From the Creators of CASPer: What You Need to Know About the CASPer Test

CASPer is an assessment tool that is rapidly gaining popularity across the world. CASPer is a situational judgment test (SJT) that presents test-takers with a series of realistic, hypothetical scenarios and asks them to type out what they would do if they were to be in that particular situation. In this article, you will learn about the CASPer from Altius Assessments, the professionals that created it!

At the end of the 2018-2019 admissions cycle, over 200,000 people have taken the test. About 50% of all U.S. medical school applicants and 80% of all Canadian medical school applicants will have had to take CASPer at some point during their application process. CASPer was first created in 2005 at McMaster University, and in 2010, Michael DeGroote School of Medicine incorporated it into their official admissions process.

CASPer has been implemented into the admissions process for many physician assistant programs and many more medical schools and other health care programs (see here for the most updated list of programs using CASPer). With its rising popularity, there has also been a rise in the number of articles that have been written about CASPer—which unfortunately have not always been completely accurate. In this article, we want to give you an overview of CASPer straight from the source directly responsible for the construction and delivery of the test.

What is CASPer measuring?

A large portion of a student’s acceptance decision to a medical program is based on their academic achievements, primarily undergraduate GPA and MCAT scores. This ensures that students have a strong foundation of knowledge and demonstrate superior cognitive abilities. However, this is not the only factor that matters when becoming a successful physician. In fact, one seminal study published in the New England Journal of Medicine found that 94% of identifiable causes leading to disciplinary decisions against doctors were due to lapses in professionalism, not due to lack of cognitive medical competence. This has resulted in a dire need for medical programs to assess their applicants’ cognitive abilities and ensure that their students possess the interpersonal and intrapersonal skills necessary to become an effective physician. This is where CASPer comes in, as it assesses non-cognitive skills, such as professionalism, communication, ethics, empathy, and motivation, and serves to complement the cognitive assessments that are already required by the programs.

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What is the format of CASPer?

The test comprises 12 sections (8 video-based scenarios and 4 word-based scenarios) presented in a randomized order and each followed by three probing questions.  The video-based scenarios are all SJTs, whereas the four word-based scenarios blend SJTs and behavioral descriptor questions, which ask respondents to talk about a specific experience. The scenarios are set in a more general context: you may be placed in a workplace setting with your boss in one scenario. In another scenario, you may be placed at a party with friends, and in another scenario, you may be placed in your own living room with your parents. The scenarios are typically not specific to the clinical setting, as we want to make sure that we are not giving an advantage to those students who have clinical experience. You can take a look at several sample scenarios here on the takeCASPer website. Ensure that the sample scenario and question set are from the official source, as many of the sample CASPer sections are from unofficial sources that are not representative of the actual test.

How is CASPer evaluated?

A different person evaluates each section of the CASPer test. This means that every student is assessed by 12 independent human raters who come from various backgrounds (e.g., physicians, nurses, educators, policymakers) and demographics (e.g., race, gender, income) to reflect the diversity of the patient population. Raters are trained to disregard spelling and grammatical mistakes when evaluating responses and focus solely on the response’s content. The 12 independent ratings are averaged, and scores are then standardized to represent the relative rankings of each student compared to their peers. The scores are automatically distributed to the selected programs approximately three weeks after taking the test. Students do not receive their scores because it is difficult to interpret a single CASPer score without knowing how everyone else performed on the test.

How do programs use CASPer in the admissions process?

There is no single answer to this question, as each school incorporates CASPer in different ways to guide their admissions process. Most programs use CASPer alongside other metrics like GPA and MCAT scores as a prescreening tool to decide who to invite to the interview process. Some programs take a more impressionistic approach when using CASPer, to help facilitate decisions on candidates on the cusp of being admitted to the program. Other programs implement a conservative cut-off score for CASPer to screen out applicants, while others take a closer look at candidates who have exceptionally high CASPer scores. For instance, Dalhousie Medical School will only consider applicants who score above -1.5 standard deviations from the mean for the interview.

What can you do to prepare for CASPer?

Unlike the traditional SJTs with right-or-wrong answers, the primary goal of CASPer is not to examine what you would do in a given scenario but why you would take that particular course of action. This makes it difficult to study for CASPer, as there is no obvious approach in answering the questions the “right” way. The general SJT literature and our own internal research have also shown that more complicated and challenging SJTs like CASPer are resistant to the effects of practice and coaching. While it may be difficult to improve your CASPer scores in the short term, we have listed several ways students can prepare in advance to ensure a smooth test-taking experience—familiarize yourself with the format of the test, double-check to make sure that you meet all the technical requirements (have a functioning webcam!), and plan your schedule well in advance to ensure that you can complete CASPer in a comfortable and quiet location.


The admissions process to medical school can be a long and daunting process for many students, and the addition of another assessment tool can be seen as another burden on what is already a fairly strenuous process. However, programs want to gather the most accurate and holistic view of their applicants to ensure that they are making the right decisions, as their students will be shaping the future quality of our healthcare. As technology has given patients easy access to a wealth of information right at their fingertips, they are no longer satisfied with just a medically competent doctor. Patients now seek doctors who are also good listeners, demonstrate empathy and compassion, and provide more personalized care. Historically, the admissions process has done an excellent job in admitting the brightest students. Still, they are now trying to do a better job ensuring that the students also possess the personal attributes that patients want to see from their physicians.

If you would like to get the most up-to-date information on everything related to CASPer, make sure to visit our Resources page at and our Twitter account @take_casper. Feel free to tweet directly or email us at [email protected] with any questions or comments you have about the test.

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This info was reviewed and updated by Dr. Lee Burnett May 22, 2021.