How AAMC PREview is Scored

What Is the AAMC PREview Exam?

The AAMC PREview is a type of situational judgment test (SJT), which purports to test a student’s performance in the AAMC 8 Core Competencies:

1. Service orientation
2. Social skills
3. Teamwork
4. Cultural competence
5. Reliability and dependability
6. Ethical responsibility to self and others
7. Resilience and adaptability
8. Capacity for improvement

Want to learn how to prepare for your AAMC PREview exam? Watch this video:

Much like the CASPer test, part of the Altus Suite, it is an assessment of your non-cognitive skills. You will be presented with 30 scenarios that outline ethical dilemmas set in professional and personal settings any premed or medical student will be familiar with. Each scenario is followed by 4–8 responses, and you will need to rate the effectiveness of each response. So, unlike in CASPer or MMI writing stations, you will not need to provide your own verbal or written answer. In AAMC PREview questions and answers, there is a question given – the scenario – and then four or more pre-written responses, which you must rate.

The four effectiveness ratings are:

The Four-Point Scale

It is important to remember that this is a rating, not a ranking. You rate each answer; you don’t rank them from best to worst. Under this paradigm, it is possible for any given response to be given the same effectiveness rating more than once per scenario. Not all responses will necessarily be used, or they might be used multiple times.



How Is the AAMC PREview Scored?

The AAMC PREview exam is evaluated in a unique way that is related to the format of the test. Your score is based on the accuracy of your rating for each response when compared with the rating of an AAMC panel of medical educators who took the test. Your score is therefore the result of how close your ratings come to those of these experts. A high score indicates that your answers were more in line with those of the professionals, while a lower score indicates that your answers were less in line with them. For example, you will receive full credit for an item if your rating matches the medical educators’ rating and partial credit if is close. However, you will receive no credit if your rating is different from that of the medical educators.

Total Score: Your final score is given as a number value between 1 and 9, with a higher score indicating better performance. To account for slight variations in difficulty between test forms, a conversion method known as equating is used to convert raw scores to scaled scores. Your “Total Score” is then presented as a number in the official score report, which will be released based on your selected testing window within 30 days. You will be notified by email when your score is released and provided with instructions on how to access it.

In your score report, you will also be assigned a confidence band and percentile rank.

Confidence Band: In the AAMC PREview exam, your score is not precise and can be affected by many factors. To avoid making distinctions between examinees with similar scores, a confidence band is employed. A confidence band is a device used in statistical analysis to indicate uncertainty or confidence in certain data. It indicates the range in which your “true score” likely lies; that is to say, you might do slightly better or worse.

Percentile Rank: The percentile rank is the percentage of examinees who received the same or lower score than you did. This information is based on data for the two most recent testing years and is updated every year in May. If the AAMC PREview percentile table used as a reference is updated, your percentile ranking could change, but your score will not.

AAMC PREview Exam Practice Question

This example is based on an actual AAMC practice scenario and their proposed responses:

"You have been elected president of your student government. Students have expressed ongoing concerns that the school’s pass rates on national certification exams are below average and that the school's curriculum is not preparing students adequately for these exams. Even though faculty are aware of this concern, they have been reluctant to make changes to the curriculum. You and the other student representatives are meeting with faculty members to discuss the concern."

This is the scenario. Here are the available responses that you would rate:

1. Present the faculty with a list of expected updates to the curriculum.
2. Ask the faculty to share their perspective on how students should better prepare for exams.
3. Ask the faculty to explain why they have been unwilling to change the curriculum.
4. Propose setting up a series of meetings with both faculty and students to discuss the curriculum.
5. Tell the faculty that the curriculum must change immediately, given the students’ concerns.

For each of these responses, you would indicate the Effectiveness Rating as follows:

• Very ineffective
• Ineffective
• Effective
• Very effective

Before moving on, you can test your ability:

Try to assign one of these ratings to each of the above responses, based on your knowledge of the 8 Core Competencies and related skills you have developed.

Now, here are the correct ratings for each response, according to the AAMC:

1. Present the faculty with a list of expected updates to the curriculum: Ineffective
2. Ask the faculty to share their perspective on how students should better prepare for exams: Very effective
3. Ask the faculty to explain why they have been unwilling to change the curriculum: Ineffective
4. Propose setting up a series of meetings with both faculty and students to discuss the curriculum: Very effective
5. Tell the faculty that the curriculum must change immediately, given the students’ concerns: Very ineffective

Would you rather watch a video?

What Is a Good AAMC PREview Score?

In a recent year, the AAMC released PREview scoring data to show average scores and the corresponding percentile ranking:

Concentrate on your own performance.

How to Rate the Items on the AAMC PREview

The next question on your mind is inevitably going to be how you can possibly achieve the high score you’re looking for. The best approach to this exam is to focus on practice tests to learn what constitutes a very effective response and to study the core competencies in action. Once you are comfortable answering questions based on these criteria and can easily identify the pressing issues, impacted parties, and priority actions should take, you will be almost ready to take the exam.

There are some key principles to keep in mind as you attempt to fill out your exam:

Eight Core Competencies

The eight core competencies are building block skills that are foundational to a medical doctor’s ability to help their patients. That’s the idea, anyway. These broad skills go beyond medical information or technical skills. They are more intrinsic to who you are as a person – less what you would expect to find demonstrated by medical school requirements and more what you might be showing off in your AMCAS most meaningful experiences or AMCAS work and activities write-ups.

1. Service orientation: if you think about the question “Why do you want to be a doctor?”, the answer probably has to do with service orientation. Do you display a constant concern for the health and well-being of others? Are you sensitive to the needs and feelings of people around you? Do you act to alleviate others’ distress? If you do, you probably have “service orientation” nailed down.
2. Social skills: this is very similar to service orientation, insofar as you will be sensitive to the feelings of others. You pick up on cues – verbal and nonverbal – and you show a talent for navigating social encounters – even when you’re uncomfortable.
3. Cultural competence: effective communication and sensitivity requires you to be aware of how a person’s culture might change their worldview and cues you to be caring and empathetic to these differences in your interactions with them.
4. Teamwork: a good teammate works well with others, shares information and burdens, and knows both their own place in a team and when to call on others for help.
5. Ethical responsibility to self and others: while it might seem glib or too simplistic to say that this involves listening to your conscience and following good moral principles, that is essentially what this means. However, you should keep in mind that this includes yourself as well as those around you. Ethics is not just being nice to people, especially if you are hurting yourself by allowing another person to get away with toxic behavior; that isn’t ethically responsible to yourself. Ethics and morals can be hard – avoiding pressure to go along with bad behavior is often more difficult than it sounds – but you need to have an ethical mindset when taking the PREview exam and know how to prepare for ethical questions in a medical school interview so that you can display your values in a positive manner.
6. Reliability and dependability: this means being a dependable team member or a person who is consistent in their work, but also taking responsibility for your actions, even when that might be uncomfortable.
7. Resilience and adaptability: the medical profession is always changing, and the situations you will find yourself in require fast, competent, and professional responses to change and even crises. Therefore, your ability to react, adapt to new situations, and outlast those situations physically and mentally are valuable qualities that medical schools look for.
8. Capacity for improvement: nobody is coming into school perfect. Improvement is an ongoing process, involving self-reflection, feedback, adaptation, and long-term goals and improvements. This kind of self-aware evaluation is also one of the most-commonly demonstrated traits in medical school personal statements.

In each scenario, identify the core competency(ies) that are being evaluated and ask yourself whether the responses demonstrate a good example of any of these competencies. The more a given response is in line with these eight principles, the more effective it will be.

The Pressing Issue

In addition to the competencies, you must identify and keep in mind the pressing issue. Each scenario will have a very specific issue that forms the crux of the problem or dilemma within it. This is the pressing issue.

In the scenario we looked at, the pressing issue is that the students don’t feel they are being prepared adequately by the curriculum at their institution. While there are other factors – the social skills involved with confronting faculty about this, for example – the identifiable, central issue is that of the students’ concerns.

The Impacted Party or Parties

Every situation you will be presented with will have an impact on someone, whether they be a patient, classmate, person you meet on the street, or simply yourself. There may be more than one vulnerable party or person/group who could be affected by the situation and your subsequent decisions. Often, this impact might be serious for one party but less significant for another.

For effective ratings, a response must show that you addressed the vulnerable party first and foremost, considered all those involved, and ensured that your actions did not negatively impact anyone involved. For ineffective ratings, there will be negative impacts on the vulnerable parties or others involved.

Establish Priorities

To perform even better, you should learn how to rate a response based on how it prioritizes the various actions that you should take if you were faced with a similar scenario. You should order the actions you would take based on the seriousness of the consequences and benefits for those in the situation. You might need to take an initial action first before proceeding to subsequent steps, so do pay attention to the order of elements in a response. More importantly, you might need to consider which party is most impacted among several. For instance, you might need to demonstrate that you'll put a patient's needs ahead of your own or a coworker's.

How to Use These Factors in Answering

Let’s return once more to our sample answer to demonstrate how you would actually rate the answers – and why – for top marks. This time, we can use our accumulated knowledge – of core competencies, the pressing issue, the impacted parties, our priorities, and the rating rubrics and methodology – to figure out why we would assign the ratings that we did.

The scenario provided previously in this article focuses on the students’ concern that your school’s pass rates on national certification exams are below average and that the school’s curriculum is not preparing students adequately for these exams. The faculty are aware of this concern but have been reluctant to make changes to the curriculum.

By choosing to discuss the issue with other student representatives and faculty members, you will engage several of the AAMC core competencies, such as service orientation, social skills, teamwork, reliability and dependability, and ethical responsibility to oneself and others. But when considering how you rate the responses, it’s best to focus on one or two competencies that are most engaged in your decision making.

The pressing issue here is the potential problem with the curriculum, which seems to be having an impact on students’ performance on essential exams.

The most-impacted parties are the students who attend the school and need to perform well on these exams. As a student yourself, you are also impacted. The faculty may also be affected if changes to the curriculum are required. On a broad scale, any student who must take these exams (regardless of whether they attend your school) could be impacted should your school improve or refuse to improve its curriculum (i.e., if curved grading is used, the overall performance of the whole cohort could be impacted).

1. Present the faculty with a list of expected updates to the curriculum.

Effectiveness rating: Ineffective

Why?

This response will not improve the situation or may cause a problem. By providing a list of “expected updates,” you are not showing openness to working with teachers or hearing their perspective; you are simply presenting demands. Therefore, you have not demonstrated the core competencies of social skills and teamwork highlighted in the scenario. Your approach addresses the most pressing issue of poor exam performance but indirectly or incompletely, as there is an assumption that the curriculum is responsible for the problem. You have not guaranteed a solution for all parties involved and might even create a negative impact for some, especially if the curriculum is not the core of the issue; for example, you might miss the point and insist on a solution that involves more work for the faculty but does not actually help students. However, further discussion may be possible, so the behavior is not “very ineffective.”

2. Ask the faculty to share their perspective on how students should better prepare for exams.

Effectiveness rating: Very effective

Why?

This response will significantly improve the situation. This answer works well as a follow-up action because you take the initiative to learn the faculty’s viewpoint on the matter, thereby engaging the core competencies of social skills and teamwork highlighted in the scenario. By seeking the faculty’s help to resolve the problem, you make no assumptions and recognize that they may well have the experience and expertise to properly address the pressing issue of poor exam performance. You ensure that both the students’ and the faculty’s needs will be taken care of with certainty and that no one is negatively impacted. This not only demonstrates a readiness to hear other people’s viewpoints, but it may also help your classmates understand, leading to a more open dialogue between parties. This will also ensure that you do not personally experience any negative impact, such as a faculty member questioning your approach, judgment, and competency to deal with a difficult situation, which could affect your standing within the school.

3. Ask the faculty to explain why they have been unwilling to change the curriculum.

Effectiveness rating: Ineffective

Why?

This response will not improve the situation. You have not demonstrated the core competencies highlighted in the scenario because your question implies that you expect teachers to defend the school’s program, which does not encourage debate or demonstrate a desire to work together. Your approach does not address the most pressing issue because it simply suggests that the faculty are wrong and does not move the discussion forward. You have not guaranteed a solution for any of the parties involved, which could create a negative impact for some. Asking the faculty to simply justify their decision is unlikely to cause more problems, however, so this is not a “very ineffective” behavior.

4. Propose setting up a series of meetings with both faculty and students to discuss the curriculum.

Effectiveness rating: Very effective

Why?

This response will significantly improve the situation. By showing a willingness to listen to and work with faculty members on the problem, you demonstrate the core competencies of social skills and teamwork highlighted in the scenario. Given your intention to discuss the issue and come up with a proactive solution for the students’ continuing concerns, you address the pressing issue and ensure that all parties are taken care of with certainty. No one is negatively impacted.

5. Tell the faculty that the curriculum must change immediately, given the students’ concerns:

Effectiveness rating: Very ineffective

Why?

This response will cause additional problems or make the situation worse. Although you are aware that the faculty are hesitant to make adjustments, by insisting on your demands, you indicate that you think you know better than them. This behavior fails to show a willingness to listen to others’ views and collaborate and could exacerbate the situation by shutting down future discussion about changes. In fact, you have demonstrated the opposite of the core competencies being highlighted in the scenario, as the response shows poor social skills (giving the faculty an ultimatum) and a complete lack of teamwork (refusing to work together). Your approach does not address the pressing issue, as it is likely to stymie any progress and lead nowhere; therefore, both the students and likely the faculty will be negatively impacted.

Conclusion

With concrete knowledge of the scoring system as well as some key strategies for how to approach this exam, you should feel a lot more confident as you prepare for the AAMC PREview.

We know that these tests can be stressful, and you might question the logic of rating someone else’s scenario responses. Just keep in mind that this is another way to make your application stand out. With medical school acceptance rates being what they are, you’ll want to give yourself every advantage. If nothing else, how to get into medical school with a low GPA can be tricky, and a great PREview score might boost your application if you need it.

Source: Association of American Medical Colleges (AAMC)

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