Professional judgement: a social practice perspective on a multiple mini-interview for specialty training selection

BMC Med Educ. 2025 Jan 3;25(1):18. doi: 10.1186/s12909-024-06535-3.

Abstract

Background: Interviewers' judgements play a critical role in competency-based assessments for selection such as the multiple-mini-interview (MMI). Much of the published research focuses on the psychometrics of selection and the impact of rater subjectivity. Within the context of selecting for entry into specialty postgraduate training, we used an interpretivist and socio-constructivist approach to explore how and why interviewers make judgments in high stakes selection settings whilst taking part in an MMI.

Methods: We explored MMI interviewers' work processes through an institutional observational approach, based on the notion that interviewers' judgements are socially constructed and mediated by multiple factors. We gathered data through document analysis, and observations of interviewer training, candidate interactions with interviewers, and interviewer meetings. Interviews included informal encounters in a large selection centre. Data analysis balanced description and explicit interpretation of the meanings and functions of the interviewers' actions and behaviours.

Results: Three themes were developed from the data showing how interviewers make professional judgements, specifically by; 'Balancing the interplay of rules and agency,' 'Participating in moderation and shared meaning making; and 'A culture of reflexivity and professional growth.' Interviewers balanced the following of institutional rules with making judgment choices based on personal expertise and knowledge. They engaged in dialogue, moderation, and shared meaning with fellow interviewers which enabled their consideration of multiple perspectives of the candidate's performance. Interviewers engaged in self-evaluation and reflection throughout, with professional learning and growth as primary care physicians and supervisors being an emergent outcome.

Conclusion: This study offers insights into the judgment-making processes of interviewers in high-stakes MMI contexts, highlighting the balance between structured protocols and personal expertise within a socially constructed framework. By linking MMI practices to the broader work-based assessment literature, we contribute to advancing the design and implementation of more valid and fair selection tools for postgraduate training. Additionally, the study underscores the dual benefit of MMIs-not only as a selection tool but also as a platform for interviewers' professional growth. These insights offer practical implications for refining future MMI practices and improving the fairness of high-stakes selection processes.

Keywords: Multiple-mini-interview; Performance assessment; Postgraduate; Professional judgment; Professionalism; Selection; Social learning; Specialty training; Work-based assessment.

MeSH terms

  • Clinical Competence
  • Education, Medical, Graduate
  • Humans
  • Interviews as Topic*
  • Judgment*
  • School Admission Criteria*