Over 22,500 allopathic medical school applicants in the 2023-2024 cycle had to take the AAMC PREview Situational Judgment Test as part of their application cycle (“AAMC Prehealth Advisor Newsletter”, November 2023). In upcoming cycles, more medical schools will likely ask applicants for PREview scores to evaluate the test’s predictive ability.
This article will review essential information about the AAMC PREview situational judgment test and early insights from the SDN/HPSA 2023 SJT Experience Survey, including details on how applicants prepared for the “unpreparable” PREview exam.
What is AAMC PREview?
The AAMC has been developing a situational judgment test for over ten years. Since the 2015 revision of the Medical College Admissions Test (MCAT), interest has remained in developing a separate assessment for non-cognitive skills essential to physicians. The goal is to support the holistic review of a high-volume applicant pool (Berardi-Demo et al., 2023).
The AAMC published a list of eight pre-professional competencies, student testimonials, and guides (Anatomy of an Applicant workbook, 2023 update) to inform applicants about the importance of these competencies in becoming a successful entering medical student. The Situational Judgment Test was intended to evaluate applicants on these competencies in a more standardized format, complementing other parts of the application, including letters of recommendation, application materials, and interviews. Pilot testing, beginning in 2020, was performed to refine the test design and address questions about whether the SJT could predict medical student performance (Ballejos et al., 2023) and be helpful in initial holistic application screening (Ellison et al., 2023). A formal roll-out as “PREview (Professional Readiness Exam)” began for the 2023-2024 AMCAS cycle (Berardi-Demo et al., 2023).
Applicants should expect a list of participating schools to be published by April before the opening of the new AMCAS and AACOMAS application window on the PREview website and in the AAMC Medical School Admissions Requirements (MSAR) school profiles and reports. In 2023, eight AMCAS medical schools required applicants to submit a PREview score to be considered for an interview and offer to their 2024 incoming class, while 10 AMCAS and one AACOMAS program recommended having a result. Two additional schools required either the PREview or Acuity Insights Casper situational judgment test. See the list on the SDN forums for a breakdown of which schools required which SJTs for the 2023-2024 cycle.
Prospective applicants should register for informational webinars about PREview scheduled for February to address any questions about exam administration. They should also query admissions professionals at the schools where they intend to apply.
PREview is designed so that an examinee should take the exam once per testing cycle, though scores are intended to be valid for multiple cycles like the MCAT. Schools and applicants are sent an overall scaled score (1 to 9) integrated into the AMCAS application. Unlike the MCAT, examinees cannot file appeals to rescore their PREview exam.
How to Prepare for AAMC PREview
Access the AAMC PREview resources
Before attending these webinars, all applicants should review the AAMC PREview website resources, including the PREview Essentials Guide, testing registration policies, and a practice exam with an answer key. The AAMC Fee Assistance Program allows eligible applicants to take PREview at no cost. Directions on requesting testing accommodations are also available on the website.
Schedule the Exam
Beginning in mid-January, test-takers can schedule their PREview exam by choosing a “Testing Window” from 14 test dates between March and September. Start times (between 8:00 AM and 1:00 AM Eastern Time) are subject to the availability of proctors. Results are posted after about four weeks. While the MCAT must be taken at a secured testing center, PREview is taken on a laptop or desktop computer at a location of the test-taker’s choice.
Be familiar with the structure of the PREview exam
Using the Meazure Learning/ProctorU platform (formerly Yardstick Assessment), PREview is an online exam comprising 186 test items covering 30 situations over 75 minutes of testing time. The PREview team has posted a video to orient examinees with the testing experience and anticipated interactions with the remote proctor, so plan on extra time for setup and a post-test quality survey. You are monitored and recorded during the exam.
Test-takers are presented with text-based hypothetical scenarios and multiple suggestions for immediate reactions to the dilemma. Medical school admissions and student services experts write, edit, and vet the scenarios. Test-takers must score each item’s effectiveness using a four-point scale from “very ineffective” to “very effective” (which is shown throughout the exam). The answer key is based on a consensus opinion from the experts, and in some cases, partial credit may be given for “close” answers, such as “effective” versus “very effective.” The PREview practice test does not highlight examples where such partial credit can be awarded.
Like the MCAT, some exam items could be experimental and will not be scored, but examinees will not know which items or scenarios are being field-tested.
Register using valid, acceptable identification
Examinees must provide a valid, acceptable photo ID for the proctor to confirm their identity during the registration process. PREview administrators have vigorously emphasized the importance of using consistent names on government-issued identification and the AAMC account used to register for PREview, the MCAT, and the AMCAS application. Test-takers should pay attention to rescheduling and no-show policies and envision circumstances to void the exam. Questions may be directed to the AAMC PREview team.
Recorded Video Interview Survey
Have you taken a recorded video interview on a platform like KiraTalent, SparkHire, or a Standardized One-Way Video Interview? We want your feedback as 2023 saw a rise in the use of these platforms in the admissions process for dentistry, physical therapy, physician assistant, and medical school programs. Fill out the 2024 HPSA/SDN Recorded Video Interview survey while it is open so we can help future applicants understand how to prepare for this step in the application process.
Preparing for PREview: 2023 HPSA/SDN SJT Experience Survey Results
The Health Professional Student Association (HPSA) ran its second Situational Judgment Test Experience Survey in the fall of 2023. So far, we received 70 responses from premed applicants who had taken the PREview exam. 64 (91.4%) had taken the exam in 2023, but our results included eight respondents who had taken the exam in previous years (2020-2022). 14 (20.3%) had their testing fee waived through the Fee Assistance Program, and two (2.9%) requested accommodations (additional time). Only 4 (5.7%) of respondents took PREview as their only SJT; 66 (94.3%) also took an Acuity Insights Assessment.
Most respondents were in their 20s, and the oldest respondents were 36 to 38 (Figure 1). Respondents had strong GPAs and were likely highly qualified candidates. As shown in Figure 2, 22 (31.4%) self-disclosed an undergraduate GPA of 3.90 or greater, and 34 (48.6%) had undergraduate GPAs between 3.50 and 3.89. Among 27 respondents who self-reported their graduate GPAs, 14 (51.9%) reported 3.90 to 4.00 graduate GPAs and 7 (25.9%) between 3.80 and 3.89.
Most respondents devoted minimal time to preparing for their SJTs (PREview and Casper): 20% said they prepared for less than one hour, another 45.7% prepared for up to four hours, and 27.1% prepared for up to 10 hours (Figure 3). Overall, test-takers devoted less than four weeks to SJT preparation, with 71.4% saying they prepared for less than one week (Figure 4).
Most respondents took PREview at home, whether in their bedrooms (55.7%) or in a more public room like a dining room, living room, or workroom (30.0%). This likely reflected the fact that the respondents discovered they had to take PREview while completing their AMCAS or secondary applications during the summer.
Prepare for SJTs
Bring the HPSA SJT workshop to your campus pre-health club! Gain confidence in yourself as you learn how Casper and PREview assess your situational awareness and decision-making skills.
Don’t fear the proctor
55 (78.6%) survey respondents disclosed they remember interacting with or seeking assistance from the remote proctor during PREview. Many free-response comments from 39 respondents revealed anxiety about remote proctoring. Several individuals found the process intrusive and uncomfortable, citing instances where proctors took control of their computers, directed room inspections, and made them remove personal items. Some felt the proctors were challenging to understand or interact with and experienced technical difficulties, while others had more neutral or positive encounters. Many expressed concerns about privacy invasion and the proctors’ level of control over their personal devices during the exam, leading to a range of discomforting experiences.
These comments resemble similar complaints from the 2022 HPSA Situational Judgment Test Experience Survey. While some research suggests that test anxiety worsened by a negative online proctoring experience could result in lower exam scores (Woldeab and Brothen, 2019), further investigation should analyze how effective test anxiety management could affect PREview test-takers and results.
Reflect on your experiences
What experiences did examinees find useful for PREview? We did not ask survey respondents to disclose details about scenarios on the exam to honor exam security. Instead, we asked respondents to identify experiences or courses that helped them with the exam and the core Premed Competencies for Entering Medical Students.
Test-takers felt that specific categories of personal or life experiences were insightful for PREview. The most popular experience categories (n=61) were
- Clinical observation, exposure, or employment (48, 78.7%),
- Employment activities (non-clinical) (47, 77.0%),
- Community service activity (non-clinical) (45, 73.8%),
- Tutoring or teaching opportunities (not to peers) (33, 54.1%),
- Leading a student organization (33, 54.1%),
- Being part of a student organization (membership) (33, 54.1),
- Peer teaching or tutoring (30, 49.2%),
- Being part of a peer study group (not linked with a specific class) (22, 36.1%),
- Being part of an affinity group or community (based on race, ethnicity, gender, commuter/postbac status, etc.) (19, 31.1%),
- Taking didactic laboratory coursework (supplementing lectures) (17, 27.9%),
- Being part of a recitation section (supplementing lectures) (10, 16.4%%), and
- Being part of a faith-based group or community (9, 14.8%).
Examinees cite lived experiences (employment) or exposure to clinical environments as most helpful in preparing for the PREview exam. Other helpful activities involve significant interpersonal interactions, such as learning support, leadership, or volunteering opportunities.
Furthermore, test-takers rely on core content that is different from the science-based MCAT. Coursework that respondents (n=42) thought was helpful for PREview included
- Humanities (such as arts or music) (30, 71.4%),
- Sociology (25, 59.5%),
- Psychology (22, 52.4%),
- Research or creativity experience/capstone (20, 47.6%),
- Philosophy (15, 35.7%), and
- History or Political Science (7, 16.7%).
Courses in these categories familiarize applicants with ethics, cultural education, and human behavior. Many of these courses can be taught with team-based assignments and in-class discussions that allow students to consider alternate perspectives and approaches.
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In a future article, we will continue our analysis of SJTs and how they could factor in early admissions decisions. Until then, good luck in preparing for PREview!
Sources cited
AAMC. 2023 AAMC PREview Essentials, accessed November 9, 2023. https://students-residents.aamc.org/media/13296/download.
Ballejos, Marlene P. PhD, MPA; Cestone, Christina PhD; Copeland, H. Liesel PhD; Dunleavy, Dana M. PhD; Geiger, Thomas MA; Patel, Dimple MS. (2023) Predicting Medical Student Performance With a Situational Judgment Test in Admissions. Academic Medicine. DOI: 10.1097/ACM.0000000000005516.
Berardi-Demo, Linda EdD, MPA; Cunningham, Tara EdD, MS; Dunleavy, Dana M. PhD; McClure, Stephanie C. MD; Richards, Boyd F. PhD; Terregino, Carol A. MD. (2023) Designing a Situational Judgment Test for Use in Medical School Admissions. Academic Medicine. DOI: 10.1097/ACM.000000000000547.
Ellison, Halle B. MD; Grabowski, Christina J. PhD; Schmude, Michelle EdD, MBA; Costa, Joseph B. PhD; Naemi, Bobby PhD; Schmidt, Martin PhD; Patel, Dimple MS; Westervelt, Marjorie PhD, MPH. (2023) Evaluating a Situational Judgment Test for Use in Medical School Admissions: Two Years of AAMC PREview Exam Administration Data. Academic Medicine. DOI: 10.1097/ACM.0000000000005548.
Woldeab, D., & Brothen, T. (2019). 21st Century assessment: Online proctoring, test anxiety, and student performance. International Journal of E-Learning & Distance Education Revue Internationale Du E-Learning Et La Formation à Distance, 34(1). Retrieved from https://www.ijede.ca/index.php/jde/article/view/1106, accessed November 10, 2023.
Use of generative AI: Comment summaries were performed using ChatGPT 3.5 (chat.openai.com) and included in this article with light editing.
AAMC PREview is a registered trademark of the Association of American Medical Colleges.
Emil Chuck, Ph.D., is Director of Advising Services for the Health Professional Student Association. He brings over 15 years of experience as a health professions advisor and an admissions professional for medical, dental, and other health professions programs. In this role for HPSA, he looks forward to continuing to play a role for the next generation of diverse healthcare providers to gain confidence in themselves and to be successful members of the interprofessional healthcare community.
Previously, he served as Director of Admissions and Recruitment at Rosalind Franklin University of Medicine and Science, Director of Admissions at the School of Dental Medicine at Case Western Reserve University, and as a Pre-Health Professions Advisor at George Mason University.
Dr. Chuck is an expert on admissions, has been quoted by the Association of American Medical Colleges (AAMC), and has volunteered as a workshop facilitator on holistic admissions for the American Dental Education Association (ADEA). He has also contributed to the essay collection The Perfect Doctor by Pager Publications and has developed competency-based rubrics supporting holistic review.