Reliability and validity of multiple mini interviews in selection to a dual degree midwifery program in Germany: a cross-sectional cohort study
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Department of Midwifery, University Hospital Würzburg, Würzburg, Germany
Institute for Medical Education and Training Research, University Hospital Würzburg, Würzburg, Germany
School of Health Sciences, University of Surrey, Guildford, United Kingdom
Institute of General Medicine, University Hospital Würzburg, Würzburg, Germany
University Women's Hospital, University Hospital Würzburg, Würzburg, Germany
Publication date: 2023-10-24
Corresponding author
Mira J Pflanz   

Department of Midwifery, University Hospital Würzburg, Würzburg, Germany
Eur J Midwifery 2023;7(Supplement 1):A28
The multiple mini interview (MMI) method was implemented and evaluated for a degree program in midwifery at one German university for the first time in 2022. In addition to the grade of the university entrance qualification (UEQ), personal attributes and psychosocial competencies were recorded as further selection criteria1 enabling a more objective and fair assessment of personal suitability compared to traditional selection interviews2. Broadly established in medicine3,4 and nursing5 internationally, MMIs consider professional aptitude6,7 according to clinical training facility requirements and avoid solely merit-based selection8 in the course of academizing midwifery in Germany.

The aim was to explore reliability, factorial and incremental validity and consider professional aptitude with undergraduate entry midwifery students. The MMI was designed to achieve best fit with program-specific requirements and promote an inclusive selection process fostering diversity in midwifery students.

In May 2022, 56 applicants were assessed in a six station MMI by examiners from different professional backgrounds. Structured questions designed to explore personal characteristics and interaction with simulated patients in practical tasks were evaluated based on checklists with semantic differentials and global ratings. An accompanying survey recorded participants’ sociodemographic data, individual motivation and self-reported personality traits according to big five inventory9. Test quality was examined by means of reliability analysis, factorial validity confirmed using maximum-likelihood factor analysis10. Incremental validity of the MMI stations in relation to the grade of UEQ and differential effects due to individual characteristics were considered correlatively.

Reliability analysis was good to excellent for all parameters (internal consistency α = 0.79-0.94, corrected item-total correlation rit = 0.46-0.77 and absolute difficulty p = 0.72-0.79). The factorial validity of MMIs and incremental validity for the practical stations was confirmed. Personal characteristics did not correlate with performance. The MMI results clearly impacted on final selection decisions: 68% of places were offered to candidates who would not have been considered based on their high school grades alone.

To promote equity and social justice in the health care workforce, unbiased admission policies are required11,12. Student selection criteria reflecting societal diversity13 can enable inclusive and faire recruitment for future midwives14. By widening the recruitment funnel, the educational system can proactively contribute to a diverse and competent future workforce.

Multiple Mini Interviews increase dimensionality in the selection of students for dual degree midwifery programs and allow the inclusion of psychosocial competencies and practical skills in the process. Diversity within the profession can be promoted by widening the applicant tool. The selection process also reflects the institutional values and paves the way for a bond between location and student.

The authors have no conflicts of interest to disclose.
There is no funding for this research.
Callwood A, Jeevaratnam K, Kotronoulas G, Schneider A, Lewis L, Nadarajah VD. Personal domains assessed in multiple mini interviews (MMIs) for healthcare student selection: A narrative synthesis systematic review. Nurse Educ Today. 2018;64:56-64. doi:10.1016/j.nedt.2018.01.016
Hell B, Trapmann S, Weigand S, Schuler H. Die Validität von Auswahlgesprächen im Rahmen der Hochschulzulassung – eine Metaanalyse. Psychol Rundsch. 2007; 58(2): 93-102. doi:10.1026/0033-3042.58.2.93
Schwibbe A, Lackamp A, Knorr M, Hissbach J, Kadmon M, Hampe W. Medizinstudierendenauswahl in Deutschland. Messung kognitiver Fähigkeiten und psychosozialer Kompetenzen. Bundesgesundheitsbl. 2018; 61:178–186. doi:10.1007/s00103-017-2670-2
Simmenroth-Nayda A, Meskauskas E, Burckhardt G, Görlich Y. Das neue Göttinger Auswahlverfahren für Medizin – welche Bewerber können profitieren? Z Evid Fortbild Qual Gesundhwes. 2014; 108(10): 609-617. doi:10.1016/j.zefq.2014.09.024
Thompson T, Sonke A. Multiple Mini Interviews as Part of Holistic Admissions Review for Nursing Schools. J Prof Nurs. 2021; 37(6): 1086–1091. doi:10.1016/j.profnurs.2021.08.009
Callwood A, Groothuizen JE, Lemanska A, Allan H. The predictive validity of Multiple Mini Interviews (MMIs) in nursing and midwifery programmes: Year three findings from a cross-discipline cohort study. Nurse Educ Today. 2020;88:104320. doi:10.1016/j.nedt.2019.104320
Groene OR, Knorr M, Vogel D, Hild C, Hampe W. Reliability and validity of new online selection tests for midwifery students. Midwifery. 2022;106:103245. doi:10.1016/j.midw.2021.103245
Sheehan A, Thomson R, Pierce H, Arundell F. The impact of Multiple Mini Interviews on the attrition and academic outcomes of midwifery students. Women Birth. 2022;35(4):e318-e327. doi:10.1016/j.wombi.2021.08.001
Rammstedt B, John O P. Kurzversion Big Five Inventory (BFI-K). Diagnostica. 2005; 51(4):195-206. doi:10.1026/0012-1924.51.4.195
Williams B, Brown T, Onsman A. Exploratory factor analysis: A five-step guide for novices. Australasian Journal of Paramedicine. 2010; 8(3):1-14. doi:10.33151/ajp.8.3.93
Frenk J, Chen L, Bhutta ZA, et al. Profesionales de la salud para el nuevo siglo: transformando la educación para fortalecer los sistemas de salud en un mundo interdependiente [Health professionals for a new century: transforming education to strengthen health systems in an interdependent world]. Rev Peru Med Exp Salud Publica. 2011;28(2):337-341. doi:10.1590/s1726-46342011000200023
Bly KC, Ellis SA, Ritter RJ, Kantrowitz-Gordon I. A Survey of Midwives' Attitudes Toward Men in Midwifery. J Midwifery Womens Health. 2020;65(2):199-207. doi:10.1111/jmwh.13060
Burton N, Ariss R. Diversity in midwifery care: working toward social justice. Can Rev Sociol. 2014;51(3):262-287. doi:10.1111/cars.12047
Effland K J, Hays K. A web-based resource for promoting equity in midwifery education and training: Towards meaningful diversity and inclusion. Midwifery. 2018; 61: 70-73.
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