Multiple mini interview
Encyclopedia
The multiple mini interview (MMI) is an interview
Interview
An interview is a conversation between two people where questions are asked by the interviewer to obtain information from the interviewee.- Interview as a Method for Qualitative Research:"Definition" -...

 format that uses many short independent assessments, typically in a timed circuit, to obtain an aggregate score of each candidate’s soft skills
Soft skills
Soft skills is a sociological term relating to a person's "EQ" , the cluster of personality traits, social graces, communication, language, personal habits, friendliness, and optimism that characterize relationships with other people...

. In 2001, the Michael DeGroote
Michael DeGroote
Michael G. DeGroote, OC is a Canadian businessman and philanthropist from Hamilton, Ontario who currently resides in Bermuda. Aside from his business career, he is best known as a major private donor to local educational institutions such as McMaster University and Hillfield Strathallan...

 School of Medicine at McMaster University
McMaster University
McMaster University is a public research university whose main campus is located in Hamilton, Ontario, Canada. The main campus is located on of land in the residential neighbourhood of Westdale, adjacent to Hamilton's Royal Botanical Gardens...

 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
Medical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...

. 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
Interpersonal skills
Interpersonal skills are sometimes also referred to as people skills or communication skills. Interpersonal skills involve using skills such as active listening and tone of voice, this include delegation and leadership...

, professionalism and ethical/moral judgment.

Introduction

Interviews have been used widely for different purposes, including assessment and recruitment
Recruitment
Recruitment refers to the process of attracting, screening, and selecting qualified people for a job. For some components of the recruitment process, mid- and large-size organizations often retain professional recruiters or outsource some of the process to recruitment agencies.The 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
Job performance
Job performance is a commonly used, yet poorly defined concept in industrial and organizational psychology, the branch of psychology that deals with the workplace. It's also part of Human Resources Management. It most commonly refers to whether a person performs their job well...

 or job retention. Meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...

 of the human resource
Human resources
Human resources is a term used to describe the individuals who make up the workforce of an organization, although it is also applied in labor economics to, for example, business sectors or even whole nations...

 literature has demonstrated low to moderate ability of interviews to predict for future job performance. 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. 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
Halo effect
The halo effect is a cognitive bias whereby one trait influences another trait or traits of that person or object. This is very common among physically attractiveness...

.

Therefore, even very short interviews within an MMI format provide similar ability to differentiate reproducibly between candidates. Ability to reproducibly differentiate between candidates, also known as overall test reliability, is markedly higher for the MMI than for other interview formats. This has translated into higher predictive validity
Predictive validity
In psychometrics, predictive validity is the extent to which a score on a scale or test predicts scores on some criterion measure.For example, the validity of a cognitive test for job performance is the correlation between test scores and, for example, supervisor performance ratings...

, correlating for future performance much more highly than standard interviews.

History

Aiming to enhance predictive correlations with future performance in medical school, post-graduate
Postgraduate education
Postgraduate education involves learning and studying for degrees or other qualifications for which a first or Bachelor's degree generally is required, and is normally considered to be part of higher education...

 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 students
Graduate school
A graduate school is a school that awards advanced academic degrees with the general requirement that students must have earned a previous undergraduate degree...

 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, and subsequent follow-up through medical school and on to national licensure examination (Medical Council of Canada Qualifying Examination Parts I and II) revealed the MMI to be the best predictor for subsequent clinical performance, professionalism, and ability to communicate with patients and successfully obtain national licensure. 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 ProFitHR and made available to both the academic
Academia
Academia is the community of students and scholars engaged in higher education and research.-Etymology:The word comes from the akademeia in ancient Greece. Outside the city walls of Athens, the gymnasium was made famous by Plato as a center of learning...

 and corporate sector. By 2009, the list of other disciplines using the MMI included schools for dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...

, pharmacy
Pharmacy
Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs...

, midwifery
Midwifery
Midwifery is a health care profession in which providers offer care to childbearing women during pregnancy, labour and birth, and during the postpartum period. They also help care for the newborn and assist the mother with breastfeeding....

, physiotherapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

 and occupational therapy
Occupational therapy
Occupational therapy is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities. Occupational therapists work with individuals who suffer from a mentally, physically, developmentally, and/or emotionally disabling condition by utilizing treatments...

, veterinary medicine
Veterinary medicine
Veterinary Medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in non-human animals...

, ultrasound
Sonographer
Sonographers are diagnostic medical professionals who operate ultrasonic imaging devices to produce diagnostic images, scans, videos, or 3D volumes of anatomy and diagnostic data. Sonography requires specialized education and skills to view, analyze and modify the scan to optimize the information...

 technology, nuclear medicine
Nuclear medicine
In nuclear medicine procedures, elemental radionuclides are combined with other elements to form chemical compounds, or else combined with existing pharmaceutical compounds, to form radiopharmaceuticals. These radiopharmaceuticals, once administered to the patient, can localize to specific organs...

 technology, X-ray
Radiologic technologist
A radiologic technologist, also known as medical radiation technologist and as radiographer, performs imaging of the human body for diagnosis or treating medical problems...

 technology, medical laboratory
Medical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.-Departments:...

 technology, chiropody
Podiatry
Podiatry is a branch of medicine devoted to the study, diagnosis, and treatment of disorders of the foot, ankle, and lower leg. The term podiatry came into use first in the early 20th century United States, where it now denotes a Doctor of Podiatric Medicine , a specialist who is qualified by their...

, dental hygiene
Dental hygienist
thumb|right|300px|Dental hygienist holding a scalerA dental hygienist is a licensed dental professional who specializes in preventive oral health, typically focusing on techniques in oral hygiene. Local dental regulations determine the scope of practice of dental hygienists...

, and postgraduate training programs in dentistry and medicine.

MMI Procedure

  1. 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
    Interpersonal relationship
    An interpersonal relationship is an association between two or more people that may range from fleeting to enduring. This association may be based on limerence, love, solidarity, regular business interactions, or some other type of social commitment. Interpersonal relationships are formed in the...

    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.
  2. Circuit(s) of stations – to reduce costs of the MMI significantly below that of most interviews, 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. 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.
  3. Interviewers – one interviewer per interview station is sufficient. 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.
  4. 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.
  5. Administrators – each circuit requires at least one administrator to ensure that the MMI is conducted fairly and on time.

Utility of the MMI

The MMI requires less expenditure of resources than standard interview formats. Test security breaches tend not to unduly influence results. Sex of candidate and candidate status as under-represented minority tends not to unduly influence results. Preparatory courses taken by the candidate tend not to unduly influence results. The MMI has been validated and tested for over seven years and the product is now available “off the shelf.”
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