Neuroinclusive online interviews: a process evaluation of the first co-designed asynchronous Multiple Mini Interview

Many jurisdictions legally require reasonable adjustments in personnel selection, to support individuals with disabilities, such as those with neurodevelopmental conditions. Recruitment to healthcare professions and education programmes is no exception. These measures often depend on applicants having formal diagnoses or a willingness to disclose their needs, overlooking the natural heterogeneity in cognition, learning, and behaviour. Consequently, traditional selection methods may inadvertently disadvantage certain candidates, Thus, more inclusive personnel selection practices are needed. We aimed to assess the effect of co-designed interview modifications on differential performance between neurodivergent and neurotypical participants in a process evaluation. The co-design approach was employed to advance an existing online interview that utilised the Multiple Mini Interview (MMI) methodology in an asynchronous digital format. The interview was evaluated in two configurations: standard and modified. The modified version enhanced the standard version by incorporating a practice portal and accessibility features identified by neurodivergent volunteers. A total of 292 individuals, comprising 148 neurotypical and 146 participants self-identifying as neurodivergent from across the United Kingdom, took part in mock MMIs scored by independent assessors using a seven-point Likert scale. Participants who self-identified as neurodivergent achieved significantly higher mean scores on the modified interview compared to the standard format (mean scores; 141.6 vs. 121.4 points; p<0.0001). In contrast, no statistically significant inter-group differences were observed for neurotypical participants for those taking the standard or modified interview. Scoring differences between neurodivergent and neurotypical participants reduced when the modified interview was used; no statistically significant intergroup difference in mean scores was observed in this condition (141.6 vs. 136.6; p=0.06). Inter-rater reliability for a random sample of double-blind scored interviews (10%) was high (ICC 0.8; p<0.001). Furthermore, 92% of neurodivergent participants reported that the optimised features facilitated the interview process, 70% perceived the outcomes as fair and objective, and 70% reported experiencing reduced anxiety compared to the unmodified interview. These findings provide evidence that interview modifications can substantially reduce pre-existing disadvantages neurodivergent applicants may face when participating in online, digital interviews in this context. Such enhancements should be universally implemented to promote greater equity in personnel selection processes. Practitioner PointsO_LIAccessibility in online interviews can be optimised through low-cost high impact features including providing practise opportunities. C_LIO_LIOptimising features should be available to all applicants to level the playing field regardless of ability/disability. C_LIO_LIA co-design, universal approach can enable applicants to optimise their interview performance and should be integral to interview structure and set up. C_LI