Hiring in Healthcare FAQS

Frequently Asked Questions

What are behavioral competencies?

In healthcare, the term "competency" traditionally refers to the clinical or technical skills required for job performance, or those defined by professional groups or accrediting bodies. In the world of the I/O psychologist, competencies get at those behaviors that we know are most often the reason for an employee's success or failure. These behaviors are often referred to as the knowledge, skills, abilities, attitudes, values and motivations that are linked to high performance.

The process for identifying the required competencies is called "Competency Modeling." Competencies are identified via an analysis of the job. Competency modeling generally includes some combination of interviews of incumbents, supervisors, and other job content experts, questionnaires, and job observation. The goal is to identify and document the behaviors that differentiate good job performers from poor ones, and what behaviors will be important in the organization's "future state." Extensive competency modeling is not always necessary, particularly for experts with significant experience in a particular industry. At least some confirmatory analysis, however, is important before implementing a selection system. This will ensure that the selection system is accurate, (i.e., it measures actual job demands) and that it is legally defensible. Selection tools or systems, in order to be defensible, must rely on some level of competency documentation. This is supported by decisions of the U.S. Supreme Court and by guidelines enforced by the Equal Employment Opportunity Commission.



Are technical and clinical competencies still relevant?

Yes – particularly in healthcare where professional standards, and the need to provide high quality care for patients, are critical. In order to meet the new demands in healthcare, however, attention MUST be paid to a candidate's ability to avoid errors, collaborate, be compassionate and create a customer service environment.



Why healthcare–specific tests?

Basic, off-the-shelf personality tests are moderately predictive. A well-designed and properly implemented generic test will increase the predictive validity of your selection system. Working in every industry, around the world, however, we've discovered that using multiple modes of measurement (beyond personality) and tailoring the assessment to the industry significantly increase their effectiveness. For instance, our assessments for nursing including nursing-specific situational judgment items.



Why test if there is a shortage of applicants?

A hiring system is not designed merely to narrow the applicant pool. If nurses are difficult to replace, you need to make the right decision the first time. A bad hiring decision is often worse than having an open position. In addition, assessments can provide powerful information for use in the management and development of the employee.



Are tests predictive of performance?

The research is conclusive.  Well-designed, properly implemented tests are far more predictive than traditional informal hiring processes.



Are tests legal?

Yes.  If you can document the job-relatedness of the test, implement the test correctly and follow the Uniform Guidelines on Employee Selection Procedures ("the Guidelines"), then EEOC and Supreme Court decisions support the use of tests.



What is a valid assessment?

Formal, structured approaches to making hiring decisions are significantly more effective than informal approaches. Under the law, any decision-making point in the hiring process is a test or an assessment. Questions used to screen applicants, interviews, and pencil and paper and computer-based tests are all decision points and should be chosen, designed and implemented in a manner to ensure accuracy and legal defensibility. You will often hear discussions about the "validity" of a particular test. It would be more accurate to talk about the validity of the hiring process, as a whole, or the validity of the conclusions you draw from the test.

That being said, individual selection tools can be evaluated on their ability to predict job-relevant criteria. Validity is usually reported as a validity coefficient and ranges between -1.0 to +1.00, although most correlations fall within the 0 to 1.0 range. A correlation of 0.0 is a random relationship between test and job performance (and therefore not predictive) whereas a 1.0 is a perfect relationship. Coefficients above .20 are generally seen as having predictive value. Select international is known to have the highest correlation coefficients in the industry.



Who works on our projects?

We don't just sell tests. We work hand in hand with our clients to build efficient, effective and legally defensible hiring systems. We have one of the largest and most qualified team of consultants in the industry, many Ph.D.- trained. Client projects are managed not by sales people but by trained industrial-organizational psychologists with expertise in the science of selection and experience solving our client's problems and helping them to meet their goals.



Why is healthcare hiring different?

We benefit from decades of experience working in every industry, but our Healthcare Solutions Team understands the unique challenges faced by our clients. Hiring in Healthcare is different:

  1. Complexity. Hospitals tend to have very complex organizational structures compared to their overall size. A 400-bed hospital might have over 1,000 different job titles.
  2. Highly trained professionals. A large portion of the workforce - physicians, nurses, allied health professionals and many technical positions - are highly-trained and have a high level of autonomy. Many have performance criteria defined by the profession and by state and national testing and licensing bodies.
  3. A fragmented organization structure. An auto manufacturer designs the entire workforce around production of the car. Hospitals, only recently, have begun to take a service line or patient-centered approach to organizational structure, built around the patient experience. Historically, a hospital is built around relatively independent departments, each with a great deal of autonomy.
  4. Decentralized and disparate hiring processes. This autonomy often fosters a decentralized and inconsistent approach to recruiting and hiring. Nursing has its approach, other departments do something else, and physician hiring is informally controlled by the C-suite and the VPMA. Inconsistency between hospitals in a system, or even hiring managers within the same hospital, make standardization difficult and create unnecessary legal risk.
  5. Customer Service is no longer a "nice to have."  Every company wants to improve customer service but with the new HCAHPS requirements, patient satisfaction scores are a critical success metric for hospitals.
  6. The nature of the Services.  Poor quality in a manufacturing plant means a poor product and a weakened competitive advantage. Poor quality in a hospital means harm to patients and the hospital's inability to fulfill its mission.



How do you build a comprehensive selection "system"?

Consider Accuracy and Legal Defensibility.  Look for solutions with a proven track record of validity - the ability to successfully predict performance. Similarly, look for solutions that will fit into your system, considering all legal and compliance issues in order to minimize risk wherever possible.

Use Assessments Designed for Selection.  Make sure you use assessments developed specifically for selection. Many assessments were intended for other purposes - usually clinical or informational. You want to find an assessment that has clear information about validity and reliability. Be wary of assessments that are "one size fits all" or provide a category or "label." Those types of assessments were not developed for pre-employment testing.

Match the Competency or Skill to the Assessment.  Finding the most accurate and appropriate assessment depends on what you are trying to measure. Each assessment type has its own strengths and weaknesses. You wouldn't want to use a personality assessment to measure presentation skills. If that skill is important, a simulation would be more appropriate.

Be Efficient.  Place assessments in your hiring funnel where they can add the most value. The most comprehensive assessments should be placed farther down the funnel where you have fewer candidates. If you have high volume at the top of the funnel, find a shorter assessment that can help screen out many of the less qualified candidates.

Be Consistent & Relevant.  Whatever assessments you use, use them consistently. Establish standards and apply them to every candidate. Make sure the assessments and their measurements are relevant to the target position. Just because an assessment contains a measurement does not mean that you have to use it in your decision making - do not use it if it is not important to success on the job.

On-Going Monitoring.  After implementation, you must periodically monitor assessments and the hiring system. Monitor pass rates and adverse impact ratios and, wherever possible, compare the selection process to key business metrics to ensure that it is effective.

Build a "System".  Incorporate and coordinate assessments into a comprehensive system of application, interviewing and the right assessments at the right point in the process.



How do candidates react to assessments?

The research is conclusive. Candidates respond well to our assessments. They are administered in a manner that places little burden on the candidate and they have substantial "face-validity" - candidates see them as fair and related to their success on the job.



Why Select International?  

Multiple modes of measure.  Our tests go beyond personality. Our assessments incorporate five modes of measurement that significantly increase our predictive validity.

An enterprise-wide approach.  Rather than simply selling tests, we can re-think the entire hiring system, from top to bottom in order to help you meet your organization's goals.

Our library of tests.  Select International has one of the largest libraries of validated tests in the industry. Rather than simply re-selling tests, we have designed most of our assessments to meet particular needs. We can constantly tailor them to meet our clients' needs.

Our experts.  Our team includes some of the world's recognized experts. We present more research on selection at national conferences than leading universities.

Our database.  We've administered millions of assessments in nearly 100 countries. This massive database allows us to build highly predictive tools.

Our Healthcare Solutions Team.  We understand your unique challenges and build solutions designed specifically for healthcare.

Legal defensibility.  We are the recognized experts and provide guidance to some of the most sophisticated companies in the world on building legally defensible hiring systems. 



Learn more about our workforce solutions.

Contact Us