Introduction:
The multiple mini interview (MMI) method was implemented and evaluated for a degree program in midwifery at one German university for the first time in 2022. In addition to the grade of the university entrance qualification (UEQ), personal attributes and psychosocial competencies were recorded as further selection criteria¹ enabling a more objective and fair assessment of personal suitability compared to traditional selection interviews². Broadly established in medicine^3,4 and nursing⁵ internationally, MMIs consider professional aptitude^6,7 according to clinical training facility requirements and avoid solely merit-based selection⁸ in the course of academizing midwifery in Germany.

Objectives:
The aim was to explore reliability, factorial and incremental validity and consider professional aptitude with undergraduate entry midwifery students. The MMI was designed to achieve best fit with program-specific requirements and promote an inclusive selection process fostering diversity in midwifery students.

Methods:
In May 2022, 56 applicants were assessed in a six station MMI by examiners from different professional backgrounds. Structured questions designed to explore personal characteristics and interaction with simulated patients in practical tasks were evaluated based on checklists with semantic differentials and global ratings. An accompanying survey recorded participants’ sociodemographic data, individual motivation and self-reported personality traits according to big five inventory⁹. Test quality was examined by means of reliability analysis, factorial validity confirmed using maximum-likelihood factor analysis¹⁰. Incremental validity of the MMI stations in relation to the grade of UEQ and differential effects due to individual characteristics were considered correlatively.

Results:
Reliability analysis was good to excellent for all parameters (internal consistency α = 0.79-0.94, corrected item-total correlation rit = 0.46-0.77 and absolute difficulty p = 0.72-0.79). The factorial validity of MMIs and incremental validity for the practical stations was confirmed. Personal characteristics did not correlate with performance. The MMI results clearly impacted on final selection decisions: 68% of places were offered to candidates who would not have been considered based on their high school grades alone.

Discussion:
To promote equity and social justice in the health care workforce, unbiased admission policies are required^11,12. Student selection criteria reflecting societal diversity¹³ can enable inclusive and faire recruitment for future midwives¹⁴. By widening the recruitment funnel, the educational system can proactively contribute to a diverse and competent future workforce.

Conclusions:
Multiple Mini Interviews increase dimensionality in the selection of students for dual degree midwifery programs and allow the inclusion of psychosocial competencies and practical skills in the process. Diversity within the profession can be promoted by widening the applicant tool. The selection process also reflects the institutional values and paves the way for a bond between location and student.