Background Aptitude tests are widely used for selecting medical students. Although their validity has been well documented, aptitude tests are sometimes suspected to create unequal opportunity for candidate groups with lower socioeconomic status due to limited resources (i.e., time, money, support) for preparatory activities. This study aims to explore how preparatory activities and money spent on preparation affect the results of the German aptitude Test for Medical Studies (TMS). Methods A standardized questionnaire was administered to all medical school applicants who sat the TMS in 2018. Participants were asked about the amount of time and money spent on different preparatory activities (i.e., information booklet, books, computer, study groups, and fee-based training courses) and their level of motivation during preparation. Univariate and multivariate multiple regressions were used to examine the influence of these variables on the TMS test score and its subtests. Results N = 7903 participants completed the questionnaire. Only preparation with books and training courses were significantly associated with an increase in the TMS total score. Self-reported motivation during preparation had a larger effect on test scores than money spent on preparation. However, all effect sizes were rather small. At the subtest level, preparation with books was the only activity which was significantly associated with an improvement in all subtests. The complex field-specific subtests were less associated with preparation than the less complex subtests. Conclusion The findings indicate that motivation may be a more important predictor for success in the TMS than money spent on preparation. As books were the most effective and cost-efficient way of preparation, financial investments for test preparation do not appear to yield significant advantages, which is an important prerequisite for equal opportunity. Using more field-specific subtests and cost-free online training opportunities could be useful in further improving equal opportunity.

Since the 1980's, scientific interest in applicants' reactions to admission procedures has been growing. Several theoretical frameworks and evaluation questionnaires were developed. Many researchers have asked potential participants about their attitudes—what is missing, however, are studies of applicants who have actually taken part in the selection procedures. In addition, applicants' reactions to student selection procedures receive less attention than applicants' reactions to personnel selection procedures. Furthermore, tests and testing conditions continue to develop, e.g., through online-based testing and test supervision at home (“proctoring”). Therefore, we used a standardized questionnaire for measuring the overall test evaluation and different dimensions of acceptance including face validity, controllability, and the absence of strain to examine six scholastic aptitude tests. We added items to get deeper insights into situational aspects. According to the results of 2,052 test participants, applicants prefer specific tests and shorter tests. Situational aspects, such as privacy, working conditions, and prior information, have an influence on the perceptions of applicants. Proctored testing is evaluated positively, but taking the test at a test center is still rated more favorably. This study discusses the practical implications.

Admission tests are among the most widespread and effective criteria for student selection in medicine in Germany. As such, the Test for Medical Studies (TMS) and the Hamburg Assessment Test for Medicine, Natural Sciences (HAM-Nat) are two major selection instruments assessing applicants’ discipline-specific knowledge and cognitive abilities. Both are currently administered in a paper-based format and taken by a majority of approximately 40,000 medicine applicants under high-stakes conditions yearly. Computer-based formats have not yet been used in the high-stakes setting, although this format may optimize student selection processes substantially. For an effective transition to computer-based testing, the test formats’ equivalence (i.e., measurement invariance) is an essential prerequisite. The present study examines measurement invariance across test formats for both the TMS and HAM-Nat. Results are derived from a large, representative sample of university applicants in Germany. Measurement invariance was examined via multiple-group confirmatory factor analysis. Analyses demonstrated partial scalar invariance for both admission tests indicating initial evidence of equivalence across test formats. Generalizability of the results is examined, and implications for the transition to computer-based testing are discussed.