In recruitment, the multiple mini-interview (MMI)
[Eva KW, Reiter HI, Rosenfeld J, Norman GR. An admissions OSCE: the multiple mini-interview. ]Medical education
Medical education is education related to the practice of being a medical practitioner, including the initial training to become a physician (i.e., medical school and internship (medical), internship) and additional training thereafter (e.g., Re ...
, 38:314–326 (2004). is an interview format that uses many short independent assessments, typically in a timed circuit, to obtain an aggregate score of each candidate's
soft skills
Soft skills, also known as power skills, common skills or core skills, are skills applicable to all professions. These include critical thinking, problem solving, public speaking, professional writing, teamwork, digital literacy, leadership, pr ...
. In 2001, the
McMaster University Medical School
The Michael G. DeGroote School of Medicine, known as the McMaster University School of Medicine prior to 2004, is the medical school of McMaster University in Hamilton, Ontario, Canada. It is operated by the McMaster Faculty of Health Sciences. It ...
began developing the MMI system, to address two widely recognized problems. First, it has been shown that traditional interview formats or simulations of educational situations do not accurately predict performance in medical school. Secondly, when a licensing or regulatory body reviews the performance of a physician subsequent to patient complaints, the most frequent issues of concern are those of the non-cognitive skills, such as
interpersonal skills
A social skill is any competence facilitating interaction and communication with others where social rules and relations are created, communicated, and changed in verbal and nonverbal ways. The process of learning these skills is called social ...
, professionalism and ethical/moral judgment. Since its formal introduction at
McMaster University Medical School
The Michael G. DeGroote School of Medicine, known as the McMaster University School of Medicine prior to 2004, is the medical school of McMaster University in Hamilton, Ontario, Canada. It is operated by the McMaster Faculty of Health Sciences. It ...
in 2004, it has been adopted by medical, dental, pharmacy, and veterinary schools around the world.
Introduction
Interviews have been used widely for different purposes, including assessment and recruitment. Candidate assessment is normally deemed successful when the scores generated by the measuring tool predict for future outcomes of interest, such as job performance or job retention.
Meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
of the
human resource
Human resources (HR) is the set of people who make up the workforce of an organization, business sector, industry, or economy. A narrower concept is human capital, the knowledge and skills which the individuals command. Similar terms include m ...
literature has demonstrated low to moderate ability of interviews to predict for future job performance.
How well a candidate scores on one interview is only somewhat correlated with how well that candidate scores on the next interview. Marked shifts in scores are buffered when collecting many scores on the same candidate, with a greater buffering effect provided by multiple interviews than by multiple interviewers acting as a panel for one interview.
The score assigned by an interviewer in the first few minutes of an interview is rarely changed significantly over the course of the rest of the interview, an effect known as the
halo effect
The halo effect (sometimes called the halo error) is the tendency for positive impressions of a person, company, brand, or product in one area to positively influence one's opinion or feelings in other areas. Halo effect is “the name given to t ...
.
Therefore, even very short interviews within an MMI format provide similar ability to differentiate reproducibly between candidates.
Ability to reproducibly differentiate between candidates, also known as overall test reliability, is markedly higher for the MMI than for other interview formats.
This has translated into higher
predictive validity In psychometrics, predictive validity is the extent to which a score on a scale or test predicts scores on some criterion measure.
For example, the validity of a cognitive test for job performance is the correlation between test scores and, for e ...
, correlating for future performance much more highly than standard interviews.
[Eva KW, Reiter HI, Trinh K, Wasi P, Rosenfeld J, Norman GR. "Predictive validity of the multiple mini-interview for selecting medical trainees. Accepted for publication January 2009 in Medical Education.]
History
Aiming to enhance predictive correlations with future performance in medical school,
post-graduate
Postgraduate or graduate education refers to academic or professional degrees, certificates, diplomas, or other qualifications pursued by post-secondary students who have earned an undergraduate ( bachelor's) degree.
The organization and stru ...
medical training, and future performance in practice, McMaster University began research and development of the MMI in 2001. The initial pilot was conducted on 18
graduate students
Postgraduate or graduate education refers to academic or professional degrees, certificates, diplomas, or other qualifications pursued by post-secondary students who have earned an undergraduate (bachelor's) degree.
The organization and struc ...
volunteering as "medical school candidates". High overall test reliability (0.81) led to a larger study conducted in 2002 on real medical school candidates, many of whom volunteered after their standard interview to stay for the MMI. Overall test reliability remained high,
and subsequent follow-up through medical school and on to national licensure examination (Medical Council of Canada Qualifying Examination Parts I and II) revealed the MMI to be the best predictor for subsequent clinical performance,
professionalism,
and ability to communicate with patients and successfully obtain national licensure.
Since its formal inception at the
Michael G. DeGroote School of Medicine
The Michael G. DeGroote School of Medicine, known as the McMaster University School of Medicine prior to 2004, is the medical school of McMaster University in Hamilton, Ontario, Canada. It is operated by the McMaster Faculty of Health Sciences. It ...
at McMaster University in 2004, the MMI subsequently spread as an admissions test across medical schools, and to other healing arts disciplines. By 2008, the MMI was being used as an admissions test by the majority of medical schools in Canada, Australia, Israel, and Brunei. Also in 2008, a pilot test was conducted with the tool at the
University of Cincinnati College of Medicine
The University of Cincinnati Academic Health Center (AHC) is a collection of health colleges and institutions of the University of Cincinnati, Cincinnati, Ohio. It trains health care professionals and provides research and patient care. AHC has st ...
, and went live in the fall of that year, as the first implementation of MMI at a medical college in the United States; additional medical schools in the country have since adopted the process.
These lead to the development of a McMaster spin-off company, APT Inc., to commercialize the MMI system. The MMI was branded as ProFitHR and made available to both the academic and corporate sector.
By 2009, the list of other disciplines using the MMI included schools for
dentistry
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions o ...
,
pharmacy
Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links heal ...
,
midwifery
Midwifery is the health science and health profession that deals with pregnancy, childbirth, and the postpartum period (including care of the newborn), in addition to the sexual and reproductive health of women throughout their lives. In many cou ...
,
physiotherapy
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...
and
occupational therapy
Occupational therapy (OT) is a global healthcare profession. It involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or ''occupations'', of individuals, groups, or communities. The field of ...
,
veterinary medicine
Veterinary medicine is the branch of medicine that deals with the prevention, management, diagnosis, and treatment of disease, disorder, and injury in animals. Along with this, it deals with animal rearing, husbandry, breeding, research on nutri ...
,
ultrasound
Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...
technology,
nuclear medicine
Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitting ...
technology,
X-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...
technology,
medical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are conducted out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment, and prevention of disease. Clinical Medical labor ...
technology,
chiropody
Podiatry () or podiatric medicine () is a branch of medicine devoted to the study, diagnosis, medical and surgical treatment of disorders of the foot, ankle, and leg.
A Doctor of Podiatric Medicine (DPM), or a podiatrist, is a healthcare ...
,
dental hygiene
Oral hygiene is the practice of keeping one's mouth clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth (dental hygiene) and cleaning between the teeth. It is important that oral hygiene be carried out ...
, and postgraduate training programs in dentistry and medicine.
MMI procedure
# Interview stations – the domain(s) being assessed at any one station are variable, and normally reflects the objectives of the selecting institution. Examples of domains include the "soft skills" – ethics, professionalism, interpersonal relationships, ability to manage, communicate, collaborate, as well as perform a task. An MMI interview station takes considerable time and effort to produce; it is composed of several parts, including the stem question, probing questions for the interviewer, and a scoring sheet.
# Circuit(s) of stations – to reduce costs of the MMI significantly below that of most interviews,
[Rosenfeld J, Eva KW, Reiter HI, Trinh K. A Cost-Efficiency Comparison between the Multiple Mini-Interview and Panel-based Admissions Interviews. Advanced ]Health science
The following outline is provided as an overview of and topical guide to health sciences:
Health sciences are those sciences which focus on health, or health care, as core parts of their subject matter. Health sciences relate to multiple acad ...
Education Theory Pract. 2008 Mar;13(1):43–58 the interview "stations" are kept short (eight minutes or less) and are conducted simultaneously in a circuit as a bell-ringer examination. The preferred number of stations depends to some extent on the characteristics of the candidate group being interviewed, though nine interviews per candidate represents a reasonable minimum.
The circuit of interview stations should be within sufficiently close quarters to allow candidates to move from interview room to interview room. Multiple parallel circuits can be run, each circuit with the same set of interview stations, depending upon physical plant limitations.
# Interviewers – one interviewer per interview station is sufficient.
In a typical MMI, each interviewer stays in the same interview throughout, as candidates rotate through. The interviewer thus scores each candidate based upon the same interview scenario throughout the course of the test.
# Candidates – each candidate rotates through the circuit of interviews. For example, if each interview station is eight minutes, and there are nine interview stations, it will take the nine candidates being assessed on that circuit 72 minutes to complete the MMI. Each of the candidates begins at a different interview station, rotating to the next interview station at the ringing of the bell.
# Administrators – each circuit requires at least one administrator to ensure that the MMI is conducted fairly and on time.
Utility of the MMI
Test security breaches tend not to unduly influence results.
While the creators of the test claim that sex of candidate and candidate status as under-represented minority tends not to unduly influence results,
independent research has demonstrated that the MMI causes both gender and socioeconomic
bias. Although some research have suggested that preparatory courses taken by the candidate tend not to unduly influence results,
such research has not been duplicated and further research has to be done to make any scientifically sound argument for or against preparatory courses. Furthermore, such research must be designed to directly examine the efficacy of leading preparatory companies' courses rather than general evaluation. Although, it may be argued that all the validation so far has been done by McMaster and/or its affiliated company which constitute a conflict of interest and any result must be interpreted with caution. However, it is worth noting that MMI performance can be compromised by introversion.
See also
*
Objective structured clinical examination
An objective structured clinical examination (OSCE) is an approach to the assessment of clinical competence in which the components are assessed in a planned or structured way with attention being paid to the objectivity of the examination which i ...
References
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Interviews
Recruitment
University and college admissions