Does emotional intelligence at medical school admission predict future academic performance

Medical school admissions committees are tasked with selecting the most suitable candidates for entrance to their programs. Traditionally, admissions committees have focused on cognitive measures, including grade point average (GPA), the Medical College Admission Test in North America, and the Graduate Medical School Admissions Test in the United Kingdom and Australia. These cognitive measures have demonstrated predictive validity and reliability.1 Although admissions committees have long acknowledged the importance of such cognitive skills in assessing applicants, more recently, they have come to recognize the importance of noncognitive skills as well.2 In addition, the Accreditation Council for Graduate Medical Education’s six core competencies are patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.3 In Canada, the CanMEDS framework includes not only medical expert and scholar roles but also professional, manager, health advocate, communicator, and collaborator roles.4 To better understand applicants’ noncognitive skills, such as their communication, interpersonal, and professionalism abilities, researchers have suggested exploring the construct of emotional intelligence (EI).5 EI is defined as the ability to monitor one’s own and others’ emotions, to discriminate among them, and to use the information to guide thinking and actions.6 Outside health care, EI has been linked to individuals’ academic success, social skills, job satisfaction, and improved interpersonal relations.7,8 Within health care, EI is considered important because understanding patients’ emotions and controlling one’s own emotions are essential to maintaining effective doctor–patient relationships and to working successfully in teams. EI also may be relevant to the competencies of professionalism and systems-based practice, which require good communication skills and teamwork.9 A recent systematic review of studies with empirical data on EI in physicians or medical students revealed that higher EI scores contributed to improved doctor–patient relationships, increased empathy, and improved teamwork and communication skills, as well as better stress management, organizational commitment, and leadership skills.9 In addition, researchers have studied specifically how to increase EI in medical students.10 Together, these findings suggest that using EI in admissions decisions could have value. However, very few studies have examined the use of EI in assessing applicants to medical school or in predicting their future performance. Carr,11 for example, found no association between EI and traditional admissions criteria. Leddy and colleagues12 found similar results—no relationship between EI at admissions, as measured by the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT), GPA, interview scores, and autobiographical sketch scores. If admissions committees are to use EI in high-stakes decision making, we need more information regarding the measure’s predictive validity. Specifically, we must understand if EI correlates with future academic performance and, if so, what type of performance EI predicts. EI is a set of four distinct yet related abilities, including perceiving emotions, using emotions, understanding emotions, and managing emotions.5 To communicate effectively with patients, physicians must develop a rapport, trust, and an ethical therapeutic relationship, as well as accurately elicit and synthesize relevant information.4 Such successful communication requires physicians to complete a complex process in which they perceive their patients’ emotions, manage their own reactions, and use those emotions to facilitate their performance.5 Recently, McNaughton13 suggested that EI is a skill that is observable and measurable through assessment methods such as the objective structured clinical examination (OSCE). In an OSCE, students must communicate effectively with standardized patients while skillfully acquiring information. Thus, we expect that a student’s EI would correlate with his or her future performance on a clinical skills test, such as an OSCE, but would not correlate with his or her future performance on written examinations of knowledge. The methods used to assess EI are relevant. In a recent systematic review of EI studies in medicine, all researchers measured EI using self-report questionnaires.9 Many raised significant concerns about relying on scores based on individuals’ subjective judgments of their own abilities because individuals could readily inflate their scores in a high-stakes environment, such as during the admissions process. Several authors demonstrated that faking on self-report tests changed the rank order of applicants.14,15 Some authors suggest that using an abilities test, such as the MSCEIT v2.0, to measure EI is preferable.11,16 Such a test directly assesses an individual’s ability to perceive emotions accurately, use emotions to facilitate thought, understand emotions, and manage emotions. It also has robust psychometric properties, is affordable, and is available in several languages.17 No gold standard exists for measuring EI, and experts in the field disagree on the construct of EI, how to measure it, and the reliability and validity of measurement tools.18 In addition, some have argued that the lack of conceptual clarity around the construct itself limits what we can interpret from EI scores.18 Thus, further research is needed to improve our understanding of this challenging construct. The purpose of our study was to explore the use of EI as a measure of applicants’ noncognitive skills at admissions. We focused on determining the degree to which scores on an abilities test of EI predicted future academic performance on assessments of students’ cognitive and noncognitive skills in medical school.