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What Predicts Performance in Canadian Dental Schools?

Ms. Smithers is a Lecturer and Dr. Catano is Professor and Chair, both in the Department of Psychology, Saint Mary’s University; Dr. Cunningham is Associate Professor and Assistant Dean, Faculty of Dentistry, Dalhousie University. Direct correspondence and requests for reprints to Dr. D.P. Cunningham, Faculty of Dentistry, Dalhousie University, 5981 University Ave., Halifax, Nova Scotia, Canada B3H 3J5; 902-494-2876 phone; 902-494-2527 fax; d.p.cunningham{at}dal.ca. This study is based on data collected as part of a master’s thesis project at Saint Mary’s University.

Key words: personality measures, predicting performance, cognitive measures, Canadian Dental Association’s interview

Submitted for publication 01/16/04; accepted 04/06/04

	Abstract

Top Abstract The canadian dental aptitude... Selection interviews Personality and Selection Methods Results Discussion Conclusions and Future... References

 
The task of selecting the best dental applicants out of an extremely competitive applicant pool is a problem faced annually by dental faculties. This study examined the validity of both cognitive and noncognitive factors used for selection to Canadian dental schools. Interest in personality measurement and the prediction offered by personality measures has escalated and may be applied to the selection of dental candidates. Therefore, the study also assessed whether the addition of a personality measure would increase the validity of predicting performance beyond that achieved by an interview and the Dental Aptitude Test. Results suggest that an interview may be useful in identifying specific behavioral characteristics deemed important for success in dental training. Consistent with previous research, results show that the Dental Aptitude Test is a good predictor of preclinical academic success, with prediction declining when clinical components of the program are introduced into the criterion. Results from the personality measure indicated that Openness to Experience was significantly related to aspects of clinical education, although, contrary to expectations, this relationship was negative. A facet of Openness, Ideas, together with Positive Emotions, a facet of Extroversion, improved prediction of performance in clinical studies beyond that provided by the Dental Aptitude Test and the Interview. Implications of the findings are discussed, and recommendations regarding the admission process to Canadian dental programs are offered.

Rarely, if ever, do selection committees include an assessment of a noncognitive variable such as personality. Properly developed personality measures that are included in personnel selection systems do have predictive validity with respect to subsequent job performance.^1,2 Such findings might suggest that the addition of personality variables into the selection process of dental students may similarly improve the prediction of success in dental school beyond the traditional predictors of cognitive ability and the original Canadian Dental Interview (CDA) first introduced in 1980. The present study examines the validity of the traditional measures used in selecting students for admission to Canadian dental schools: a measure of cognitive ability, the Dental Aptitude Test (DAT), and the original CDA interview. In addition, the study explored increases in predictive validity that might accrue through the addition of a measure of personality. Of particular interest was the ability of the measures used as part of the admissions process to predict both academic and clinical performance in dental school. The performance of student cohorts was tracked over a one-, two-, or three-year period, depending upon their year in the dental program, and correlated with their admission scores on the DAT and interview and personality data that was collected during this study.

	The Canadian Dental Aptitude Test

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One of the criteria used to select dental students into dental schools is the Dental Aptitude Test (DAT). In 1967, the Canadian Dental Association began the DAT program in Canada.³ This initiative arose from the need to have additional scientific data as a basis for admission decisions and to assist in determining which students possess the highest degree of intellectual ability.⁴ The test was modeled on the American Dental Admission Test. At present there are four components in the DAT: the Survey of Natural Science Examination, the Reading Comprehension Examination in the Dental Sciences, the Perceptual Motor Ability Component, and the Carving Dexterity test. The Survey of Natural Science Examination is an achievement test of biology- and inorganic or general chemistry-based material.⁵ The Reading Comprehension Examination requires applicants to read a passage involving some aspect of basic dental and clinical science and then answer questions based on the passage. The Perceptual Motor Ability test measures both two- and three-dimensional perceptual ability by incorporating line and angle discrimination, block counting, space relationship, and object visualization. The final component of the DAT is the Carving Dexterity test, a test of manual dexterity. Applicants are required to follow directions and to visualize in three dimensions in carving a figure from a piece of soap. Scores from the DAT also form an Academic Average component.

The DAT is a valid selection instrument. Dental students who are admitted into study based on DAT scores do significantly better than those accepted through other factors.⁶ The DAT predicts academic performance of students during the first two years of dental training. DAT scores also correlate with grades in theory courses in dental school.⁷

The DAT assesses various characteristics that contribute to learning or performance in dental school. In particular, the DAT Academic Average is a measure of general cognitive ability. Those high in general cognitive ability are superior problem solvers, acquire knowledge quickly, and excel in abstract thinking.⁸ Dental students are required to acquire considerable amounts of knowledge in relatively short periods of time. Individuals with high cognitive ability should have more success in academic components of their programs, as suggested by previous studies.⁸ It is not clear whether the DAT predicts success in the clinical aspects of dental training. Although the psychomotor ability components—the Carving Dexterity test and the Perceptual Motor Ability test—are thought to assess the performance skills needed in the practice of dentistry, there appears to be conflicting evidence related to this thinking. Sandow et al.⁹ in a study of 459 students found that there was a positive correlation with the Perceptual Motor Ability test and the grade point average (GPA) of the students in the first and final years, with a weaker correlation with the GPA in the second and third years. Coy, McDougall, and Sneed,¹⁰ on the other hand, in a study of 492 students found that the Perceptual Motor Ability test accounted for only 5 to 9 percent of the variance in Preclinical Operative Dentistry practical exam scores. Similarly, Oudshoorn,¹¹ in a study of 212 students in four successive first-year classes, found that both the Perceptual Motor Ability test and the Carving Dexterity test could account for no more than 7 to 10 percent of the course grade variance. He concluded that, "within the context of the present study, the PA and CD scores demonstrated no practical utility as predictors of psychomotor performance." Gray, Deem, and Straja¹² in a study of 169 students took the average of the final grades in years 3 and 4 and found that the PAT accounted for only 0.26 of the variance of the final clinical grades in selected clinical courses and therefore "did not play a role in predicting student performance in the clinical courses." Kramer,¹³ on the other hand, in a study involving 5,009 students in which eight predictor measures from the DAT including the PAT were correlated with the technique GPA of the students in their freshman and sophomore years concluded that "the results of this study indicate that DAT subscale scores contribute unique information to the prediction of performance in the first two years of dental school."

	Selection Interviews

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Interviews are the most widely used method for personnel selection and for the selection of applicants to all types of higher education.¹⁴ Selection interviews are generally used to allow organizations and professional programs, such as dentistry, the opportunity to develop a personal impression of an applicant. They also enable an interviewer to verify the authenticity of data gathered on an applicant elsewhere in the application process.¹⁵ More importantly, interviews help an interviewer to infer if a candidate has the necessary knowledge, skills, abilities, and interests that are required for success in a targeted position.¹⁶

The traditional selection interview is prone to numerous biases and perceptual and information-processing errors. For example, interviewers rate applicants more favorably if the applicants are perceived as being similar to themselves. Interview ratings are susceptible to first impressions of an applicant formed upon reading a résumé or application form; these impressions affect the way the interview is conducted, the questions asked, and the evaluation of the candidate’s answers. In addition, interview ratings are influenced by visual cues such as physical attractiveness of the applicant, eye contact, body orientation, smiling, and hand gestures as well as vocal cues such as rate of speaking, number and duration of pauses, variability in loudness, and pitch, e.g., lower voices tend to be rated more positively than higher voices for management. These biases and errors have contributed to the poor reliability and validity of unstructured interviews.¹⁷

Interviews can be conducted in various ways. For example, interviews can be structured in the sense that they have predetermined questions and answers. Conversely, interviews can lack structure. In an unstructured interview, a number of candidates can be asked different questions that may or may not be accompanied by a rating scale.¹⁶ Interviews can also vary in their level of structure.¹⁷ Another type of interview is the Behaviorally Based Interview, which is derived from a job analysis and is based on the premise that past performance will predict future performance.¹⁸ Furthermore, different types of interviews can be conducted with one interviewer or a panel of interviewers.

Different types of interviews also have varying degrees of validity, and the level of structure that an interview possesses appears to be a moderator of its predictive validity. Structured interviews, for instance, have superior levels of validity to those that are not structured.¹⁹ The estimated validity of interviews that are not structured has been reported to be as low as 0.14, while the validity of those that are structured and based on job analysis procedures tend to be as high as .60.¹⁸ Validity will also increase to the degree that the interview questions are related to the content of the job.^20,21 In addition, interviews with scales that provide detailed information for the evaluation of responses are associated with much higher levels of validity than those lacking predetermined rating scales.²²

The original selection interview used by Canadian dental schools was developed in the late 1970s by the Dental Aptitude Test committee of the Council on Education of the Canadian Dental Association (CDA). The interview assesses eight characteristics that the committee believed were important to success in dental school: motivation, ability to relate, adaptability, self-appraisal, maturity, attitudes, problem exploration, and sense of responsibility. There is also a "gut feel" component based on the interviewers’ perception of the interviewee. There are guidelines that the interviewer can utilize to aid in evaluating responses that suggest evaluating consistency of response, depth of understanding, conviction, absence of social desirability, and conceptualization of questions. However, the interviewer is free to interpret these guidelines, and points on the scale used for scoring are not clearly defined. The interview is usually conducted with a panel of two to three interviewers and takes approximately forty-five minutes. The inter-rater reliability of the interview ranges from 0.83 to 0.87. The interview was implemented during the 1980 admission cycle.²³

The CDA interview has been in constant use since its inception. Interview teams at five of the ten dental schools in Canada, including the two schools used in this study, were trained over a two-year period from 1980 to 1982, and they have been periodically updated.²⁴ Once selection for each year is made from one of four variants of the interview, the standard set of interview questions is issued to each of the participating schools as they prepare for the yearly interview activity. The training emphasized the need for consistent application of the questions and the use of the definitions of the characteristics in assessing a score. The interviewers were blinded to all of the other admission information about the candidate such as academic records, letters of recommendation, university of previous study, and DAT scores. Despite the popularity of the CDA’s interview, there is little if any research on its validity, and aside from the initial aforementioned inter-rater reliability study, there have been no further reliability studies.

The development of the original Canadian dental school interview predates advances in the last two to three decades that substantially increase the predictive validity of selection interviews. Interviews based on questions that are derived systematically from a job or occupational analysis, that are related to behaviors performed in the job or occupation, that have an answer key agreed upon by subject matter experts, and that are administered in a structured order by a trained interview panel generally have validities that are at least twice those of other types of interviews.²²

	Personality and Selection

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Noncognitive factors, such as personality measures, predict success in various educational settings and provide useful information for the selection of students in various programs of study.^25–27 Successful military pilots, for example, have distinct personality characteristics that are significantly different from those of the general population.²⁸ Business students who reach general management positions earlier in their careers tend to be more socially extroverted and to desire higher levels of independence and autonomy.²⁷ Dental students tend to show characteristics that are different from those of students in business, social work, engineering, and medicine.²⁹ Based on these findings, personality may be an important factor that could aid in the prediction of success in many academic programs.

Interest in the relationship between personality and dental school performance stems from the view that students with various personality types may differ in their performance throughout dental education. Noncognitive factors, such as personality measures, may also predict success in various educational settings and may provide useful information for the selection of students into various programs of study.²⁷ Many admissions officers responsible for the selection of dental school candidates believe that high academic potential is not the only requirement for success in dental programs or in practice; caring characteristics and time management skills are also important.³⁰ Dental students become more organized, conscientious, and punctual as they progress through their dental training.³¹ As well, they become more independent over time.³² Dental students high in extroversion appear to experience less difficulty in clinical components of their dental programs compared to introverts who experience less difficulty in the academic components of the program.²⁷ Similarly, students high in "judging and sensing" received a higher class ranking over the course of their education in dental programs.²⁷

Many different types of personality measures have been used for selection purposes, all of which have varying degree of validity.³³ The majority of the research related to dental school performance and personality, however, is descriptive in nature and relies on measures of personality that may not be suitable for the purpose of admission decisions. The Myers Briggs Type Indicator (MBTI), which has been used extensively in dental research on personality, may not have relevance in predicting performance in dental school and may be more suited to teambuilding and career development than selection procedures.³⁴ The MBTI has relatively poor reliability. A review of several studies showed that on average 37 percent of test takers had at least one change in their primary type upon retest. The MBTI is one of the most easily manipulated (i.e., open to purposive faking) personality instruments.³⁵ Furthermore, the MBTI is a very poor predictor of future job success when used to select employees.³⁶ The MBTI types do not coincide with the Big Five Model of personality.³⁶ The Five Factor Model of Personality (FFM), or the Big Five Model, assesses characteristics of personality that may provide admissions officers with more informative data. The FFM is backed by an extensive amount of research, including meta-analytic studies, that shows different components of the model are very good predictors of job performance.³⁷ Based on this extensive research, any personality measure used in dental research should be psychometrically sound and reflect the properties of the FFM.

The FFM is a universal template that can be used for understanding the structure of personality.³⁸ This useful taxonomy is comprised of five dimensions: Neuroticism, the tendency to experience negative affect, such as anxiety, depression, and hostility; Extroversion, the quantity and intensity of interpersonal interaction; Openness, the proactive seeking and appreciation of new experiences; Agreeableness, the quality of one’s interpersonal interactions along a continuum from compassion to antagonism; and Conscientiousness, the amount of persistence, organization, and motivation in goal-directed behaviors.^39,40 The emergence of the FFM aids in the classification of personality measures and eliminates terminological confusion.⁴¹

Openness to Experience is significantly correlated with measured intelligence.⁴⁰ Students who score high on Openness to Experience are likely to be more open to new ideas and learning experiences.¹ Those that are more Open to Experience are also better at problem-solving skills, which would be an advantageous quality in clinical components of dental training.³⁵ Conscientious individuals are likely to exert more effort on tasks and possess higher levels of organizational skills.⁸ These are skills that are related to first-year dental grades⁴² and may be beneficial in a highly taxing dental training environment. Highly conscientious students are also more likely to set and achieve goals, which makes them more likely to outperform others.⁴³ Conscientious individuals also exhibit superior performance in jobs, like dentistry, that involve personal interaction in clinical settings.⁴⁴

There is an ongoing debate on whether the FFM is sufficient to predict job success in all situations. Some researchers take the view that the use of multiple, narrow facet of personality may be more useful than broad traits as represented by the FFM,⁴⁵ while others favor the use of the broader FFM.⁴⁶ Certain personality factors may be relevant in the prediction of dental school performance both at a facet level and at a broader level of prediction. Using broad and narrow traits for personality assessment may reveal links between these traits and performance that would otherwise remain hidden. Aggregating facets into one dimension has the potential of losing information.

In theory, one could argue that those who possess desired personality traits will outperform those who do not, especially in clinical components of training. Assessing applicants for personality characteristics that may be related to dental training or practice may lead to improvements in the selection process over and above those provided for by assessments of cognitive and other abilities and obtained through selection interviews.

Few studies have examined the incremental validity of multiple predictors used in selecting applicants for admission to dental training programs. Most programs admit students on the basis of measures of general cognitive ability (grade point average, scores from the DAT) and an interview. Predictions from these sources may be enhanced by adding a valid and reliable measure of personality. Using a sample of dental students in Canada, the present study:

1. examined the validity of the DAT and the CDA interview in selecting candidates for Canadian dental schools with respect to both academic and clinical performance;
   
2. evaluated the validity of the Five Factor Model of Personality in predicting both academic and clinical components of dental training; and
   
3. examined whether the addition of a personality measure improved selection.
   

	Methods

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Of the 216 students invited to be part of the study, 67.13 percent participated. Thus, 145 dental students from first through third year at two Canadian dental schools participated. The average age of the students was 25.9 (SD = 3.45). Forty-six percent of the students were male, and 54 percent were female. Students were invited to partake in the study by the researchers and were informed that participation was strictly voluntary. They were assured that any data obtained through the course of the study would remain confidential. Each participant signed a consent form that clearly explained the purpose of the study and thereby verified consent for use of his or her dental school grades, DAT scores, and interview data. The study was approved by the Research Ethics Board at each participating school.

A personality inventory, the NEO-PI-R, Form S was used to assess personality. The NEO-PI-R, a 240-item scale, is a very reliable and valid measure of personality based on the Five Factor Model.⁴⁰ It provides measures of Extroversion, Conscientiousness, Neuroticism, Openness, and Agreeableness. As well, each broad factor is composed of six narrower traits that can be scored separately to assess personality characteristics. Cronbach’s alpha coefficients for the broader scales of the NEO-PI-R in the current study were: .83 for the Agreeableness scale, .84 for the Neuroticism scale, .62 for the Extroversion scale, .83 for the Conscientiousness subscale, and .70 for the Openness subscale. The NEO-PI-R is also a valid measure of personality. This has been demonstrated through studies addressing the convergent validity of the measure.⁴⁶

All participants had taken the Canadian DAT as part of admission to dental school. Scores were obtained from student records for the Survey of Natural Science Examination, the Reading Comprehension Examination, the Perceptual Motor Ability Test, the Carving Dexterity Test, and Academic Average. In the event that a student had more than one set of scores for the DAT, the average of the DAT scores was used in the analysis.

All participants had completed the original CDA Interview (1980) as part of the admission procedures. Trained interviewers scored participants according to CDA guidelines. Scores were obtained from student records. In the event that a student had more than one interview score in his or her file, the average of the interview scores was used in the analysis.

We used four criterion measures as part of the study. The first was weighted GPA in the first year of dental training. This was a composite measure derived from academic coursework and was weighted by the value of the course. It was an average from courses that covered topics such as human biochemistry, anatomy, histology, physiology, basic mechanisms of disease, infectious diseases, cariology, and periodontology. The second criterion included the weighted GPAs from year two in dental training and covered advanced topics of virtually the same courses from year one. The third criterion was a weighted GPA of clinical competence in year three of dental education. This score was an average score derived specifically from results of clinical courses that had a major component of the course grade derived directly from assessments made in the dental clinic. The fourth criterion used a weighted GPA and assessed academic coursework in year three. The "academic" performance criterion assessed traditional classroom, didactic performance with minimal or no clinical activity involved.

	Results

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Control Variables
Age correlated with the Year 1 GPA (r = –.29, p<.001), Year 2 GPA (r = –.21, p<.05), and Year 3 Clinical (r = –.28, p<.05) criteria. In all cases, younger students, those who more recently graduated from university, received higher grade point averages. Older students, however, performed better on the DAT Perception test (r = .21, p<.05). Age was not related to personality or scores on the interview.

Year of study correlated with Year 1 GPA (r = –.16, p<.05), with more recently admitted students having higher first-year academic GPAs than those participants coming from later years in their dental programs. Those participants in later years of study were also higher in Neuroticism (r = .27, p<.01), while those in earlier years of study were higher in Conscientiousness (r = –.21, p<.05). Participants in later years of study did better on the interview (r = .37, p<.01). Year of Study and Age, as could be expected, were correlated (r = .37, p<.01).

Gender correlated with the Academic Average (r = –.18, p<.05), Perception (r = –.15, p<.05), and Soap Carving (r = –.21, p<.05) subtests of the DAT. In all cases, males scored higher than females. With respect to personality, females were higher in terms of Agreeableness (r = .14, p<.05), Neuroticism (r = .28, p<.01), and Openness (r = .17, p<.05). Gender was not related to interview performance.

The participant’s dental school was related to performance on the four DAT components (Academic Average: r = .51, p<.01; Perception: r = .41, p<.01; Reading Comprehension: r = .35, p<.01; Soap Carving: r = .43, p<.01). In all cases participants from School 1 scored higher on the DAT tests than those from School 2. The participant’s dental school was correlated with the Interview (r = –.52), with participants from School 2 having higher interview scores. Agreeableness (r = –.27; p<.01) and Neuroticism (r = .16, p<.05) also were related to the participants’ dental school. Participants from School 2 rated higher in Agreeableness while those from School 1 rated higher in Neuroticism.

Predictors of Success in Dental School
Pearson Product moments for all study variables are presented in Table 1. The DAT Academic Average (cognitive ability) was positively related to first-year academic performance (r = .24, p<.01). Students who performed better on the Academic Average component of the DAT outperformed students who scored lower on the Academic Average component of the DAT. Academic Average was not correlated with any other performance measure; that is, cognitive ability predicted academic success only in the first year of dental school.

Openness to Experience was negatively related to Year 2 academic performance (r = –.18, p<.05), to Year 3 clinical performance (r = –.15, p<.05), and to Year 3 academic work (r = –.40, p<.01). Those students who scored lower on the Openness to Experience factor performed better in their second and third years of dental school in both academic and clinical work; that is, students who were less imaginative, not as intellectually curious, and more focused on the task at hand performed better than students who scored higher on the Openness to Experience dimension. None of the other broad personality factors predicted performance in any year of dental training. Agreeableness was, however, positively related to the interview. Students who were more Agreeable had higher scores on the interview (r = .21, p<.01); that is, students who are sympathetic and moved by others’ needs received higher interview scores than applicants who were less sympathetic to others’ needs.

Three facets of Agreeableness correlated with different criteria: 1) Straightforwardness, a measure of an individual’s frankness and sincerity, predicted performance in year two of training (r = .24, p<.01); 2) Compliance, a measure of control of aggression and forgiving, predicted Year 3 coursework performance; students who were less Compliant performed better (r = –.37, p<.01); and 3) students who scored lower on Tender-Mindedness, or were less sympathetic and less moved by appeals to pity rather than reason, also did better in Year 3 coursework performance (r = –.26, p<.05). As well, Vulnerability, a facet of Neuroticism, predicted third-year coursework; students who were more vulnerable performed better in third-year coursework (r = .38, p<.01). Positive Emotions, a facet of Extroversion, predicted third-year clinical training; students who had more positive emotions performed better in clinical components of dental training (r = .25, p<.05). Three facets of Openness to Experience correlated with the different criteria: 1) individuals who spent more time Fantasizing or daydreaming performed worse in Year 3 coursework (r = –.33, p<.05); 2) those who were less Open to New Ideas, that is, those who had a tendency to narrowly focus on a limited number of topics, performed better in Year 2 coursework (r = –.20, p<.05), Year Three coursework (r = –.33, p<.05), and Year 3 clinical work (r = –.26, p<.05); and 3) those who scored low on Aesthetics, that is, those who had less of an appreciation for art and music, performed better in Year 3 coursework (r = –.33, p<.05). There were no significant relationships between any facets of Conscientiousness and the different criteria. Neither did any facet of any of the five factors predict success in Year 1 coursework.

Hierarchical Regression Analyses
Hierarchical regression analyses were used to determine the contribution of the DAT, the interview, and personality measures in predicting dental school performance for each of the four criterion measures. Age, gender, school, and current year of study were entered on the first step of each analysis to control for their relationship with the criterion. When second- and third-year dental school performance was the criterion, performance measures in earlier years were also entered as control variables on the first step. Following the importance attached to the DAT and the interview in selecting dental students, the three DAT components that were assumed to be proxies for general cognitive ability (Academic Average, Perceptual Ability, and Reading Comprehension) were entered as a block on step two followed by the interview on step three. Openness to Experience, the only broad personality measure that correlated with the criterion measures, was entered on step four. The remaining four personality factors were excluded from the regression analyses. This order of entry was maintained for all four regression analyses.

To examine whether any of the narrow personality traits predicted success beyond the DAT and interview, the regressions for Year 2 and Year 3 criteria were reanalyzed, substituting the narrow facets that were significantly correlated with the criteria in place of Openness. Since variance accounted for by the first three steps of the regression equations remained unchanged, only the results for the narrow facts are reported from these additional hierarchical regressions.

Table 2 presents the results of the first analysis. The set of control variables produced a significant R² change (R² = .12, F_4,121 = 3.98 , p<.01); how-ever, the only significant predictor in the set was Age (ß= .30, p<.01). The addition of the DAT measures accounted for an additional 5 percent of the variance in first-year dental school performance (R² = .05, F_3,171 = 2.52, p<.05) with the DAT academic average component being the only significant DAT measure (ß= .28, p<.01). The addition of the interview and Openness to Experience did not significantly improve prediction of first-year academic performance.

	Discussion

Top Abstract The canadian dental aptitude... Selection interviews Personality and Selection Methods Results Discussion Conclusions and Future... References

Control Variables
While the control variables were not a central focus of the study, the results for these variables are interesting, most notably those for age. Younger students performed better in classroom work during the second and third years and in clinical work during the third year. Younger students are more likely to have entered dental school directly from undergraduate programs and perhaps have prerequisite academic material more readily at hand. The clinical performance grades may represent a bias on the part of instructors in favor of younger students; on the other hand, younger students may simply perform better. Future research should confirm whether the age results hold. If so, dental programs may want to put in place special programs to help older students adapt to dental education programs.

Students in the first year of dental school exhibit more conscientiousness than do students in later years. Given low attrition rates, students in their final years of study may feel more assured of their eventual success and feel less need to focus on their academic work. This is also reflected in their higher levels of Neuroticism, or emotional stability. Students in later years of study were more likely to exhibit a relaxed, controlled approach to changes in their work environment or in emergency situations and to make an emotionally mature response to stressful situations.

The differences with respect to gender do not appear to be systemic. For example, while males scored higher on the DAT components than females, those differences did not result in more males being admitted to dental school. More than half of the participants were female. The difference in DAT scores between dental schools is most likely due to dental schools’ having the right to set their own minimum requirements on the DAT.

The DAT Measures as Predictors of Dental Performance
The present study validates the use of the DAT in the selection of students for dental school. The DAT Academic Average component, a measure of general cognitive ability, predicts academic success in the first and second years of dental education programs. It did so in Year 2 even after controlling for the first year’s academic performance. It did not predict either academic or clinical performance in the third year. These results are consistent with previous studies showing that measures of general cognitive ability are very good predictors of student performance in the first and second year of dental education.^13,47

The DAT measures did not predict third-year academic success. This is not surprising since the student cohort’s academic performance becomes more homogeneous over time. The DAT measures were also poor predictors of clinical performance in the third year. Range restriction does not explain this failure, as there is no reason to assume that all of the students possess similar clinical skills. Rather, clinical success is likely to be more dependent on skills, abilities, and characteristics other than general cognitive ability; in particular, it may be related to characteristics that may be assessed by the interview or by personality measures.

Personality as a Predictor of Dental Performance
We had expected that both Conscientiousness and Openness to Experience would predict dental school performance. While this was the case to some extent with Openness to Experience, Conscientiousness failed to predict either academic or clinical performance in any year of study. Although Conscientiousness has been linked to various aspects of performance,¹ there may be limits to the range of occupations over which this relationship holds. For example, being overly Conscientious may actually hinder performance in areas of work that require quick decision making.⁴⁸ In clinical dental training, students often make complex decisions in a short time frame involving various approaches to solving dental problems. This argument, however, does not explain the failure to find a relationship between conscientiousness and academic performance.

Openness to Experience predicted success in dental school in both Year 2 and Year 3, including the clinical aspects (Table 1). Students who were less open to new experiences performed better than those who were more open. Students who were less imaginative, not as intellectually curious, and who had a tendency to focus their minds on the task at hand performed better in both academic and clinical work in their second and third years of dental school. In part, these results may reflect the dental education environment, which may not be conducive to creativity. The dental school curriculum is often described as a cookbook approach to learning and often requires students to follow established procedures. Such an environment would not favor more creative students and would likely reward those that were comfortable using established methods and techniques.

It is a question for future research to determine if the results reported here for Openness to Experience would occur in dental schools that followed a less traditional curriculum, particularly those using a problem-based learning approach or from dental schools that admitted a high percentage of students from nontraditional backgrounds. Openness to Experience might be more valued in those settings. In any event, the Openness to Experience results do raise questions about current dental school curricula, particularly when they suggest that students who were less open to new ideas received higher grades in their clinical studies.

Personality traits may be differentially relevant depending on the requirements of the job.⁴⁹ This was the case in the present study. The addition of Openness to Experience to the DAT measures and the interview improved the prediction of Year 2 and Year 3 academic success but not Year 3 clinical performance. Openness to Experience was an effective predictor even after controlling for academic performance in previous years, while the DAT and interview did not add new information. These results again argue for the need to assess different predictors for the academic and clinical components of dental education. Students who are focused and methodical may do well in the academic aspects of dental school, and these same characteristics may carry on into performance in clinical areas.

Broad vs. Narrow Personality Measures
The results from this study support the use of narrow personality traits in the selection process. In several cases, facets of the broad personality factor correlated with success in dental school when the broad factor did not predict success. For example, Extroversion and Neuroticism were not linked to any of the criteria; however, facets of each, Positive Emotions and Vulnerability, respectively, did predict different criteria. With respect to Positive Emotions, students who were more cheerful and optimistic performed better in clinical components of dental training. This relationship would not have been detected if we had only used the broad personality factors. Similarly, the broad factor of Agreeableness was not linked to criteria, but we know, from the narrow factor data, that students who were high in Straightforwardness and low in Compliance and Tender-Mindedness outperformed their peers in academic studies.

Openness to Experience did not improve the prediction of performance in the Year 3 clinical studies, but one of its facets, Open to Ideas, together with Positive Emotions accounted for an additional 11 percent of the variance in the clinical criterion. The variance that is specific to the narrow facets can be diluted when an aggregate measure of personality is used for prediction purposes.⁵⁰ These results argue for the use of the narrow facets in the admission process. Using only the broad factors may lead to the loss of important information. Some may argue that adding a personality variable to the admissions criteria may not be justified due to the relatively small amount of variance accounted for by these measures. The use of a low cost paper and pencil, self-report measure must be balanced against the costs of mistakes made in admissions that do not surface till later in the dental program. The two personality facets improved prediction of performance in clinical studies by 11 percent, compared to an increase of 7 percent brought about by a costlier interview.

The Interview as a Predictor of Dental Performance
The results of the present study show that the interview was sensitive to behavioral characteristics in third-year clinical training that the DAT did not assess. The positive relationship between the personality factor Agreeableness and the Interview suggests that the interview is identifying students who are concerned for the welfare of others and who are moved by other people’s needs. The interview is identifying behavioral qualities that may be important for success in clinical practice both in training and in dental practice.

The interview did not predict academic performance in either Year 1 or Year 2 of dental training. Since students with higher interview scores are likely to perform more poorly in the first year of dental education, combining interview scores with measures of cognitive ability will lead to the selection of students who are likely to do less well academically in their first year of studies than students who would have been selected solely on the basis of cognitive ability. A better strategy for incorporating the interview into the selection process is to use a "multiple hurdle" strategy in which successful applicants must score above cut-off scores that are set, independently, on each of the selection components.

Interviews used for the selection for educational programs, such as dentistry, should be based on requirements of the program.⁵¹ Furthermore, the validity of an interview will increase as it becomes more structured⁵² and as the content of the interview is related to the content of the job or occupation.^20,21 The original CDA interview (1980) used in this study, although based on techniques available at the time, was developed prior to advances in interviewing technology. The Canadian Dental Association has now developed a new interview protocol using behavioral-based and situational questions that were derived from a job analysis involving critical incidents related to dental practice. The interview questions assess seven competencies that had previously been linked to dental success: self-control, sensitivity to others, tact and diplomacy, oral communication, integrity, judgment and analysis, and conscientiousness.⁵³ The new interview is now being used as part of the selection process. Future research will be required to determine if the new interview improves admission decisions.

Currently, the medical school at McMaster University has tested a "multiple mini-interview (MMI), consisting of 10 short objective structured clinical examination (OSCE)-style stations, in which they were presented with scenarios that required them to discuss a health-related issue (e.g., the use of placebos) with an interviewer, interact with a standardized confederate while an examiner observed the interpersonal skills displayed, or answer traditional interview questions."⁵⁴ This procedure has many of the characteristics of a situational-based interview that now forms part of the new CDA interview procedures. While this procedure has a reported reliability of 0.65, it remains to be seen whether the results of the procedure have predictive validity and can generalize beyond the specific school where those data were collected.

	Conclusions and Future Directions

Top Abstract The canadian dental aptitude... Selection interviews Personality and Selection Methods Results Discussion Conclusions and Future... References

 
The most significant finding from this study is that there were different sets of predictors in the academic and clinical components of dental training. Admission decisions based only on measures related to cognitive abilities and academic performance in undergraduate work will for the most part only predict academic success (traditional classroom didactic performance) in dental school. Adding a well-designed interview component to the selection process has the potential of predicting clinical performance in the later clinical years of dental school. Dental students need to possess both academic and clinical skills. A highly structured interview that is tied to clinical behaviors deemed successful for the practice of dentistry may serve as a valid predictor of successful clinical performance. Applicants to dental school would then be required to exhibit high scores on both the interview and the cognitive measures.

This study also supports the use of personality measures in the selection process and the importance of assessing behavioral characteristics, although more work is needed in this regard. The positive relationship between the interview and Agreeableness raises the possibility that an appropriate set of personality measures may do just as well in predicting clinical success. Similarly, the fact that two narrow facets, Positive Emotions and Ideas, led to an 11 percent improvement in prediction of clinical success argues for the inclusion of personality measures in the admissions process. Personality profiles may provide important information for the application process. Certain personality variables may predict progress in clinical components of the program, while others may help to distinguish those who will pass from those likely to fail.

Narrow facets were better predictors of clinical performance than the broad factors. One reason for this may have been that the facets more closely reflected aspects of clinical performance that played a role in the grades assigned to clinical performance by the students’ instructors. Clinical grades may reflect a degree of subjectivity on the part of the course instructor, more so than grades assigned to academic coursework. As part of our future research we are developing a behaviorally anchored rating scale that reflects the seven competencies that have been identified as contributing to success in the dental profession and that form the basis of the new CDA interview. The competencies used to grade clinical performance will be based on the same competencies used to select students. Hopefully, a new criterion measure of this type will remove some of the subjectivity inherent in the clinical criterion used in the present study.

Normative personality data needs to be collected both from more dental students and from dental practitioners to determine the relationship between personality and performance in dental school as well as performance in practice. Do the personality traits that contribute to performance in dental training remain valid predictors of job performance during a dental career? We are presently engaged in a national longitudinal study that may provide answers to this question.

The positive relationship between the original CDA interview (1980) and Agreeableness also provides evidence that behavioral characteristics are important in the selection process and lend support for the development of the new interview. Interestingly, the factor Agreeableness (being concerned for the welfare of others and being moved by other people’s needs) relates to the category "Sensitivity to Others" in the newly developed CDA interview. It remains to be seen how the new interview will predict performance in clinical aspects of dental education, but this particular result provides promising evidence that it will fare well in the process.

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Top Abstract The canadian dental aptitude... Selection interviews Personality and Selection Methods Results Discussion Conclusions and Future... References

 

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