The attitudes, perceptions and experiences of medical school applicants following the closure of schools and cancellation of public examinations in 2020 due to the COVID-19 pandemic: a cross-sectional questionnaire study of UK medical applicants

COVID-19 meets control-value theory: Emotional reactions to canceled high-stakes examinations

In many countries, examinations scheduled for summer 2020 were canceled as part of measures designed to curb the spread of the COVID-19 pandemic. To examine how four retrospective emotions about canceled examinations (relief, gratitude, disappointment, and anger) and one prospective emotion (test anxiety) were related to control-value appraisals, a sample of 474 participants in the UK aged 15-19 years, who would have taken high-stakes examinations if they had not been canceled, self-reported measures of control, value, retrospective emotions and test anxiety. Data were analysed using the confirmatory factor analysis within exploratory structural equation modeling (EwC) approach. Relief, gratitude, and anger were predicted from expectancy × value interactions. Disappointment was related to expectancy only. Test anxiety was predicted independently by expectancy and positive/negative value. Findings offer broad support for Control-Value Theory and show how the appraisals underpinning achievement emotions can differ when focused on canceled examinations rather than success or failure.

Institutional choice among medical applicants: a profile paper for The United Kingdom Medical Applicant Cohort Study (UKMACS) prospective longitudinal cohort study

PURPOSE

To generate a large cohort of those in 2019 seriously considering applying to study Medicine, collecting data on a range of socioeconomic and other demographic factors that influence choice of medical schools and to link to other datasets to form a longitudinal study of progress through medical school and careers in medicine.

DESIGN

Cross-sectional questionnaire studies, part of the longitudinal UK Medical Applicant Cohort Study (UKMACS).

SETTING

UK medical school admissions in 2020.

PARTICIPANTS

UK residents aged 16+ and seriously considering applying to study Medicine. The cohort was primarily drawn from those registering in 2019 for the U(K)CAT (University Clinical Aptitude Test (formerly the UK Clinical Aptitude Test)) with additional potential applicants responding to an open call. Participants consented to their data being linked within the UK Medical Education Database.

FINDINGS TO DATE

UKMACS Wave 1 questionnaire respondents consisted of 6391 consenting respondents from across the UK. In 2019, 14 980 of the 17 470 UK-domiciled medicine applicants were first-time applicants. The questionnaires show that many of these applicants have a need for more help and guidance to make informed choices, with less advantaged groups reporting themselves as being at a disadvantage when applying due to limited understanding of information and limited access to guidance to enable informed and effective decision-making.

FUTURE PLANS

To link the cohort with successive Universities and Colleges Admissions Service and other datasets to analyse outcomes of applications and establish national longitudinal evidence to understand how medical choices are made and how they impact on educational, career and workforce outcomes.

Assessing Cognitive Factors of Modular Distance Learning of K-12 Students Amidst the COVID-19 Pandemic towards Academic Achievements and Satisfaction

The COVID-19 pandemic brought extraordinary challenges to K-12 students in using modular distance learning. According to Transactional Distance Theory (TDT), which is defined as understanding the effects of distance learning in the cognitive domain, the current study constructs a theoretical framework to measure student satisfaction and Bloom’s Taxonomy Theory (BTT) to measure students’ academic achievements. This study aims to evaluate and identify the possible cognitive capacity influencing K-12 students’ academic achievements and satisfaction with modular distance learning during this new phenomenon. A survey questionnaire was completed through an online form by 252 K-12 students from the different institutions of Occidental Mindoro. Using Structural Equation Modeling (SEM), the researcher analyses the relationship between the dependent and independent variables. The model used in this research illustrates cognitive factors associated with adopting modular distance learning based on students’ academic achievements and satisfaction. The study revealed that students’ background, experience, behavior, and instructor interaction positively affected their satisfaction. While the effects of the students’ performance, understanding, and perceived effectiveness were wholly aligned with their academic achievements. The findings of the model with solid support of the integrative association between TDT and BTT theories could guide decision-makers in institutions to implement, evaluate, and utilize modular distance learning in their education systems.

Rates, perceptions and predictors of depression, anxiety and Post Traumatic Stress Disorder (PTSD)-like symptoms about Covid-19 in adolescents

Increasing evidence has shown that the Covid-19 outbreak, and subsequent school closures and exam cancellations that followed, has impacted adolescent mental health. The current cross-sectional study examined rates of depression, anxiety and Post Traumatic Stress Disorder (PTSD)-like symptoms about Covid-19 in adolescents and whether current or past mental health support, additional support in school, keyworker status, poorer household relationships since the outbreak of Covid-19 or reduced physical activity were associated with elevated levels of depression, anxiety or PTSD-like symptoms. Lastly, it examined perceived changes in mental health due to the Covid-19 pandemic, school closures and the cancellation of exams. A total of 899 adolescents (14–18 years) took part in the ’in isolation instead of in school’ (INISS) project. Findings indicated that older adolescents, females, those who currently or previously received mental health support or additional support in school and adolescents who reported poorer relationships at home since Covid-19 were more likely to meet clinical threshold levels for their mental health. Adolescents highlighted worsening of their mental health due to Covid-19 and school closures with mixed positive and negative impact of exam cancellations. Adolescents experiencing clinical threshold levels of depression and anxiety uniquely reported worsening of their mental health since the Covid-19 pandemic, school closures and exam cancellations. Understanding the rates, perceptions and factors associated with increases in depression, anxiety and PTSD-like symptoms in adolescents during the Covid-19 pandemic will inform national policy in supporting adolescent mental health and recovery from the Covid-19 pandemic.

Predictive validity of A-level grades and teacher-predicted grades in UK medical school applicants: a retrospective analysis of administrative data in a time of COVID-19

OBJECTIVES

To compare in UK medical students the predictive validity of attained A-level grades and teacher-predicted A levels for undergraduate and postgraduate outcomes. Teacher-predicted A-level grades are a plausible proxy for the teacher-estimated grades that replaced UK examinations in 2020 as a result of the COVID-19 pandemic. The study also models the likely future consequences for UK medical schools of replacing public A-level examination grades with teacher-predicted grades.

DESIGN

Longitudinal observational study using UK Medical Education Database data.

SETTING

UK medical education and training.

PARTICIPANTS

Dataset 1: 81 202 medical school applicants in 2010-2018 with predicted and attained A-level grades. Dataset 2: 22 150 18-year-old medical school applicants in 2010-2014 with predicted and attained A-level grades, of whom 12 600 had medical school assessment outcomes and 1340 had postgraduate outcomes available.

OUTCOME MEASURES

Undergraduate and postgraduate medical examination results in relation to attained and teacher-predicted A-level results.

RESULTS

Dataset 1: teacher-predicted grades were accurate for 48.8% of A levels, overpredicted in 44.7% of cases and underpredicted in 6.5% of cases. Dataset 2: undergraduate and postgraduate outcomes correlated significantly better with attained than with teacher-predicted A-level grades. Modelling suggests that using teacher-estimated grades instead of attained grades will mean that 2020 entrants are more likely to underattain compared with previous years, 13% more gaining the equivalent of the lowest performance decile and 16% fewer reaching the equivalent of the current top decile, with knock-on effects for postgraduate training.

CONCLUSIONS

The replacement of attained A-level examination grades with teacher-estimated grades as a result of the COVID-19 pandemic may result in 2020 medical school entrants having somewhat lower academic performance compared with previous years. Medical schools may need to consider additional teaching for entrants who are struggling or who might need extra support for missed aspects of A-level teaching.

Medical applicant general practice experience and career aspirations: a questionnaire study

Background

Increasing access to general practice work experience placements for school students is a strategy for improving general practice recruitment, despite limited evidence and concerns surrounding equity of access to general practice experiences.

Aims

To examine the association between undertaking general practice experience and the perceptions of general practice as an appealing future career among prospective medical applicants. To identify socioeconomic factors associated with obtaining general practice experience.

Design & setting

Cross-sectional questionnaire study in the UK.

Method

Participants were UK residents aged ≥16 years and seriously considering applying to study medicine in 2019/2020. They were invited to take part via the University Clinical Aptitude Test (UCAT). Questionnaire data were analysed using a linear regression of general practice appeal on general practice experience, adjusting for career motivations and demographics, and a logistic regression of general practice experience on measures of social capital and demographics.

Results

Of 6391 responders, 4031 were in their last year of school. General practice experience predicted general practice appeal after adjusting for career motivation and demographics (b = 0.37, standard error [SE] = 0.06, P<0.00001). General practice experience was more common among students at private (odds ratio [OR] = 1.65, 95% confidence interval [CI] = 1.31 to 2.08, P<0.0001) or grammar schools (OR = 1.33, 95% CI = 1.02 to 1.72, P = 0.03) and in the highest socioeconomic group (OR = 1.62, 95% CI = 1.28 to 2.05, P<0.0001), and less likely among students of ‘other’ ethnicity (OR = 0.37, 95% CI = 0.20 to 0.67, P = 0.0011).

Conclusion

Having general practice experience prior to medical school was associated with finding general practice appealing, which supports its utility in recruitment. Applicants from more deprived backgrounds were less likely to have had a general practice experience, possibly through lack of accessible opportunities.