What’s the difference between Casper and PREview? Here’s everything you need to know about these two potentially required situational judgment tests for medical school applicants.
Casper, the Computer-Based Assessment for Sampling Personal Characteristics, is a situational judgment test administered by Acuity Insights that’s used by about 35 medical schools. Its popularity inspired the AAMC (Association of American Medical Colleges) to develop and administer its own situational judgment test, the PREview Professional Readiness Exam.
However, Casper and PREview are not the same test, and depending on which schools you are applying to, you may need to take both or neither.
Keep in mind that if you are applying to residency, you may need to take a Casper test then as well. PREview, on the other hand, is only a potential requirement for those applying to medical school.
Casper is a computer-based situational judgment test that measures who you are beyond your hard skills and grades. The test was developed in 2010 in Canada to assess a student’s interpersonal communication skills, ethical decision-making, empathy, and problem-solving.
PREview is also a situational judgment test developed over the past few years by the AAMC. PREview has a multiple-choice format, and currently, only a handful of medical schools require it.
| Differences | Casper | PREview |
| Test Type: | Video and typed responses | Multiple choice responses |
| Test Length: | 65-85 minutes | 90-115 minutes |
| Test Cost: | $85 USD, which includes distributing scores to 7 schools. Any additional school will cost $18. | 1-time cost of $100. Unlimited distribution of scores to medical schools. |
| Test Results: | Provided only to schools | Provided to students and schools |
| Participating Schools: | Approximately 27 MD and DO schools, as well as residency programs. | Required by 10 schools, recommended by 18. |
| Administered By: | Acuity Insights | AAMC |
Both Casper and PREview require similar preparation, but their test formats are quite different. For Casper, you’re required to answer questions in a live video submission as well as a typed section. PREview is a multiple-choice test.
Casper is split into two sections.
First, there is a video response section that asks participants to verbally respond to four scenarios, some video-based and some word-based. Each scenario is followed by two questions. You have one minute to answer each question in a video recording. Once the one minute is up, your answer is automatically submitted. You cannot edit, go back, or change your answer.
Second is a typed response section that asks you to type your responses to seven scenarios, some word-based and some video-based. Each scenario is followed by two corresponding questions. You have 3.5 minutes to type your responses to both questions. After 3.5 minutes, you are automatically advanced to the next scenario.
You cannot go back and change your answers. If your timer runs out or you submit your answers before your allotted 3.5 minutes are up, your responses are automatically saved and uploaded.
In total, including an introduction and two breaks, the Casper test takes 65-85 minutes to complete.
This is How the Casper Test Is Scored.
The PREview exam consists of 30 hypothetical scenarios that students may encounter in medical school. The scenarios are based on real-life situations in healthcare, education, and other settings. The questions are developed for premeds, so no healthcare or clinical experience is required to score well on the test.
Students are asked to evaluate the effectiveness of behavioral responses to each of these scenarios in a multiple-choice format.
Each scenario is a short paragraph that outlines a potential problem students may face. The scenario is followed by a list of potential items (responses) that describe the actions you could take in response to the dilemma. Students must rate the effectiveness of each response using a 4-point scale:
1 = very ineffective, 2 = ineffective, 3 = effective, and 4 = very effective.
While the number of items (responses) that follow each scenario will vary, the test contains a total of 186 questions.
Casper test questions are based on nine competencies that test a student’s soft skills.
The nine Casper competencies are:
The AAMC’s PREview exam is based on their new and improved premed competency model. It includes professional, science, and thinking and reasoning competencies.
Professional Competencies:
The Science Competencies:
Thinking and Reasoning Competencies:
AAMC’s PREview exam covers a broader range of personality traits and skills, including commitment to growth, human behavior, quantitative reasoning, and scientific inquiry. The scenarios you encounter on the test will have a broader range of circumstances and will require test-takers to apply interdisciplinary thinking.
Although PREview expects many more schools to adopt its new situational judgment test, so far, only a handful have required it. As of February 2026, 10 schools require a PREview test, and another 18 recommend students take it.
View the full list of required and recommended PREview schools in 2026.
In comparison, Casper is currently required by 27 medical schools and a handful of residency programs.
View a full list of schools participating in Casper in 2026.
Your Casper score is automatically submitted to the medical schools you’re applying to about two to three weeks after you take the test—but you are not able to see your results. Instead, about a month after you take the test, you will receive a “quartile,” which indicates how you performed in relation to the other applicants who took Casper.
The quartiles break down like this:
Landing in the first quartile means the raters (the people evaluating your exam) felt that 75% of your peers provided answers that were more empathetic and complete than yours. Landing in the fourth quartile means the raters regarded your answers as better than 75% of your peers.
PREview works a bit differently. About a month after completing the test, you and the participating schools you selected will receive a single score ranging from 1 (lowest) to 9 (highest). This score is based on how closely your effectiveness ratings align with those of the medical educators who helped develop the PREview’s scoring key.
Your total score is accompanied by a “confidence band,” which shows the range in which your total score lies. Since some questions will naturally be more ethically complex than others, confidence bands were designed to help signal “the lack of precision of test scores.” They are meant to discourage distinctions between test-takers with similar scores.
Along with your total score and confidence band, a percentile rank will also be reported. Similar to Casper’s quartiles, percentile ranks of scores represent the percentages of examinees who earned the same or lower scores than you did.
Casper costs $85 USD and includes the distribution of your results to 7 schools of your choosing. An additional $18 USD is charged for each additional program to which you want your results sent.
PREview costs a 1-time fee of $100 USD, which includes the distribution of your results to an unlimited number of participating programs.
If you only need to submit your Casper score to 7 or fewer schools, Casper is the cheaper option. For 8 or more schools, PREview becomes cheaper, but expect both of them to run you around $100.
If you determine that you need to take either or both of these situational judgment tests, we have comprehensive guides available for both Casper and PREview.
The Med School Insiders Casper AI Course and the PREview AI Course leverage cutting-edge AI technology combined with in-depth video tutorials. They’re the most comprehensive situational judgment test resource out there.
Get instant feedback on both the typed and video response sections of the Casper test, including immediate personalized evaluation and emotion detection analysis. For the typed section, our platform will help you improve your typing speed as you simultaneously master essential Casper vocabulary.
The course includes unlimited practice problems, which means you’ll have endless opportunities to refine your skills, adapt to various scenarios, and truly understand the nuances of the Casper exam.
Plus, it comes with a 3-day money-back guarantee, so you can try it at no risk.
We’re ranking all 22 specialties by the percentage of positions filled by US MD seniors. This is lowest to highest fill rate for US MD seniors, starting with the most accessible specialties up to the hardest.
Are you ready to apply to medical school? Use these 6 questions to assess your GPA, MCAT, clinical hours, and application strategy before you submit.
