Abstract
Introduction: The multiple mini-interview (MMI) is widely used in residency selection to assess non-cognitive competencies, whilst Key Feature Questions (KFQs) evaluate clinical reasoning at critical decision points. Understanding associations between these tools may enhance candidate evaluation.
Methods: This retrospective study included 122 anaesthesiology residency candidates from three consecutive cohorts (2023–2025). MMI scores across five domains (motivation, crisis management, stress/mood management, situational awareness and decision-making, and growth mindset), grade point average (GPA), multiple-choice question (MCQ) scores, and KFQ scores were analysed. Spearman's correlation examined associations with KFQ performance, and multiple linear regression identified independent contributors.
Results: The mean candidate age was 27.9 years (±1.98); 76.2% were female. Moderately strong positive correlations were observed between KFQ scores and MMI domains of motivation (r = 0.577, p < 0.001), crisis management (r = 0.511, p < 0.001), and situational awareness and decision-making (r = 0.658, p < 0.001). GPA and MCQ scores showed no significant associations with KFQ performance. Regression analysis explained 56.8% of the variance in KFQ scores (R² = 0.568, p < 0.001), with motivation (B = 0.361, p < 0.001), crisis management (B = 0.300, p = 0.016), and decision-making (B = 0.621, p < 0.001) as significant contributors.
Conclusion: Key MMI domains – motivation, crisis management, and situational awareness and decision-making – were significantly associated with clinical reasoning performance as measured by KFQs, whilst GPA and MCQ scores were not. These findings support integrating structured non-cognitive assessments alongside cognitive measures in anaesthesia residency selection, highlighting the value of a multi-dimensional approach to candidate evaluation.