Assessment of non-clinical attributes in paramedicine using multiple mini-interviews.

BACKGROUND Non-clinical attributes are increasingly emphasised as an important factor in paramedic practice. However, the assessment of these attributes often lacks the evidence base to support it. Exploring the relationship between non-clinical attributes and clinical skills is also of theoretical and practical importance. OBJECTIVE To first seek evidence of reliability and validity for the assessment of non-clinical attributes using the multiple mini-interview (MMI) in paramedic contexts and second, to explore the association between non-clinical attributes and clinical skills in paramedicine. METHODS Entry to practice level paramedic candidates completed a 10-station MMI to assess non-clinical attributes on day 1 and a 10-station simulation-based assessment (SBA) of clinical skills on day 2. Both were assessed using different global rating scales. Our primary outcomes included MMI inter-station reliability (calculated using generalisability theory) and Pearson's correlation between non-clinical attributes and clinically focused skills. RESULTS 30 trainees completed the MMI and 26 of the 30 completed the SBA. Inter-station reliability for the MMI reached 0.77. Pearson's correlations (disattenuated correlations in parentheses) between the overall MMI score and mean SBA global rating scores reached r=0.31 (r=0.48) and ranged by dimension from r=-0.11 (-0.17) (procedural skills) to r=0.54(r=0.83) (communication). CONCLUSIONS The MMI demonstrated evidence of reliability and validity for the assessment of non-clinical attributes in paramedic contexts. Non-clinical attributes and paramedic clinical skills are likely distinct but related constructs, each contributing to the construct of paramedic practice. Programmes of assessment should include both to ensure the construct of paramedic practice is adequately represented.