The UK Clinical Aptitude Test: Is it a fair test for selecting medical students?

Figures & data

Table

Practice points

Selection to study medicine should be fair. Aptitude tests aim to improve on existing selection tools and widen access to the study of medicine. This study reports that differentials in access to information about the UKCAT and advice on preparation influence candidate performance in the test and undermine its aim to widen participation.

Figure 1. (a) Bar graph of the percentage of respondents who were advised to prepare for the test by a tutor, teacher or career advisor contrasted by the type of school/college a respondent attended. (b) Bar graph of the percentage of respondents who considered their school or college was fully informed about the UKCAT contrasted by the type of school/college a candidate attended. Note: School/college type attended: SFC = Sixth Form College and FEC Further Education College.

Table 1.  Independent predictors of respondent performance on total UKCAT score, model fit statistics total UKCAT score (F (10, 556)) = 8.18 p = 0.0000), R² = 0.14

	Mean score difference^#	SE	t	p > t	95% Confidence interval		Effect size	95% Confidence interval
Preparation for the UKCAT
Prepared for 5–20 hrs	43	23.3	1.9	*	2	89	0.2	0.05–0.39
Prepared for 20+hrs	68	30.2	2.3	*	9	127	0.2	0.02–0.45
Used UKCAT + commercial resources	56	20.8	2.7	**	15	96	0.4	0.22–0.64
Mathematics studied beyond GCSE	60	22.1	2.7	**	16	103	0.6	0.38–0.82
Educational institution
Last attended comprehensive school	97	27.5	3.5	***	43	151	0.5	0.23–0.77
Last attended Grammar (no-fees) school	116	25.4	4.7	***	67	165	0.6	0.36–0.84
Last attended Grammar (fees) school	131	53.0	2.5	*	27	214	0.7	0.21–1.20
Last attended Public/Independent school	65	24.7	2.6	**	17	113	0.4	0.16–0.64
Last attended Further Education College	–68	43.1	–1.6	0.11	–153	15
Last attended other type of school	65	67.5	0.9	0.33	–66	198
Gender and age
Male	34	17.8	2.0	*	0.2	70	0.2	0.03–0.37
Age-group ≥ 20 years of age	–134	38.9	–3.4	**	–210	–58	0.8	0.61–1.19
Constant	2445	33.5	72.8	***	2379	2511	–	–

Notes: ^#The coefficient is the difference in the mean total UKCAT score compared to the reference group. Reference groups: prepared for 0–5 hours; used commercial resource or UKCAT on-line practise test only; no mathematics studied beyond GCSE level; educational background reference group was Sixth Form College; female was gender reference group; aged 19 years and under was the age-group reference group. Effect size calculated as mean total UKCAT score difference between predictor and its baseline category divided by pooled estimate of SDs of both groups.

Statistically significant differences are indicated by * = p < 0.05, ** = p < 0.01 and *** = p < 0.001, in column p > t.

Table 2.  Independent predictors of respondent performance in the VR subsection of the UKCAT, model fit statistics (F (13, 552)) = 14.24 p = 0.0000), R² = 0.25]

Subsection scores	Mean score difference^#	SE	t	p > t	95% Confidence interval
QR	0.32	0.05	6.76	***	0.22	0.41
AR	0.11	0.04	2.70	**	0.03	0.20
DA	0.12	0.03	3.23	**	0.04	0.19
Constant	227	36.52	6.21	***	155.11	298.58

Note: Refer notes of Table 1.

Table 3.  Independent predictors of respondent performance in the QR subsection of the UKCAT, model fit statistics (F (13, 552)) = 21.51 p = 0.0000), R² = 0.33

Subsection scores	Mean score difference^#	SE	t	p > t	95% Confidence interval		Effect size	95% Confidence interval
VR	0.33	0.05	6.41	***	0.23	0.44
AR	0.11	0.03	2.88	**	0.03	0.19
DA	0.13	0.04	3.86	***	0.07	0.21
Last attended Grammar (no-fees) school	38	7.64	4.97	***	23.01	53.04	0.5	0.08–1.08
Mathematics studied beyond GCSE	32	7.52	4.31	***	17.63	47.20	0.6	0.20–1.00
Male	19	5.82	3.22	**	7.32	30.19	0.3	0.13–0.47
Constant	271	34.54	7.85	***	203.48	339.19

Notes: Refer notes of Table 1.

Table 4.  Independent predictors of respondent performance in the AR subsection of the UKCAT, model fit statistics (F (13, 552)) = 12.06 p = 0.0000), R² = 0.22

Subsection scores	Mean score difference^#	SE	t	p > t	95% Confidence interval		Effect size	95% Confidence interval
VR	0.13	0.04	2.70	**	0.03	0.22
QR	0.12	0.04	2.81	**	0.04	0.21
DA	0.15	0.04	4.19	***	0.08	0.23
Used UKCAT + commercial resources	24	6.23	3.87	***	11.87	36.38	0.4	0.21–0.6
Age-group ≥ 20 years	–23	11.9	–1.9	*	–46.89	–0.32	0.6	0.32–0.87
Last attended Grammar (fee-paying) school	48	17.73	2.73	**	13.54	83.21	0.8	0.66–0.90
Constant	355	35.67	9.95	***	284.98	425.12

Notes: Refer notes of Table 1.

Table 5.  Independent predictors of respondent performance in the DA subsection of the UKCAT, model fit statistics (F (13, 552)) = 11.84 p = 0.0000), R² = 0.22

Subsection scores	Mean score difference^#	SE	t	p > t	95% Confidence Interval		Effect size	95% Confidence interval
VR	0.17	0.05	3.32	**	0.07	0.28
QR	0.20	0.05	3.94	***	0.10	0.30
AR	0.20	0.05	4.02	***	0.10	0.30
Age-group ≥ 20 years	–26	12.03	–2.1	*	–49.36	–2.09	1.6	0.66–2.54
Constant	254	41.79	6.09	***	172.50	336.69

Notes: Refer notes of Table 1.

Figure 2. The interaction effect between preparation time and type of resource used on total UKCAT score. Notes: UKCAT or commercial defines respondents who used either solely the UKCAT on-line practise test or solely commercial practise resources in their preparation for the test. Both define respondents who use both the UKCAT on-line practise test and commercial practise resources in preparation for the test. Fitted values are the values predicted by the regression model including the interaction term.