title: To what extent does the Health Professions Admission Test-Ireland predict performance in early undergraduate tests of communication and clinical skills? An observational cohort study.
abstract: BACKGROUND
  Internationally, tests of general mental ability are used in the selection of medical students. Examples include the Medical College Admission Test, Undergraduate Medicine and Health Sciences Admission Test and the UK Clinical Aptitude Test. The most widely used measure of their efficacy is predictive validity.A new tool, the Health Professions Admission Test- Ireland (HPAT-Ireland), was introduced in 2009. Traditionally, selection to Irish undergraduate medical schools relied on academic achievement. Since 2009, Irish and EU applicants are selected on a combination of their secondary school academic record (measured predominately by the Leaving Certificate Examination) and HPAT-Ireland score. This is the first study to report on the predictive validity of the HPAT-Ireland for early undergraduate assessments of communication and clinical skills.
  
  
  METHODS
  Students enrolled at two Irish medical schools in 2009 were followed up for two years. Data collected were gender, HPAT-Ireland total and subsection scores; Leaving Certificate Examination plus HPAT-Ireland combined score, Year 1 Objective Structured Clinical Examination (OSCE) scores (Total score, communication and clinical subtest scores), Year 1 Multiple Choice Questions and Year 2 OSCE and subset scores. We report descriptive statistics, Pearson correlation coefficients and Multiple linear regression models.
  
  
  RESULTS
  Data were available for 312 students. In Year 1 none of the selection criteria were significantly related to student OSCE performance. The Leaving Certificate Examination and Leaving Certificate plus HPAT-Ireland combined scores correlated with MCQ marks.In Year 2 a series of significant correlations emerged between the HPAT-Ireland and subsections thereof with OSCE Communication Z-scores; OSCE Clinical Z-scores; and Total OSCE Z-scores. However on multiple regression only the relationship between Total OSCE Score and the Total HPAT-Ireland score remained significant; albeit the predictive power was modest.
  
  
  CONCLUSIONS
  We found that none of our selection criteria strongly predict clinical and communication skills. The HPAT- Ireland appears to measures ability in domains different to those assessed by the Leaving Certificate Examination. While some significant associations did emerge in Year 2 between HPAT Ireland and total OSCE scores further evaluation is required to establish if this pattern continues during the senior years of the medical course.
authors.affiliation: Discipline of General Practice, Clinical Science Institute, National University of Ireland, Galway, Ireland. maureen.kelly@nuigalway.ie
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Kelly
authors.forename: Daniel
authors.initials: D
authors.lastname: Regan
authors.forename: Fidelma
authors.initials: F
authors.lastname: Dunne
authors.forename: Patrick
authors.initials: P
authors.lastname: Henn
authors.forename: John
authors.initials: J
authors.lastname: Newell
authors.forename: Siun
authors.initials: S
authors.lastname: O'Flynn
mesh_terms: D000293:Adolescent; D001077:Aptitude Tests; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data*; D003099:College Admission Test / Q000706:statistics & numerical data; D003142:Communication; D004504:Education, Medical, Undergraduate / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D011237:Predictive Value of Tests; D055815:Young Adult