Dr Alison Callwood

Lecturer in Integrated Care (Midwifery)
PhD, SFHEA, MSc, PGCert, Dip HE/RM, BSc(Hons) Nursing/RGN
+44 (0)1483 686747
DK 05


University roles and responsibilities

  • Practice Liaison Link Tutor at St Richards Hospital, Chichester


    Research interests

    My teaching

    My publications


    Callwood A, Cooke D, Allan H (2014) Developing and piloting the multiple mini-interview in pre-registration student midwife selection in a UK setting, Nurse Education Today 34 (12) pp. 1450-1454
    © 2014 Elsevier Ltd.Background: Published research has demonstrated that the multiple mini-interview (MMI) is a reliable assessment instrument in medical and nursing student selection. There is a dearth of evidence specifically relating to the advancement and subsequent evaluation of MMIs in the context of student midwife selection. Objectives: To develop, pilot and examine the reliability of MMIs in pre-registration student midwife selection in a UK setting. Design and setting: DeVellis' framework for questionnaire development underpinned the generation of MMI scenarios. BSc (Hons) Midwifery Studies students at a Higher Education Institution in the UK volunteered to participate in 'mock' MMI circuits during the first week of their programme. Results: An eight station model was piloted. Communication skills were rated at each station as a generic attribute. Station specific attributes assessed included: compassion and empathy; respect for difference and diversity; honesty and integrity; intellectual curiosity and reflective nature; advocacy; respect for privacy and dignity; team working and initiative; the role of the midwife and motivation to become a midwife. Participants' responses to scenario questions were rated on a 7 point scale. Cronbach's alpha scores measuring internal consistency ranged from 0.91 to 0.97. Conclusion: The systematic development of the MMI model and scenarios resulted in 'excellent' reliability across all stations. These findings endorse the MMI technique as a reliable alternative to the personal interview in informing final decisions in pre-registration student midwife selection.
    Callwood Alison, Cooke Deborah, Bolger Sarah, Lemanska Agnieszka, Allan Helen (2017) The reliability and validity of multiple mini interviews (MMIs) in values based recruitment to nursing, midwifery and paramedic practice programmes: Findings from an evaluation study,International Journal of Nursing Studies 77 pp. 138-144 Elsevier
    Background: Universities in the United Kingdom (UK) are required to incorporate values based recruitment (VBR) into their healthcare student selection processes. This reflects an international drive to strengthen the quality of healthcare service provision. This paper presents novel findings in relation to the reliability and predictive validity of multiple mini interviews (MMIs); one approach to VBR widely being employed by universities.

    Objectives: To examine the reliability (internal consistency) and predictive validity of MMIs using end of Year One practice outcomes of under-graduate pre-registration adult, child, mental health nursing, midwifery and paramedic practice students.

    Design: Cross-discipline evaluation study. Setting: One university in the United Kingdom.

    Participants: Data were collected in two streams: applicants to A) The September 2014 and 2015 Midwifery Studies programmes; B) September 2015 adult; Child and Mental Health Nursing and Paramedic Practice programmes. Fifty-seven midwifery students commenced their programme in 2014 and 69 in 2015; 47 and 54 agreed to participate and completed Year One respectively. 333 healthcare students commenced their programmes in September 2015. Of these, 281 agreed to participate and completed their first year (180 adult, 33 child and 34 mental health nursing and 34 paramedic practice students).

    Methods: Stream A featured a seven station four-minute model with one interviewer at each station and in Stream B a six station model was employed. Cronbach?s alpha was used to assess MMI station internal consistency and Pearson?s moment correlation co-efficient to explore associations between participants? admission MMI score and end of Year one clinical practice outcomes (OSCE and mentor grading).


    Stream A: Significant correlations are reported between midwifery applicant?s MMI scores and end of Year One practice outcomes. A multivariate linear regression model demonstrated that MMI score significantly predicted end of Year One practice outcomes controlling for age and academic entry level: coefficients 0.195 (p = 0.002) and 0.116 (p = 0.002) for OSCE and mentor grading respectively. In Stream B no significant correlations were found between MMI score and practice outcomes measured by mentor grading.

    Internal consistency for each MMI station was ?excellent? with values ranging from 0.966?0.974 across Streams A and B.

    Conclusion: This novel, cross-discipline study shows that MMIs are reliable VBR tools which have predictive validity when a seven station model is used. These data are important given the current international use of different MMI models in healthcare student selection processes.

    Callwood Alison, Bolger Sarah, Allan H (2017) The ?values journey? of nursing and midwifery students selected using multiple mini interviews;
    Year One findings
    Journal of Advanced Nursing 74 (5) pp. 1139-1149 Wiley

    to explore how adult, child and mental health nursing and midwifery students, selected using
    multiple mini interviews, describe their ?values journey? following exposure to the clinical practice


    Values based recruitment incorporates assessment of healthcare students? personal
    values using approaches like multiple mini interviews. Students? experience of adjustment to their
    values during their programme is conceptualised as a ?values journey?. The impact of VBR in
    alleviating erosion of personal values is unclear.


    A cross
    -professional longitudinal cohort study was commenced at one university in England
    in 2016 with data collection points at the end of
    two and
    three. Non
    -probability consecutive
    sampling resulted in 42 healthcare students (8 adult, 8 child and 9 mental health nursing and 17
    midwifery students) taking part.


    Six semi
    -structured focus groups were conducted at the end of participants? Year One
    (DC1). Data analysis incorporated inductive and deductive approaches in a hybrid synthesis.


    Participants described a ?values journey? where their values, particularly communication,
    courage and wanting to make a difference, were both challenged and retained. Participants personal
    journeys also acknowledged the: ?courage it takes to use values?; ?reality of values in practice? and
    ?need for self-reflection on values?.

    Groothuizen Johanna, Callwood Alison, Gallagher Ann (2017) What is the value of Values Based Recruitment for nurse education programmes?,Journal of Advanced Nursing 74 (5) pp. 1068-1077 Wiley
    A discussion of issues associated with Values Based Recruitment for nurse education programmes.

    Values Based Recruitment is a mandatory element in selection processes of students for Higher Education healthcare courses in England, including all programmes across nursing. Students are selected on the basis that their individual values align with those presented in the Constitution of the National Health Service. However, there are issues associated with the use of values as selection criteria that have been insufficiently addressed. These are discussed.

    Discussion paper.

    Data Sources

    This article is based on documents published on the website of the executive body responsible for the implementation of a policy regarding Values Based Recruitment in Higher Education Institutions up until June 2017 and our evaluation of the conceptualisation of Values Based Recruitment, underpinned by contemporary theory and literature.

    Implications for nursing
    Values Based Recruitment influences who is accepted onto a nurse education programme, but there has been limited critical evaluation regarding the effectiveness of employing values as selection criteria. Values are subject to interpretation and evidence regarding whether or how Values Based Recruitment will improve practice and care is lacking. The issues discussed in this article show that Higher Education Institutions offering nursing courses, whether in England or in other countries, should be critical and reflective regarding the implementation of Values Based Recruitment methods.

    We call for a debate regarding the meaning and implications of Values Based Recruitment and further research regarding its validity and effectiveness.

    Callwood Alison, Jeevaratnam Kamalan, Kotronoulas Grigorios, Schneider Annegret, Lewis Liane, Nadarajah Vishna Devi (2018) Personal domains assessed in multiple mini interviews (MMIs) for healthcare student selection: A narrative synthesis systematic review,Nurse Education Today 64 pp. 56-64 Elsevier


    To examine the personal domains multiple mini interviews (MMIs) are being designed to assess, explore how they were determined and contextualise such domains in current and future healthcare student selection processes


    A systematic review of empirical research reporting on MMI model design was conducted from database inception to November 2017.

    Data Sources

    Twelve electronic bibliographic databases.

    Review Methods

    Evidence was extracted from original studies, and integrated in a narrative synthesis guided by the PRISMA statement for reporting systematic reviews. Personal domains were clustered into themes using a modified Delphi technique.


    A total of 584 articles were screened. 65 unique studies (80 articles) matched our inclusion criteria of which seven were conducted within nursing/midwifery faculties. Six in 10 studies featured applicants to medical school. Across selection processes, we identified 32 personal domains assessed by MMIs, the most frequent being: communication skills (84%), teamwork/collaboration (70%), and ethical/moral judgement (65%). Domains capturing ability to cope with stressful situations (14%), make decisions (14%), and resolve conflict in the workplace (13%) featured in fewer than ten studies overall. Intra- and inter-disciplinary inconsistencies in domain profiles were noted, as well as differences by entry level. MMIs deployed in nursing and midwifery assessed compassion and decision-making more frequently than in all other disciplines. Own programme philosophy and professional body guidance were most frequently cited (~50%) as sources for personal domains; a blueprinting process was reported in only 8% of studies.


    Nursing, midwifery and allied healthcare professionals should develop their theoretical frameworks for MMIs to ensure they are evidence-based and fit-for-purpose. We suggest a re-evaluation of domain priorities to ensure that students who are selected, not only have the capacity to offer the highest standards of care provision, but are able to maintain these standards when facing clinical practice and organisational pressures.

    Callwood Alison, Groothuizen Johanna, Allen Helen Therese (2019) The ?values journey? of nursing and midwifery students selected using multiple mini interviews; year two findings,Journal of Advanced Nursing 75 (5) pp. pp 1074-1084 Wiley


    To explore how adult, child, mental health nursing and midwifery students describe their ?values journey? after completing their second year following exposure to the clinical practice environment.


    Where student nurses and midwives are selected using multiple mini interviews, in a values?based recruitment process, the conservancy and or development of their personal values remains unclear.


    A hermeneutic, cross?professional longitudinal study was commenced at one university in England in 2016 with data collection points at the end of years one (DC1), two (DC2) and three (DC3). From the 42 participants recruited in year one, 28 went on to participate in data collection at DC2 (3 adult, 6 child, 3 mental health nurses and 16 midwifery students).


    Four semi?structured focus groups were conducted. Data analysis incorporated inductive and deductive approaches in a hybrid synthesis.


    Participants did not feel their values had changed fundamentally since year one. However, the prioritization of their values and how they were ?put into practice? had changed. Key themes identified were: ?changed sense of self as a healthcare practitioner?; ?influences on values in practice? and ?reflection on values.?


    Reframing of personal values is an integral part of learning across clinical and academic settings. Critical reflective practice should be integrated into pre?registration health education programmes to support student nurses and midwives sustain their learning around values; to maintain ?good? values in the face of observed ?bad? values.

    Groothuizen Johanna Elise, Callwood Alison, Gallagher Ann (2018) NHS constitution values for values-based recruitment: a virtue ethics perspective,Journal of Medical Ethics 44 (8) pp. 518-523 BMJ Publishing Group
    Values-based recruitment is used in England to select healthcare staff, trainees and students on the basis that their values align with those stated in the Constitution of the UK National Health Service (NHS). However, it is unclear whether the extensive body of existing literature within the field of moral philosophy was taken into account when developing these values. Although most values have a long historical tradition, a tendency to assume that they have just been invented, and to approach them uncritically, exists within the healthcare sector. Reflection is necessary. We are of the opinion that selected virtue ethics writings, which are underpinned by historical literature as well as practical analysis of the healthcare professions, provide a helpful framework for evaluation of the NHS Constitution values, to determine whether gaps exist and improvements can be made. Based on this evaluation, we argue that the definitions of certain NHS Constitution values are ambiguous. In addition to this, we argue that ?integrity' and ?practical wisdom', two important concepts in the virtue ethics literature, are not sufficiently represented within the NHS Constitution values. We believe that the NHS Constitution values could be strengthened by providing clearer definitions, and by integrating ?integrity' and ?practical wisdom'. This will benefit values-based recruitment strategies. Should healthcare policy-makers in other countries wish to develop a similar values-based recruitment framework, we advise that they proceed reflectively, and take previously published virtue ethics literature into consideration.
    Groothuizen Johanna Elise, Callwood Alison, Allan Helen Therese (2019) The 'values journey' of nursing and midwifery students selected using multiple mini interviews: Evaluations from a longitudinal study,Nursing Inquiry Wiley
    Values?based practice is deemed essential for healthcare provision worldwide. In England, values?based recruitment methods, such as multiple mini interviews (MMIs), are employed to ensure that healthcare students? personal values align with the values of the National Health Service (NHS), which focus on compassion and patient?centeredness. However, values cannot be seen as static constructs. They can be positively and negatively influenced by learning and socialisation. We have conceptualised students? perceptions of their values over the duration of their education programme as a ?values journey?. The aim of this hermeneutic longitudinal focus group study was to explore the ?values journey? of student nurses and midwives, recruited through MMIs, across the 3 years of their education programme. The study commenced in 2016, with 42 nursing and midwifery students, originally recruited onto their programmes through multiple mini interviews. At the third and final point of data collection, 25 participants remained. Findings indicate that students' confidence, courage and sense of accountability increased over the 3 years. However, their values were also shaped by time constraints, emotional experiences and racial discrimination. We argue that adequate psychological support is necessary as healthcare students embark on and progress through their values journey, and propose a framework for this.

    In England, a Values Based Recruitment (VBR) policy intends to ensure that healthcare students? individual values align with the values of the National Health Service (NHS) Constitution. However, students? values may become compromised with increased clinical experience, due to, for instance, distress, negative role models and hidden curricula.


    To explore potential differences in values between first, second, and third year students of adult nursing, in order to theorise whether and how such students? values may change over the duration of their programme, upon exposure to clinical practice environments.


    1. To develop an instrument (Situational Judgement Test, SJT) that assesses students? congruence with the NHS Constitution values, and whether these are prioritised.

    2. To establish whether the values (assessed using the SJT) of students with differing levels of experience (years one, two, and three ? particularly clinical practice experience) vary.

    3. To generate insights into the considerations and reflections that students have regarding SJT items, and determine whether these vary between the different year groups.

    4. To verify and gain a deeper understanding of these findings in the context of students? (practice) learning, as well as input for recommendations, through adult nursing Practice Liaison Tutors within the university.


    This research was granted a Favourable Ethical Opinion by the University of Surrey Ethics Committee. An SJT was developed (objective 1), and reliability and validity were determined with a pilot sample of 47 volunteers. Subsequently, first (n=13), second (n=15) and third (n=9) year students (total N=37) completed the SJT and participated in discussion sessions (objectives 2 and 3). Analysis took place using inferential statistics and thematic methods. Afterwards, six tutors were presented with the findings and interviewed (objective 4).


    SJT scores were highest in year one and lowest in year three (significant difference between first and third year group, F=7.28, p=.002). First year students expressed idealism. Second and third year students, however, experienced organisational hierarchy and difficulty speaking up against poor practice on their placements, at times de-prioritising the NHS Constitution values in response. Tutors could relate to these findings and suggested strategies to support students.


    Despite the VBR policy, students? congruence with the NHS Constitution values may become compromised with increased clinical experience. Recommendations are made for education and placement organisations to prepare students for clinical practice, address hierarchy, and provide a safe and ethical learning environment.

    Callwood Alison, Groothuizen Johanna, Lemanska Agnieszka, Allan Helen (2019) The predictive validity of Multiple Mini Interviews (MMIs) in nursing and midwifery programmes: Year three findings from a cross-discipline cohort study,Nurse Education Today 88 104320 Elsevier
    Background: Education literature worldwide is replete with studies evaluating the effectiveness of Multiple Mini Interviews (MMIs) in admissions to medicine but
    Objectives: To examine the predictive validity of MMIs using end of programme clinical and academic performance indicators of pre-registration adult, child, and
    mental health nursing and midwifery students.
    Design and setting: A cross-sectional cohort study at one university in the United Kingdom.
    Participants: A non-probability consecutive sampling strategy whereby all applicants to the September 2015 pre-registration adult, child, mental health nursing and
    midwifery programmes were invited to participate. Of the 354 students who commenced year one, 225 (64%) completed their three-year programme and agreed to
    take part (adult 120, child 32, mental health nursing 30 and midwifery 43).
    Methods: All applicants were interviewed using MMIs with six and seven station, four-minute models deployed in nursing and midwifery student selection respectively.
    Associations between MMI scores and the cross-discipline programme performance indicators available for each student at this university at the end of
    year three: clinical practice (assessed by mentors) and academic attainment (dissertation mark) were explored using multiple linear regression adjusting for applicant
    age, academic entry level, discipline and number of MMI stations.
    Results: In the adjusted models, students with higher admissions MMI score (at six and seven stations) performed better in clinical practice (p academic attainment (p = 0.122) at the end of their three-year programme.
    Conclusion: These findings provide the first report of the predictive validity of MMIs for performance in clinical practice using six and seven station models in nursing
    and midwifery programmes. Further evidence is required from both clinical and academic perspectives from larger, multi-site evaluations.

    Additional publications