About the program
The Physician Assistant program at Florida State University is a 27-month, 7-semester, 111-credit hour program that is heavily focused on biomedical sciences, simulation and procedural skills. Students in this program are trained to practice patient-centred healthcare in community settings with special attention to elder, rural, minority and underserved populations throughout the state of Florida.

No. of applicants,
Class of 2021
1,321

No. of matriculants,
Class of 2021
60

Highlights

Challenge

• Dealing with students’ problematic behavior took up too much time
• Some applicants who were invited to interview lacked some of the personal and professional characteristics the program needed 
• Demographic differences in GRE scores made it challenging to build a diverse student body, something of great importance in helping develop medical professionals to support underserved communities in Florida

Solution

• Implemented Casper test to assess non-cognitive skills. The program is now using a cut-off score to help inform which applicants get invited to interview

Results

• Strong correlation between Casper score and MMI performance
• Positive reviews on the level of professionalism demonstrated by the program’s students from healthcare practitioners in the community
• Use of a cut-off score is helping streamline the admissions process

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Deep dive

Hurricane Michael hit Florida over two years ago, killing over a dozen people and causing $25 billion in damage. Parts of the state are still recovering from Michael and now the coronavirus pandemic is hitting them hard, putting a huge strain on the healthcare system as many medical professionals left the Florida panhandle after the hurricane.

“You could say that Florida’s healthcare system needs medical attention,” said Thomas Morgan, Assistant Professor and Director of Admissions for The School of Physician Assistant Practice. “There are just so many medically underserved communities, particularly in migrant towns, and we need to work harder to find and train the right people to go back into those communities so people can get the care they need.”  

Since its creation in 2000 through Chapter C2000-303, Laws of Florida, Florida State University’s (FSU) College of Medicine has addressed the need for more physicians in the state, especially in rural communities and other areas where there are elder, minority, and other underserved populations. All programs, including the physician assistant program at FSU employ a community-based education model, rather than hospital-based, to help direct students towards a career focused on helping these specific communities. 

Morgan shared that “all of our students need to have the grades to do well in the program, but just as important is their desire to help us achieve our mission of improving the quality of care for all Floridians.”

Trying to find students who fit with the program’s mission was difficult using the traditional admissions processes and tools. GPA and GRE test results only reflect the student’s cognitive skills while personal statements and reference letters have been useless in gaining insight into the applicant’s character and level of professionalism. 

“You’d be surprised by some of the stories we have about people we’ve interviewed for the program who were honestly just the opposite of what we were looking for,” said Morgan. “A person’s behavior and honest commitment to the profession is a must, and we really don’t want to have to spend more time dealing with problematic behavior.”

Instances of poor behavior are not uncommon in medical education programs or even in the healthcare profession itself. The fact of the matter is that there is an abundance of tools to assess cognitive skills, but very few to find committed and ethical professionals. So when Morgan met the Acuity Insights team at the PAEA conference in Minnesota a few years ago, he was excited about the potential of the Casper test to fill the gap.

“There were a few things about Casper that piqued my interest,” shared Morgan. “First was the ability to immediately screen out applicants who would most likely demonstrate unprofessional behavior. Second, I was really impressed by the amount of research that went into designing the test and the rating method used to help minimize bias. We definitely see much smaller demographic differences in Casper scores than we do in the GRE, and that’s important because we want to recruit from those medically underserved populations and send them back as trained healthcare professionals. Third, Casper is relatively inexpensive for applicants compared to other tests.”

Since using Casper, Morgan and his colleagues have also noticed a strong positive correlation between applicants’ test scores and their performance in the multiple mini interview (MMI). He said, “In the year we first implemented Casper, I didn’t share the applicants’ Casper scores with the rest of the committee until after we completed the multiple mini interviews. After we had ranked the applicants based on their interview performance, I shared the scores and we saw a strong correlation between their interview performance and Casper score, particularly among those who ranked at the bottom of our list. It just shows that the data backs up the product and can really help us improve our process.”

So how does the FSU physician assistant program leverage Casper in the admissions process? Morgan explained that he takes the verified applicants from the CASPA system and inputs the data into a spreadsheet that includes applicants’ GPA, Casper score, and HRSA indicators. Those with a high GPA would rank at the top, but applicants with HRSA indicators would receive a “mission-fit bump” on the list to ensure there was a balance between strong academic performance and mission alignment. Since noticing the correlation between Casper scores and MMI performance in that first year, the FSU program will now implement a cut-off Casper score. Those who do not meet the minimum score will not be invited to interview. As Morgan puts it, “It just helps ensure we’re spending our time interviewing the right candidates and not any potential problem students.”

After weighing the applicants’ GPA, HRSA indicators, and Casper scores, Morgan invites the top candidates to the MMI, and from there the admissions committee reviews and ranks the candidates based on their interview performance. Those at the top receive offers of admission. 

“I think we’ve finally got a process that works for us,” concludes Morgan. “I’m much more confident in the quality of students we’re bringing into the program and Casper plays a huge role in that. Without a doubt, other programs would benefit by using it too.”