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1.  Can personal qualities of medical students predict in-course examination success and professional behaviour? An exploratory prospective cohort study 
BMC Medical Education  2012;12:69.
Over two-thirds of UK medical schools are augmenting their selection procedures for medical students by using the United Kingdom Clinical Aptitude Test (UKCAT), which employs tests of cognitive and non-cognitive personal qualities, but clear evidence of the tests’ predictive validity is lacking. This study explores whether academic performance and professional behaviours that are important in a health professional context can be predicted by these measures, when taken before or very early in the medical course.
This prospective cohort study follows the progress of the entire student cohort who entered Hull York Medical School in September 2007, having taken the UKCAT cognitive tests in 2006 and the non-cognitive tests a year later. This paper reports on the students’ first and second academic years of study. The main outcome measures were regular, repeated tutor assessment of individual students’ interpersonal skills and professional behaviour, and annual examination performance in the three domains of recall and application of knowledge, evaluation of data, and communication and practical clinical skills. The relationships between non-cognitive test scores, cognitive test scores, tutor assessments and examination results were explored using the Pearson product–moment correlations for each group of data; the data for students obtaining the top and bottom 20% of the summative examination results were compared using Analysis of Variance.
Personal qualities measured by non-cognitive tests showed a number of statistically significant relationships with ratings of behaviour made by tutors, with performance in each year’s objective structured clinical examinations (OSCEs), and with themed written summative examination marks in each year. Cognitive ability scores were also significantly related to each year’s examination results, but seldom to professional behaviours. The top 20% of examination achievers could be differentiated from the bottom 20% on both non-cognitive and cognitive measures.
This study shows numerous significant relationships between both cognitive and non-cognitive test scores, academic examination scores and indicators of professional behaviours in medical students. This suggests that measurement of non-cognitive personal qualities in applicants to medical school could make a useful contribution to selection and admission decisions. Further research is required in larger representative groups, and with more refined predictor measures and behavioural assessment methods, to establish beyond doubt the incremental validity of such measures over conventional cognitive assessments.
PMCID: PMC3473297  PMID: 22873571
2.  Graduate entry to medicine: widening psychological diversity 
At Nottingham University more than 95% of entrants to the traditional 5-year medical course are school leavers. Since 2003 we have admitted graduate entrants (GEM) to a shortened (4-year) course to 'widen access to students from more disadvantaged backgrounds'. We have recently shown that the GEM course widens academic and socio-demographic diversity of the medical student population. This study explored whether GEM students also bring psychological diversity and whether this could be beneficial.
We studied: a) 217 and 96 applicants to the Nottingham 5- and 4-year courses respectively, applying in the 2002-3 UCAS cycle, and, b) 246 school leavers starting the 5-year course and 39 graduate entrants to the 4-year course in October 2003. The psychological profiles of the two groups of applicants and two groups of entrants were compared using their performance in the Goldberg 'Big 5' Personality test, the Personal Qualities Assessment (PQA; measuring interpersonal traits and interpersonal values), and the Lovibond and Lovibond measure of depression, anxiety and stress. For the comparison of the Entrants we excluded the 33 school leavers and seven graduates who took the tests as Applicants.
Statistical analyses were undertaken using SPSS software (version 16.0).
Graduate applicants compared to school leaver applicants were significantly more conscientious, more confident, more self controlled, more communitarian in moral orientation and less anxious. Only one of these differences was preserved in the entrants with graduates being less anxious. However, the graduate entrants were significantly less empathetic and conscientious than the school leavers.
This study has shown that school leaver and graduate entrants to medical school differ in some psychological characteristics. However, if confirmed in other studies and if they were manifest in the extreme, not all the traits brought by graduates would be desirable for someone aiming for a medical career.
PMCID: PMC2784445  PMID: 19912642
3.  Selecting medical students 
BMJ : British Medical Journal  2006;332(7550):1156.
PMCID: PMC1459620  PMID: 16690689
4.  Intellectual aptitude tests and A levels for selecting UK school leaver entrants for medical school 
BMJ : British Medical Journal  2005;331(7516):555-559.
An extension of A level grades is the most promising alternative to intellectual aptitude tests for selecting students for medical school
PMCID: PMC1200591  PMID: 16150766
5.  Effect of Gd3+ on bradykinin-induced catecholamine secretion from bovine adrenal chromaffin cells 
British Journal of Pharmacology  1999;128(7):1435-1444.
The effects of Gd3+ on bradykinin- (BK-) induced catecholamine secretion, 45Ca2+ efflux and cytosolic [Ca2+] were studied using bovine adrenal chromaffin cells.BK increased secretion in a Ca2+-dependent manner. From 1–100 μM, Gd3+ progressively inhibited secretion induced by 30 nM BK to near-basal levels, however from 0.3–3 mM Gd3+ dramatically enhanced BK-induced secretion to above control levels. Gd3+ also increased basal catecholamine secretion by 2–3 fold at 1 mM. These effects were mimicked by Eu3+ and La3+.Gd3+ enhanced secretion induced by other agonists that mobilize intracellular Ca2+ stores, but simply blocked the response to K+.Gd3+ still enhanced basal and BK-induced secretion in Ca2+-free solution or in the presence of 30 μM SKF96365, however both effects of Gd3+ were abolished after depleting intracellular Ca2+ stores.Gd3+ (1 mM) reduced the rate of basal 45Ca2+ efflux by 57%. In Ca2+-free buffer, BK transiently increased cytosolic [Ca2+] measured with Fura-2. The [Ca2+] response to BK was substantially prolonged in the presence of Gd3+ (1 mM).The results suggest that Gd3+ greatly enhances the efficacy of Ca2+ released from intracellular stores in evoking catecholamine secretion, by inhibiting Ca2+ extrusion from the cytosol. This suggests that intracellular Ca2+ stores are fully competent to support secretion in chromaffin cells to levels comparable to those evoked by extracellular Ca2+ entry. Drugs that modify Ca2+ extrusion from the cell, such as lanthanide ions, will be useful in investigating the mechanisms by which intracellular Ca2+-store mobilization couples to Ca2+-dependent exocytosis.
PMCID: PMC1571780  PMID: 10602322
Ca2+ channels; chromaffin cells; catecholamine secretion; Gd3+; Na+/Ca2+-exchanger; Ca2+-ATPase; Ca2+ stores; inositol-1,4,5-trisphosphate
6.  Select medical students 
BMJ : British Medical Journal  1998;317(7166):1149-1150.
PMCID: PMC1114119  PMID: 9784462

Results 1-7 (7)