CASPer & AAMC PREview

Part of The Application. Some schools use a situational-judgment test to see how you reason when people, rules, and competing responsibilities collide. The tests are not a morality contest, and you cannot memorize your way into being a thoughtful colleague. You can learn the format, practice staying organized under time pressure, and make your reasoning visible.

First: do you need one?

Do not register because someone online said every applicant should take both. Check each school's current admissions requirements, and note whether CASPer or AAMC PREview is required, recommended, accepted, or not used. Some schools use neither. Some use one. A school may change its policy between cycles.

Keep a column in your school-list tracker for the test, registration deadline, test date, score-release timing, and whether the result must arrive before the school considers your file complete. If you apply through more than one pathway, check each school's policy rather than assuming MD and DO programs use the same test.

What the tests are

Both are situational-judgment tests, but they are not the same exam.

CASPer

CASPer is administered by Acuity Insights. For the 2026–27 admission cycle, the standard test is described as 11 scenarios: four video-response scenarios and seven typed-response scenarios, with optional breaks, for an estimated total time of 65–85 minutes. The exact structure can change by cycle and applicant type, so confirm the current format in your Acuity account before test day.1

You respond in the required format to open-ended questions about video or written situations. You see only your quartile. Schools receive more detailed score information, and each school decides how much weight to give it. ⟳ Verify what is reported to you and to programs in your Acuity account. There is no answer script that guarantees a high result, and discussing specific live-test content can violate the test agreement.

AAMC PREview

PREview is the AAMC's professional-readiness exam. The current format presents text-based scenarios followed by response behaviors. You rate each behavior on a four-point effectiveness scale: very ineffective, ineffective, effective, or very effective. The current exam contains 186 questions, including field-test items that do not count toward the score.2

The score report is on a 1–9 scale with a confidence band and percentile information, but each school decides how it uses the result. Do not treat a score as a universal measure of your character or your future clinical performance.

What they can — and cannot — tell a school

These tests give schools a standardized, time-limited sample of how you respond to social and professional dilemmas. They can show whether you notice affected people, distinguish urgent from non-urgent concerns, communicate respectfully, and know when to ask for help.

They cannot show your whole character. They do not replace your letters, experiences, interview, or the way you behave over time. They are also artificial: you are reasoning from a short prompt with incomplete facts while a clock is running. Your task is to show a defensible approach to the information you have.

A reasoning framework

There is no single paragraph structure that every answer must follow. A useful internal checklist is:

  1. Name the concern. What is the immediate problem, and who could be affected?
  2. Separate facts from assumptions. What do you know, and what would you need to clarify?
  3. Protect safety and dignity. Is anyone at risk of harm, discrimination, coercion, or an unsafe delay?
  4. Consider perspectives. What might each person be experiencing or worried about?
  5. Communicate directly and respectfully. When appropriate, speak privately with the person involved rather than making a public accusation.
  6. Use the right support. Follow policy and involve a supervisor, faculty member, compliance office, or emergency resource when the issue exceeds your role.
  7. Follow up. A good response includes what you would do after the first conversation: document appropriately, check on safety, or reassess when new information appears.

You will not need every step in every scenario. The point is to keep your answer from becoming either a reflexive punishment or an empathy monologue with no action.

How to prepare without buying a personality

Start with the official practice material from Acuity Insights and the AAMC PREview resources. Learn the interface, response format, timing, breaks, technical requirements, and rules before you pay for anything else.

Then practice a small number of scenarios deliberately:

  • For CASPer typed responses, practice answering both questions within the time limit without trying to write an essay. Clear, complete reasoning matters more than elegant prose.
  • For CASPer video responses, practice speaking for a short, timed answer while looking at the camera. You do not need to sound rehearsed; you need to be understandable and organized.
  • For PREview, practice distinguishing “effective” from “very effective” and “ineffective” from “very ineffective.” The task is to rate the response in context, not to choose the most compassionate-sounding sentence in isolation.
  • After each practice scenario, ask what information you ignored, whose perspective you missed, whether your action matched your stated values, and whether you escalated appropriately.
  • Practice on the equipment and connection you will actually use. If you need accommodations, request them early through the official process rather than waiting for test day.

Typing speed can matter for the typed section, but do not turn practice into a speed contest. Short, organized sentences are enough. Your goal is to make your reasoning visible before the clock ends.

What not to do

  • Do not buy a course because it promises to reveal the secret moral answer.
  • Do not answer every conflict by reporting someone immediately, or by avoiding action in the name of empathy.
  • Do not assume the most severe punishment is the most ethical response.
  • Do not make yourself the hero who solves a problem outside your role.
  • Do not use absolute language when the situation needs facts, conversation, or supervision.
  • Do not invent policies or clinical knowledge the prompt has not given you.
  • Do not discuss live test prompts or try to reconstruct them afterward.
  • Do not forget that your own safety and boundaries matter too.

Timing and logistics

Register early enough to see the available dates and score-release schedule. Confirm that your result will reach every school that requires it. Put the test date beside your primary and secondary deadlines, and leave room for a technical problem, accommodation request, or a retest policy that is more limited than you assumed.

Read the current examinee rules. Secure your room, camera, microphone, identification, internet connection, and permitted materials. On test day, follow the instructions on the screen rather than relying on an old blog post or a friend's memory of a previous format.

The honest takeaway

You are not trying to sound like a perfect person. You are trying to show a pattern of judgment: notice the people involved, understand your scope, communicate before assuming, protect safety, use help appropriately, and reflect when new information changes the situation.

That is useful preparation for medicine even if a particular school never asks for the score. It is also why no course can substitute for practicing how you actually think.

CASPer and AAMC PREview requirements, formats, scoring, fees, dates, accommodations, and school policies change. Verify the current instructions with Acuity Insights, the AAMC PREview portal, and each school's admissions page before registering. This is educational information from one physician's perspective, not admissions advice. — Last reviewed: 2026-08-03

Footnotes

  1. Acuity Insights: Casper test format and length, current for the 2026–27 admission cycle at the time of review. ↩

  2. AAMC PREview test format and AAMC PREview score information. ↩