Dr Alison Callwood

Aim to explore how adult, child and mental health nursing and midwifery students, selected using multiple mini interviews, describe their ‘values journey’ following exposure to the clinical practice environment. Background: Values based recruitment incorporates assessment of healthcare students’ personal values using approaches like multiple mini interviews. Students’ experience of adjustment to their values during their programme is conceptualised as a ‘values journey’. The impact of VBR in alleviating erosion of personal values is unclear. Design A cross -professional longitudinal cohort study was commenced at one university in England in 2016 with data collection points at the end of years one, two and three. Non -probability consecutive sampling resulted in 42 healthcare students (8 adult, 8 child and 9 mental health nursing and 17 midwifery students) taking part. Methods Six semi -structured focus groups were conducted at the end of participants’ Year One (DC1). Data analysis incorporated inductive and deductive approaches in a hybrid synthesis. Findings Participants described a ‘values journey’ where their values, particularly communication, courage and wanting to make a difference, were both challenged and retained. Participants personal journeys also acknowledged the: ‘courage it takes to use values’; ‘reality of values in practice’ and ‘need for self-reflection on values’.

Values‐based practice is deemed essential for healthcare provision worldwide. In England, values‐based recruitment methods, such as multiple mini interviews (MMIs), are employed to ensure that healthcare students’ personal values align with the values of the National Health Service (NHS), which focus on compassion and patient‐centeredness. However, values cannot be seen as static constructs. They can be positively and negatively influenced by learning and socialisation. We have conceptualised students’ perceptions of their values over the duration of their education programme as a ‘values journey’. The aim of this hermeneutic longitudinal focus group study was to explore the ‘values journey’ of student nurses and midwives, recruited through MMIs, across the 3 years of their education programme. The study commenced in 2016, with 42 nursing and midwifery students, originally recruited onto their programmes through multiple mini interviews. At the third and final point of data collection, 25 participants remained. Findings indicate that students' confidence, courage and sense of accountability increased over the 3 years. However, their values were also shaped by time constraints, emotional experiences and racial discrimination. We argue that adequate psychological support is necessary as healthcare students embark on and progress through their values journey, and propose a framework for this.

Objectives To examine the personal domains multiple mini interviews (MMIs) are being designed to assess, explore how they were determined and contextualise such domains in current and future healthcare student selection processes Design A systematic review of empirical research reporting on MMI model design was conducted from database inception to November 2017. Data Sources Twelve electronic bibliographic databases. Review Methods Evidence was extracted from original studies, and integrated in a narrative synthesis guided by the PRISMA statement for reporting systematic reviews. Personal domains were clustered into themes using a modified Delphi technique. Results A total of 584 articles were screened. 65 unique studies (80 articles) matched our inclusion criteria of which seven were conducted within nursing/midwifery faculties. Six in 10 studies featured applicants to medical school. Across selection processes, we identified 32 personal domains assessed by MMIs, the most frequent being: communication skills (84%), teamwork/collaboration (70%), and ethical/moral judgement (65%). Domains capturing ability to cope with stressful situations (14%), make decisions (14%), and resolve conflict in the workplace (13%) featured in fewer than ten studies overall. Intra- and inter-disciplinary inconsistencies in domain profiles were noted, as well as differences by entry level. MMIs deployed in nursing and midwifery assessed compassion and decision-making more frequently than in all other disciplines. Own programme philosophy and professional body guidance were most frequently cited (~50%) as sources for personal domains; a blueprinting process was reported in only 8% of studies. Conclusions Nursing, midwifery and allied healthcare professionals should develop their theoretical frameworks for MMIs to ensure they are evidence-based and fit-for-purpose. We suggest a re-evaluation of domain priorities to ensure that students who are selected, not only have the capacity to offer the highest standards of care provision, but are able to maintain these standards when facing clinical practice and organisational pressures.

Aim To explore how adult, child, mental health nursing and midwifery students describe their “values journey” after completing their second year following exposure to the clinical practice environment. Background Where student nurses and midwives are selected using multiple mini interviews, in a values‐based recruitment process, the conservancy and or development of their personal values remains unclear. Design A hermeneutic, cross‐professional longitudinal study was commenced at one university in England in 2016 with data collection points at the end of years one (DC1), two (DC2) and three (DC3). From the 42 participants recruited in year one, 28 went on to participate in data collection at DC2 (3 adult, 6 child, 3 mental health nurses and 16 midwifery students). Methods Four semi‐structured focus groups were conducted. Data analysis incorporated inductive and deductive approaches in a hybrid synthesis. Findings Participants did not feel their values had changed fundamentally since year one. However, the prioritization of their values and how they were “put into practice” had changed. Key themes identified were: “changed sense of self as a healthcare practitioner”; “influences on values in practice” and “reflection on values.” Conclusion Reframing of personal values is an integral part of learning across clinical and academic settings. Critical reflective practice should be integrated into pre‐registration health education programmes to support student nurses and midwives sustain their learning around values; to maintain “good” values in the face of observed “bad” values.

Aim A discussion of issues associated with Values Based Recruitment for nurse education programmes. Background Values Based Recruitment is a mandatory element in selection processes of students for Higher Education healthcare courses in England, including all programmes across nursing. Students are selected on the basis that their individual values align with those presented in the Constitution of the National Health Service. However, there are issues associated with the use of values as selection criteria that have been insufficiently addressed. These are discussed. Design Discussion paper. Data Sources This article is based on documents published on the website of the executive body responsible for the implementation of a policy regarding Values Based Recruitment in Higher Education Institutions up until June 2017 and our evaluation of the conceptualisation of Values Based Recruitment, underpinned by contemporary theory and literature. Implications for nursing Values Based Recruitment influences who is accepted onto a nurse education programme, but there has been limited critical evaluation regarding the effectiveness of employing values as selection criteria. Values are subject to interpretation and evidence regarding whether or how Values Based Recruitment will improve practice and care is lacking. The issues discussed in this article show that Higher Education Institutions offering nursing courses, whether in England or in other countries, should be critical and reflective regarding the implementation of Values Based Recruitment methods. Conclusion We call for a debate regarding the meaning and implications of Values Based Recruitment and further research regarding its validity and effectiveness.

ObjectivesGlobal, COVID-driven restrictions around face-to-face interviews for healthcare student selection have forced admission staff to rapidly adopt adapted online systems before supporting evidence is available. We have developed, what we believe is, the first automated interview grounded in multiple mini-interview (MMI) methodology. This study aimed to explore test–retest reliability, acceptability and usability of the system.Design, setting and participantsMultimethod feasibility study in Physician Associate programmes from two UK and one US university during 2019–2020.Primary, secondary outcomesFeasibility measures (test–retest reliability, acceptability and usability) were assessed using intraclass correlation (ICC), descriptive statistics, thematic and content analysis.MethodsVolunteers took (T1), then repeated (T2), the automated MMI, with a 7-day interval (±2) then completed an evaluation questionnaire. Admission staff participated in focus group discussions.ResultsSixty-two students and seven admission staff participated; 34 students and 4 staff from UK and 28 students and 3 staff from US universities. Good-excellent test–retest reliability was observed at two sites (US and UK2) with T1 and T2 ICC between 0.65 and 0.81 (p

Values-based recruitment is used in England to select healthcare staff, trainees and students on the basis that their values align with those stated in the Constitution of the UK National Health Service (NHS). However, it is unclear whether the extensive body of existing literature within the field of moral philosophy was taken into account when developing these values. Although most values have a long historical tradition, a tendency to assume that they have just been invented, and to approach them uncritically, exists within the healthcare sector. Reflection is necessary. We are of the opinion that selected virtue ethics writings, which are underpinned by historical literature as well as practical analysis of the healthcare professions, provide a helpful framework for evaluation of the NHS Constitution values, to determine whether gaps exist and improvements can be made. Based on this evaluation, we argue that the definitions of certain NHS Constitution values are ambiguous. In addition to this, we argue that ’integrity' and ’practical wisdom', two important concepts in the virtue ethics literature, are not sufficiently represented within the NHS Constitution values. We believe that the NHS Constitution values could be strengthened by providing clearer definitions, and by integrating ’integrity' and ’practical wisdom'. This will benefit values-based recruitment strategies. Should healthcare policy-makers in other countries wish to develop a similar values-based recruitment framework, we advise that they proceed reflectively, and take previously published virtue ethics literature into consideration.

Background: Universities in the United Kingdom (UK) are required to incorporate values based recruitment (VBR) into their healthcare student selection processes. This reflects an international drive to strengthen the quality of healthcare service provision. This paper presents novel findings in relation to the reliability and predictive validity of multiple mini interviews (MMIs); one approach to VBR widely being employed by universities. Objectives: To examine the reliability (internal consistency) and predictive validity of MMIs using end of Year One practice outcomes of under-graduate pre-registration adult, child, mental health nursing, midwifery and paramedic practice students. Design: Cross-discipline evaluation study. Setting: One university in the United Kingdom. Participants: Data were collected in two streams: applicants to A) The September 2014 and 2015 Midwifery Studies programmes; B) September 2015 adult; Child and Mental Health Nursing and Paramedic Practice programmes. Fifty-seven midwifery students commenced their programme in 2014 and 69 in 2015; 47 and 54 agreed to participate and completed Year One respectively. 333 healthcare students commenced their programmes in September 2015. Of these, 281 agreed to participate and completed their first year (180 adult, 33 child and 34 mental health nursing and 34 paramedic practice students). Methods: Stream A featured a seven station four-minute model with one interviewer at each station and in Stream B a six station model was employed. Cronbach’s alpha was used to assess MMI station internal consistency and Pearson’s moment correlation co-efficient to explore associations between participants’ admission MMI score and end of Year one clinical practice outcomes (OSCE and mentor grading). Results: Stream A: Significant correlations are reported between midwifery applicant’s MMI scores and end of Year One practice outcomes. A multivariate linear regression model demonstrated that MMI score significantly predicted end of Year One practice outcomes controlling for age and academic entry level: coefficients 0.195 (p = 0.002) and 0.116 (p = 0.002) for OSCE and mentor grading respectively. In Stream B no significant correlations were found between MMI score and practice outcomes measured by mentor grading. Internal consistency for each MMI station was ‘excellent’ with values ranging from 0.966–0.974 across Streams A and B. Conclusion: This novel, cross-discipline study shows that MMIs are reliable VBR tools which have predictive validity when a seven station model is used. These data are important given the current international use of different MMI models in healthcare student selection processes.

Background: Education literature worldwide is replete with studies evaluating the effectiveness of Multiple Mini Interviews (MMIs) in admissions to medicine but

Objectives: Global, Covid-driven restrictions around face-to-face interviews for healthcare student selection have forced admissions staff to rapidly adopt adapted online systems before supporting evidence is available. We have developed, what we believe is, the first automated interview grounded in Multiple Mini-Interview (MMI) methodology. This study aimed to explore test re-test reliability, acceptability, and usability of the system. Design, setting and participants: Multi-method feasibility study in Physician Associate (PA) programmes from two UK and one US university during 2019 - 2020. Primary, secondary outcomes: Feasibility measures (test-retest reliability acceptability and usability) were assessed using intra-class correlation (ICC), descriptive statistics, thematic and content analysis. Methods: Volunteers took (T1), then repeated (T2), the automated MMI, with a seven-day interval (+/- 2) then completed an evaluation questionnaire. Admissions staff participated in focus group discussions. Results: Sixty-two students and seven admission staff participated; 34 students and four staff from UK and 28 students and three staff from US universities. Good-excellent test-retest reliability was observed with T1 and T2 ICC between 0.62-0.81 (p