has been apparent to the LGBT community that that there are a wide variety of other physical and mental health issues that are also important and that the proportion of gay and bisexual men who have HIV/AIDS is relatively small. Very little general LGBT health research has been published so far and there are very few health services that specifically address the general health concerns of the LGBT community. This systematic review presents all available research conducted in the West Midlands on LGBT health since 2000. Local health research is compared to UK national, peer reviewed and published LGBT health research in order to determine whether the local results are unusual compared to national LGBT data, and to routinely collected data on the UK population, where appropriate, in order to determine whether and where the LGBT population differ from the general population. Only UK research has been included because there was no previous UK specific systematic review so it was unclear how generalisable foreign research would be to the UK

Rotorcraft digital advanced avionics system (RODAAS) functional description

A functional design of a rotorcraft digital advanced avionics system (RODAAS) to transfer the technology developed for general aviation in the Demonstration Advanced Avionics System (DAAS) program to rotorcraft operation was undertaken. The objective was to develop an integrated avionics system design that enhances rotorcraft single pilot IFR operations without increasing the required pilot training/experience by exploiting advanced technology in computers, busing, displays and integrated systems design. A key element of the avionics system is the functionally distributed architecture that has the potential for high reliability with low weight, power and cost. A functional description of the RODAAS hardware and software functions is presented

Using pattern languages in participatory design

In this paper, we examine the contribution that pattern languages could make to user participation in the design of interactive systems, and we report on our experiences of using pattern languages in this way. In recent years, there has been a growing interest in the use of patterns and pattern languages in the design of interactive systems. Pattern languages were originally developed by the architect, Christopher Alexander, both as a way of understanding the nature of building designs that promote a ‘humane’ or living built environment; and as a practical tool to aid in participatory design of buildings. Our experience suggests that pattern languages do have considerable potential to support participatory design in HCI, but that many pragmatic issues remain to be resolved.</p

A model balancing cooperation and competition explains our right-handed world and the dominance of left-handed athletes

An overwhelming majority of humans are right-handed. Numerous explanations for individual handedness have been proposed, but this population-level handedness remains puzzling. Here we use a minimal mathematical model to explain this population-level hand preference as an evolved balance between cooperative and competitive pressures in human evolutionary history. We use selection of elite athletes as a test-bed for our evolutionary model and account for the surprising distribution of handedness in many professional sports. Our model predicts strong lateralization in social species with limited combative interaction, and elucidates the rarity of compelling evidence for "pawedness" in the animal world.Comment: 5 pages of text and 3 figures in manuscript, 8 pages of text and two figures in supplementary materia