PT  - JOURNAL ARTICLE
AU  - Marina Sawdon
AU  - JC McLachlan
TI  - ‘10% of your medical students will cause 90% of your problems’: a prospective correlational study
AID  - 10.1136/bmjopen-2020-038472
DP  - 2020 Nov 01
TA  - BMJ Open
PG  - e038472
VI  - 10
IP  - 11
4099  - http://bmjopen.bmj.com/content/10/11/e038472.short
4100  - http://bmjopen.bmj.com/content/10/11/e038472.full
SO  - BMJ Open2020 Nov 01; 10
AB  - Objectives Our aim was to explore the relationship between medical student Conscientiousness Index scores and indicators of later clinical performance held in the UK Medical Education Database (UKMED). Objectives were to determine whether conscientiousness in first-year and second-year medical students predicts later performance in medical school and in early practice. Policy implications would permit targeted remediation where necessary or aid in selection.Design A prospective correlational study.Setting A single UK medical school and early years of practice, 2005–2018.Participants The data were obtained from the UKMED on 858 students. Full outcome data was available for variable numbers of participants, as described in the text.Main outcome measures Scores on the UK Foundation Programme Office’s Situational Judgement Test (SJT) and Educational Performance Measure (EPM), the Prescribing Safety Assessment (PSA) and Annual Review of Competency Progression (ARCP) outcomes.Results Linear regression analysis shows Conscientiousness Index scores significantly correlate with pregraduate and postgraduate performance variables: SJT scores (R=0.373, R2=0.139, B=0.066, p<0.001, n=539); PSA scores (R=0.249, R2=0.062, B=0.343, p<0.001, n=462); EPM decile scores for the first (lowest) decile are significantly lower than the remaining 90% (p=0.003, n=539), as are PSA scores (p<0.001, n=463), and ARCP year 2 scores (p=0.019, n=517). The OR that students in the first decile fail to achieve the optimum ARCP outcome is 1.6126 (CI: 1.1400 to 2.2809, p=0.0069, n=618).Conclusions Conscientiousness Index scores in years 1 and 2 of medical school have predictive value for later performance in knowledge, skills and clinical practice. This trait could be used either for selection or for targeted remediation to avoid potential problems in the future.