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| The multiple mini interview (MMI)<ref name="EvaKW1">Eva KW, Reiter HI, Rosenfeld J, Norman GR. An admissions OSCE: the multiple mini-interview. [[Medical education|Medical Education]], 38:314-326 (2004).</ref> 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]]. In 2001, the [[Michael DeGroote]] School of Medicine at [[McMaster University]] 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]], professionalism and ethical/moral judgment.
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| | {{CMG}} {{AE}} [[User:William Patrick|William Patrick B.S.]] |
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| ==Introduction==
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| 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]] of the [[human resources|human resource]] literature has demonstrated low to moderate ability of interviews to predict for future job performance.<ref name="BarrickMR">Barrick MR, Mount MK. The Big 5 personality dimensions and job performance: a meta-analysis. Personnel Psychology 1991, 44:1-26.</ref> 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.<ref name="EvaKW2">Eva KW, Reiter HI, Rosenfeld J, Norman GR. The relationship between interviewer characteristics and ratings assigned during a Multiple Mini-Interview. Academic Medicine, 2004 Jun; 79(6):602.9.</ref> 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]].
| | ==[[Traditional medical school interview | The Traditional Medical School Interview]]== |
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| Therefore, even very short interviews within an MMI format provide similar ability to differentiate reproducibly between candidates.<ref name="DodsonM1">Dodson M, Crotty B, Prideaux D, Carne R, Ward A, de Leeuw E. The multiple mini-interview: how long is long enough? Med Educ. 2009 Feb;43(2):168-74.</ref> Ability to reproducibly differentiate between candidates, also known as overall test reliability, is markedly higher for the MMI than for other interview formats.<ref name="EvaKW1"/> This has translated into higher [[predictive validity]], correlating for future performance much more highly than standard interviews.<ref name="EvaKW3">Eva KW, Reiter HI, Rosenfeld J, Norman GR. The ability of the Multiple Mini-Interview to predict pre-clerkship performance in medical school. Academic Medicine, 2004, Oct; 79(10 Suppl): S40-2.</ref><ref name="ReiterHI1">Reiter HI, Eva KW, Rosenfeld J, Norman GR. Multiple Mini-Interview Predicts for Clinical Clerkship Performance, National Licensure Examination Performance. Med Educ. 2007 Apr;41(4):378-84.</ref><ref name="EvaKW4">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.</ref><ref name="HofmeisterM1">Hofmeister M, Lockyer J, Crutcher R. The multiple mini-interview for selection of international medical graduates into family [[Residency (medicine)|medicine residency]] education. Med Educ. 2009 Jun;43(6):573-9.</ref>
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| ==History==
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| Aiming to enhance predictive correlations with future performance in medical school, [[Postgraduate education|post-graduate]] 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 school|graduate students]] 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,<ref name="EvaKW1"/> and subsequent follow-up through medical school and on to national licensure examination ([http://www.mcc.ca/ Medical Council of Canada] Qualifying Examination Parts I and II) revealed the MMI to be the best predictor for subsequent clinical performance,<ref name="EvaKW3"/><ref name="EvaKW4"/> professionalism,<ref name="ReiterHI1"/> and ability to communicate with patients and successfully obtain national licensure.<ref name="EvaKW4"/><ref name="HofmeisterM1"/> Since its formal inception at the Michael G. DeGroote School of Medicine at McMaster University in 2004, the MMI subsequently spread as an admissions test across medical schools, and to other disciplines. By 2008, the MMI was being used as an admissions test by the majority of medical schools in Canada, Australia and Israel, as well as other medical schools in the United States and Brunei. This success lead to the development of a McMaster spin-off company, APT Inc., to commercialize the MMI system. The MMI was branded as [http://www.profithr.com/ ProFitHR] and made available to both the [[Academia|academic]] and corporate sector.<ref name="ProFit">www.ProFitHR.com</ref> By 2009, the list of other disciplines using the MMI included schools for [[dentistry]], [[pharmacy]], [[midwifery]], [[Physical therapy|physiotherapy]] and [[occupational therapy]], [[veterinary medicine]], [[Sonographer|ultrasound]] technology, [[nuclear medicine]] technology, [[Radiologic technologist|X-ray]] technology, [[medical laboratory]] technology, [[Podiatry|chiropody]], [[Dental hygienist|dental hygiene]], and postgraduate training programs in dentistry and medicine.
| | ==[[Multiple mini interview | The Multiple Mini Interview (MMI)]]== |
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| ==MMI Procedure==
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| # 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 relationship]]s, 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.
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| # Circuit(s) of stations – to reduce costs of the MMI significantly below that of most interviews,<ref name="RosenfieldJ1">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|Health Science]] Education Theory Pract. 2008 Mar;13(1):43-58</ref> 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.<ref name="EvaKW2"/> 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.
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| # Interviewers – one interviewer per interview station is sufficient.<ref name="EvaKW2"/> 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.
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| # 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.
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| # Administrators – each circuit requires at least one administrator to ensure that the MMI is conducted fairly and on time.
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| ==Utility of the MMI==
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| The MMI requires less expenditure of resources than standard interview formats.<ref name="ProFit"/> Test security breaches tend not to unduly influence results.<ref name="ReiterHI2">Reiter HI, Salvatori P, Rosenfeld J, Trinh K, Eva KW. The Impact of Measured Violations of Test Security on Multiple-Mini Interview (MMI). Medical Education, 2006; 40:36-42.</ref> Sex of candidate and candidate status as under-represented minority tends not to unduly influence results.<ref name="EvaKW1"/><ref name="MoreauK1">Moreau K, Reiter HI, Eva KW. Comparison of Aboriginal and Non-Aboriginal Applicants for Admissions on the Multiple Mini-Interview using Aboriginal and Non-Aboriginal Interviewers. Teaching and Learning in Medicine, 2006; 18:58-61.</ref> Preparatory courses taken by the candidate tend not to unduly influence results.<ref name="GriffinB1">Griffin B, Harding DW, Wilson IG, Yeomans ND. Does practice make perfect? The effect of coaching and retesting on selection tests used for admission to an Australian medical school. Med J Aust. 2008 Sep 1;189(5):270-3</ref> The MMI has been validated and tested for over seven years and the product is now available “off the shelf.”<ref name="HofmeisterM1"/>
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| ==Additional Resources==
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| ===Student Doctor Network===
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| [http://studentdoctor.net/2011/01/the-multiple-mini-interview-for-medical-school-admissions/ The Multiple Mini-Interview for Medical School Admissions: What to Expect and How to Prepare]
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| ===McMaster University School of Medicine===
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| [http://www.fhs.mcmaster.ca/mdprog/documents/InterviewerManual.doc Manual For Interviewers] (.doc)
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| [http://journals.lww.com/academicmedicine/Fulltext/2004/06000/The_Relationship_between_Interviewers_.21.aspx 9 MMI scenarios used by McMaster University in Spring 2002]
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| ===University of Saskatchewan College of Medicine===
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| [http://www.medicine.usask.ca/pt/admission/Practice_MMI_QuestionsUofS.pdf Practice MMI Questions] (.pdf)
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| ===University of Calgary Medical School===
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| [http://www.ucalgary.ca/mdprogram/admissions/mmi General Information on the MMI]
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| [http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2923.2009.03292.x/pdf 9 MMI scenarios]. If inaccessible, the abstract is available [http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2923.2009.03292.x/abstract here]
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| [http://vp.ucalgary.ca/images/admissions/MMIPodcast.mov Video recording of an MMI response]
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| ===School of Medical Rehabilitation at the University of Manitoba===
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| [http://umanitoba.ca/faculties/medicine/units/medrehab/media/pt_mmi_presentation.pdf MMI powerpoint presentation with station descriptions and suggestions for appropriate responses] (.ppt)
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| ===UC Davis School of Medicine===
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| Does the MMI format favor introverts? An [http://www.ucdmc.ucdavis.edu/publish/news/newsroom/6802 interesting study] suggests it does.
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| ==References==
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| {{reflist}}
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