Assessing the predictive validity of the UCAT—A systematic review and narrative synthesis

Abstract

Background

The University Clinical Aptitude Test (UCAT) is an admissions assessment used by a consortium of universities across the UK, Australia, and New Zealand, to aid the selection of applicants to medical and dental degree programmes. The UCAT aims to measure the mental aptitude and professional behaviours required to become successful doctors and dentists. We conducted a systematic review to establish the predictive value of the UCAT across measures of performance at undergraduate and post-graduate levels.

Methods

A literature search was conducted in April 2020 using eight electronic databases: MEDLINE, APA PsycInfo, SCOPUS, Web of Science, EThOS, OpenGrey, PROSPERO, and the UCAT website. Data were extracted from selected studies and tabulated as results matrices. A narrative synthesis was performed.

Results

Twenty-four studies satisfied our inclusion criteria, 23 of which were deemed to be of good quality (using the Newcastle-Ottawa Scale). For over 70% of univariate data points, the UCAT exerted no statistically significant predictive validity; for the remainder, predictive power was weak. The cognitive total and verbal reasoning subtests had the largest evidence base as weakly positive predictors of academic performance. The SJT subtest was a weak predictor of professional behaviour during medical school. Studies specific to dental schools demonstrated variable findings across the five studies. Only 1 study looked at post-graduate outcome measures and demonstrated that the UCAT was not a predictor of health- or conduct-related fitness to practice declarations at GMC registration.

Conclusions

These data provide some support for the use of cognitive total and verbal reasoning subtests as part of medical school selection. Further research is needed to investigate outcomes beyond professional registration and for dental students.

Keywords:

• Assessment
• medicine
• predictive
• validity
• UCAT

Disclosure statement

C.B. is Deputy Admissions Lead at Warwick Medical School, which uses the UCAT as part of the admissions process. Warwick Medical School is therefore a member of the UCAT Consortium. This review was conducted independently of the UCAT consortium.

Glossary

University Clinical Aptitude Test (UCAT): An admissions assessment used by a consortium of universities across the UK, Australia, and New Zealand, to aid the selection of applicants to medical and dental degree programmes. The UCAT aims to measure mental aptitude and professional behaviours required to become successful doctors and dentists (UKCAT Consortium 2020).

Additional information

Funding

C.B. is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Notes on contributors

Laksha Bala

Laksha Bala, MRCGP, FHEA, Research Fellow in Medical Education at Imperial College School of Medicine, London, UK.

Stephen Pedder

Stephen Pedder, MBChB, medical student at the University of Warwick, Coventry, UK. When this study was undertaken, now a Foundation Year One doctor.

Amir H. Sam

Amir H. Sam, PhD, FRCP, SFHEA, Head of Imperial College School of Medicine, London, UK.

Celia Brown

Celia Brown, PhD, SFHEA, Professor of Medical Education, University of Warwick, Coventry, UK.