Competency-Based, Applicant-Centered Multiple Mini-Interviews for Selection into Japan’s Basic Postgraduate Clinical Training: Optimizing Acceptability and Feasibility Over 7 Years

抄録

Aim: Although quantitative acceptability/feasibility results on Multiple Mini-Interviews (MMIs) have been favorable, qualitative data-focused reports, especially from non-western countries are scarce. We investigated acceptability/feasibility analyses of a competency-based, applicant-centered, situational question (SQ)/past-behavior question (PBQ) -based MMI with fewer station numbers and with longer interview time for selection for Japan's basic postgraduate clinical training program (JBPGCTP) at a local teaching hospital, Okinawa Prefectural Nanbu Medical Center/Children's Medical Center (OPNMC/CMC), with emphasis on qualitative data.

Methods: First, identification of OPNMC/CMC physicians' competencies and their selection-oriented ranking were made. Based on this, a three-station MMI, with each lasting eight to twelve minutes per question was developed. This MMI was administered in an applicant-centered manner, an on-demand, first-come-first-serve style over six months annually. Interview questions were prepared in two formats, SQs and PBQs. Immediately after the MMI, both applicants and examiners were asked to complete a post-MMI survey. Qualitative analyses used the "selection procedural justice theory" for coding. Analyses periods were classified into three phases: 2013—2014 (Phase I), 2015 (Phase II), and 2016—2019 (Phase III) with the question types per station being "one PBQ then one SQ fixed in order"," PBQs/SQs alternated in order", and" only one PBQ", respectively.

Results: Quantitative analyses revealed statistically significant improvement in both applicant and examiners' perceptions: phase III than Phase I and II (P<0.05). Both stakeholders perceived PBQs to be preferable to SQs. Both felt three or four station numbers to be the most acceptable and feasible. In qualitative analyses, both acknowledged the importance of ensuring station structuredness and interview time.

Conclusion: The results showed favorable acceptability and feasibility of competency-based, applicant-centered, PBQ (rather than SQ)-based, postgraduate MMI with fewer station numbers and longer interview time per question.