What is the CASPer Test?

The CASPer test is a computerized situational judgement test. CASPer was designed to test non-academic skills of applicants to professional programs. It was developed by researchers at McMaster University, and it was used by their medical school beginning in 2010. Since then it has been adopted by several US and Canadian medical, dental, and nursing schools. Schools have begun using this test as a screening tool during the early part of their application process.

Situational Judgement Tests

A situational judgement test is a type of psychological test. It presents the test taker with a series of hypothetical scenarios and asks them how they would respond. Situational judgement tests are used to measure behavioral tendencies. As appropriate behavior can vary depending on the situation, these test must be created individually for specific uses. These types of tests have been used for over 50 years. One of the first situational judgement tests was used by employers to determine if a job candidate had the necessary leadership skills to be a manager. Today, situational judgement tests have found a variety of uses. Most, recently there has been a lot of interest in using situational judgement tests for medical school admissions.

The AAMC has recently become quite interested in the use of situational judgement tests in medical school admissions. The organization recognizes that the practice of medicine requires physicians to work as part of a team to care for their patients. In addition, they understand that physicians must have the skills to interact effectively with patients and colleagues of diverse socio-cultural backgrounds. Therefore, they are urging medical schools to take these qualities into account when selecting their incoming classes.

The AAMC is in the process of developing their own situational judgement test. They cite multiple countries who use situational judgement testing in the medical school application process, as well as in selecting physicians in general practice. Although the AAMC situational judgement test is not currently being used in any official capacity, it will soon be given at several medical schools around the country as part of a pilot study.

The Importance of Non-Academic Skills

Recently, medical schools have started to recognize that the smartest students do not necessarily become the best doctors. In addition, they found that academic aptitude correlates poorly to how well people perform in medical school. Medical schools have come to the realization that students who have issues that prevent them from graduating most often have  problem s with professionalism or interpersonal skills, rather that academic difficulties. Conversely, medical students with strong interpersonal skills perform better in introduction to clinical medicine courses, clinical clerkships, and score better on the OSCE exam. Furthermore, schools have a much greater success rate remediating students with academic difficulties rather that those with non-academic concerns. For this reason, medical schools are looking closer at applicants’ professionalism and interpersonal skills when they are selecting their incoming class.

Another factor driving the focus on non-academic skills is patient satisfaction. Ultimately, medicine is a business. In order to succeed, doctors must make their customers (their patients) happy. Consumers of medicine have become less tolerant of the highly-skilled but aloof physician who does not answer their questions. Multiple surveys have shown that patients rate a physician’s communication skills and bedside manner as very important. In addition, it has been found that a patient who has a good rapport with their physician is less likely to make a malpractice claim, regardless of their health outcome.  In response, hospital administrations have been emphasizing creating a positive experience for patients. Many hospitals have adopted patient-centered policies; such as including the patient in daily rounds and holding doctors accountable for patient satisfaction surveys. Because medical schools are directly responsible for supplying new doctors to hospitals and outpatient clinics, it is in their best interest to follow the trends in consumer medicine. Because patients demand a caring physician with good communication skills, medical schools are now looking for these qualities in prospective students.

Pre-professional Competencies

The AAMC has responded to the focus on non-academic skills by identifying nine non-academic competencies. Medical school applicants should be able to demonstrate that they have have developed these skills. The non-academic pre-professional competencies are:

  • Service orientationclinical experience teamwork
  • Social skills
  • Cultural competence
  • Teamwork
  • Oral communication
  • Ethical responsibility to self and others
  • Reliability and dependability
  • Resilience and adaptability
  • Capacity for improvement

Medical schools look for applicants who demonstrate mastery of the pre-professional competencies. However, it is sometimes difficult to determine which students have these skills. Most schools rely on recommendation letters and information presented in a student’s personal statement. However, some schools have begun to look for an additional measure of non-academic skill.

The CASPer Test

Currently, the CASPer test is the only situational judgement test officially being used during admissions screening for medical school. Some medical schools are turning to the CASPer test to provide standardized information about their applicants’ non-academic skills. Although most medical schools currently do not require the test, more and more schools adopt the test each year. Right now, the following US medical schools require the CASPer test as part of the application process:

Registering for the CASPer test

The CASPer test is delivered by Altus Assessments. It is a computerized test that is taken at a location of your choice. However, you must register for a specific date and time to take the test. You should plan to register well in advance of your preferred test date. However, the registration deadline is 3 days prior to the test. The registration fee is $10. In addition, you will be charged an additional $10 for each school that will receive the results.

Because you will be using your own computer for the test, it is very important that you ensure that it meets the technical requirements before the start of your test. It would be quite frustrating to attempt to take your test, only to find that your computer does not meet their specifications. In order to take the CASPer test, your computer must have

  • Browser (chrome is recommended)
  • Stable broadband internet connection
  • Speakers or headphones
  • keyboard
  • webcam

You should plan to take the test on a desktop or laptop computer. Tablets are not recommended. If you do not have a suitable computer, you should make arrangements to borrow one; or plan to take your test at a library or your school’s computing center. If you are not sure if your computer meets the requirements, the testing system allows you to run a check after you have registered to take the CASPer test.

CASPer Test Format

CASPer consists of 12 sections. Each section starts with a video or a short written passage. For video sections, you are first given a description of  your role in the scenario. After each video or written passage, you will be asked three open-ended questions about the scenario. You have 5 minutes to answer all three questions. Pay close attention to the videos, the program does not give you the ability to watch it more than once. You are allotted approximately two minutes to read the written passage sections. You will have the option of taking a 15 minute break halfway through the test. You should block two hours from your schedule to complete the CASPer test, however, you will probably finish in less time.

Scoring CASPer

There is no passing or failing grades on the CASPer test. Instead, test takers are given ratings on professionalism and personal characteristics.  Altus Assessments has chosen not to share the exact rating system for the CASPer test. However, we do know a few things about the rating process.

  • Each question is scored by an individual rater
  • Raters use a predefined, Likert-type scale
  • Spelling, punctuation, and grammar do not affect the rating
  • You will not be given your results

Preparing for the CASPer Test

Although it difficult to study for situational judgement tests, it is possible to work on the skills that the test measures. CASPer is designed to measure your professionalism and interpersonal skills. Therefore, you should work on these skills in preparation for the test.


Professionalism means behaving with responsibility, integrity, accountability, and excellence. For the purposes of the test, you need to recognize professional behavior. In addition, you will need to know how to remain professional in a conflict. An easy way to remember professionalism is with the 5 C’s.

  • Caring- strive to learn new skills and develop a higher level of proficiency
  • Character- act with honesty and integrity
  • Clothing- be conscious of your image, dress in a manner that shows respect for your job
  • Composure- remain calm and level-headed in times of stress
  • Communication- state your intentions clearly

Interpersonal skills

It can be helpful to work on your interpersonal skills before taking the CASPer test. Review the pre-clinical competencies and identify any that you have

Women cooperating with interpersonal skills for CASPer

difficulty with. Then look for situations to practice these skills. In addition, you may find it helpful to get an interpersonal skills workbook. Working through the exercises will help you develop strong interpersonal skills.

Organize your thoughts

One of the most difficult aspects of the test is organizing your thoughts and writing a thorough answer to the questions. For this reason, it is helpful to develop a technique. One method is to take one minute to read through all three questions in the section and think of your answers. This will give you one minute to write each answer, and one minute to make any corrections. Although you will not be penalized for spelling or grammatical errors, they are distracting and can make your writing difficult to understand. Therefore, try to write clearly and accurately.

Practice ethics case studies

The CASPer test is designed to evaluate your ability to think, problem-solve, and respond in difficult situations. A good way to practice these skills is to work through ethics case studies. Read the scenario and think about the issues. What are the pros and cons of each viewpoint? Next, make a decision on how you would handle the situation. Write why you made that choice. Finally, read the discussion of the case study, if one is given. See if you chose the “correct” viewpoint. If so, check to see if your reasoning aligned with the explanation. If your answer was different from the solution, see why they chose their particular response. Here are some particularly good resources for bioethics case studies:

How is CASPer being used in Medical School Admissions?

Medical schools use the CASPer test in the early part of the admissions process. Most schools are not completely transparent about how they use this test. For most applicants, taking CASPer should benefit your application. People who are drawn to medicine are generally ethical and compassionate people, which will be reported on the test. In addition, students with average grades and MCAT scores now have another measure of their competence. Therefore, they will theoretically fare better in the admissions process than previously. Conversely, people who lack interpersonal skills and are of questionable moral character will be identified by this test. They may have a more difficult time gaining admission to medical school. However, this is likely a good thing. Their personal character traits make them less suited for a career in medicine. Ultimately, the would probably be happier following a different career path.

The Future of Medical School Admissions

Whether the CASPer test will become a requirement for all medical schools remains to be seen. However, it is clear that situational judgement tests as a tool for medical school admissions are here to stay. Future medical school applicants will almost certainly have to take the CASPer test, or another situational judgement test, in order to be considered for admission.

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