Challenging the fairness of MMIs for direct entry vs. graduate entry medical students

Introduction:
The Multiple Mini Interview (MMI) has become a prominent tool in assessing non-cognitive skills essential for medical professionals. However, concerns have been raised regarding its fairness across different entry pathways into medical school. This study investigates the fairness of using MMIs for both direct entry and graduate entry students, aiming to ensure equitable admissions processes in medical education.

Objective:
This research addresses several key questions:
•Do MMIs demonstrate factorial validity for both direct entry and graduate entry students?
•Are the attributes measured by MMIs interpreted consistently across these groups?
•Are there significant differences in MMI performance between direct entry and graduate entry students?

Method:
The individuals involved (N = 432) are prospective students at Bond University's medical program for 2024. Data were analysed using Confirmatory Factor Analysis (CFA) to assess the dimensionality and factorial validity of MMIs. Multigroup Confirmatory Factor Analysis (MG-CFA) was employed to determine if MMIs measure the same underlying construct for both direct entry and graduate entry students. Latent mean differences were examined to identify any significant group disparities in MMI performance.

Results:
CFA results provided robust evidence supporting the construct validity of MMIs across both direct entry and graduate entry student cohorts. The core attributes assessed by MMIs were found to be consistent across these groups, demonstrating measurement equivalence. Importantly, there were no significant performance differences in overall MMI scores between direct entry and graduate entry students.

Discussion/Conclusion:
This study affirms the fairness and validity of MMIs in medical school admissions, showing that MMIs are effective tools for assessing non-cognitive skills across different entry pathways. These findings support the continued use of MMIs to ensure an equitable selection process. The results have significant implications for admissions committees and policymakers striving to maintain fairness and inclusivity in medical school admissions.
Keywords: Multiple Mini Interviews (MMI), Fairness, Construct Validity, Entry Pathways