How is the Casper Test Scored for the 2023-2024 Cycle?


The Casper test, the major component of Acuity Insights, doesn’t assess your medical knowledge or even your ability to apply that knowledge. Casper is designed to measure an applicant’s professionalism, ethical decision making, empathy, and communication skills. You may be wondering, if Casper isn’t a test of your academics, how is the Casper test scored?

In this post, we will cover how the Casper test is scored, including information about the raters, what specifically is being tested, and how scores are formulated.

When you’re done here, read our comprehensive Casper Test Guide, which outlines everything you need to know about Casper, including test logistics, how to prepare, and FAQs.


What Is Casper and Do You Need to Take the Test?

Casper is one of the components within the Acuity Insights, a multi-part assessment designed to evaluate a prospective medical student’s people skills and bedside manner.

Infographic Acuity Insights - Casper, Snapshot, Duet explained

Learn more: Understanding Acuity Insights: Casper, Snapshot, and Duet

Casper stands for “Computer-Based Assessment for Sampling Personal Characteristics.” True to its name, Casper is a computer-based test designed to assess your interpersonal and intrapersonal skills, empathy, professionalism, ethics, and bedside manner. In other words, Casper measures the kind of person you are beyond your hard skills and grades.

While impressive grades, exceptional cognitive ability, and other hard skills are essential to every medical student and future physician, interpersonal skills and a strong bedside manner are also essential.

Doctors must be able to communicate effectively with their patients. They need to listen closely to what their patients tell them in order to gather information and deduce what could be wrong with their health. Doctors also need to be able to clearly deliver an expansive range of challenging, and at times devastating, information to people in fragile emotional states.

Casper was developed in 2010 by Harold Reiter and Kelly Dore at McMaster University’s Program for Educational Research and Development (PERD) in Canada to measure these interpersonal skills in medical school applicants. The test did not catch on immediately, but it has seen a recent surge in popularity that is showing no sign of slowing down. There are currently dozens of US medical schools that require applicants to take the Casper.

Do you know if you have to take the test? New schools are added to the list every year. Find out which schools require applicants to take Casper and what Casper test dates are available.


How Is the Casper Test Scored?

Casper is made up of 14 scenarios. The test is divided into two response sections, a video response section and a typed response section. There are two word-based scenarios and four video-based scenarios in the video response section and three word-based scenarios and five video-based scenarios in the typed response section.

Infographic Casper Test Format Explained - Video vs Typed

Each video response scenario comes with two open-ended questions, presented one at a time. You have one minute to record your response to each question. Each typed response scenario comes with three open-ended questions, presented all at once. You have five minutes in total to type your responses to all three questions. The scenarios are a mix of SJTs (Situational Judgment Tests) and behavioral descriptor questions. Generally, the scenarios are not based in a clinical setting. For example, you could be in a grocery store or at a party with friends. The scenarios are designed to be as relatable as possible.

In total, the Casper test takes about 90-110 minutes to complete, and that includes an introduction, an optional ten-minute break after the conclusion of the video responses and before the typed responses begin, and an optional five-minute break during the typed response section.

1| What Casper Tests

Casper is a test of your soft skills, such as your ability to listen and communicate with peers and patients, as well as your ability to effectively empathize with others.

Casper tests for the following 10 Constructs:

  • Collaboration
  • Communication
  • Empathy
  • Equity
  • Ethics
  • Motivation
  • Problem solving
  • Professionalism
  • Resilience
  • Self-awareness

What does Casper assess? assessment icons

There’s a lot more to being a doctor than excelling at science. Patients need to be able to trust their doctor with a great deal of sensitive information, and they need to believe their doctor has their best interests at heart. If a patient doesn’t trust your judgment or advice, then you have failed in your role. A perfect 528 on the MCAT doesn’t effectively demonstrate an applicant’s ability to connect with patients in this way, which is why the Casper test was created.

2| How You Are Assessed

Each section of Casper is scored by a unique rater, meaning no two sections of your test will be graded by the same person. Your Casper score is therefore composed of multiple independent impressions of you.

Raters are not provided with any personal information about you, they don’t know anything about you or where you’re from, and they don’t know how you answered the questions in the other scenarios. Raters are only provided with your typed or video reply to the specific scenario they are scoring.

A Casper response is scored relative to other responses to the same scenario. This means your score signifies the strength of your response compared to other test takers’ responses. Raters are trained to use a likert scale ranging from 1 to 9 (1 being poor and 9 being excellent) to evaluate responses.

According to Acuity Insights, “Each response score is a function of how well the applicant demonstrates social intelligence and professionalism characteristics, as well as well as how the response compares to other applicants’ responses to the same scenario in the same test sitting.”

Casper scores reflect your overall ability to effectively reflect on and communicate responses to professional and interpersonal dilemmas with critical reasoning and social interpretation. They are Z-scores, also known as standardized scores, of applicants’ raw mean Casper scores. In addition to calculating a score, Acuity Insights also calculates an applicant’s percentile rank and quartile rank.

As an applicant, you will not receive your specific score; you will only receive a quartile rank that indicates how well you performed relative to your peers on the typed response section of Casper. Schools will receive both your Casper score as well as your percentile rank.

For the 2022-2023 and 2023-2024 cycles, Acuity Insights is only sending your typed response scores to all participating schools. Your quartile results are also only based on your typed responses.

You still need to prepare for the video response section, even though your results are not included in your Casper score. Expect Acuity Insights to change this in future iterations of the test.

Scores are divided into four equal parts, meaning a quarter of scores are placed in each quartile.

This is how the quartiles break down:

  • 25% of applicants score in the first quartile (0-24 percentile)
  • 25% of applicants score in the second quartile (25-49 percentile)
  • 25% of applicants score in the third quartile (50-74 percentile)
  • 25% of applicants score in the fourth quartile (75-100 percentile)

Casper Quartiles explained

If you score in the fourth quartile, it means you performed better than everyone in the third, second, and first quartile. In other words, you did better than 75% of other Casper test takers. If you scored in the first quartile, it doesn’t mean you failed—but it does mean you did worse than 75% of other Casper test takers.

Raters are also not provided with any kind of answer key—they are given general information about which central concepts and ideas are essential to each scenario. Therefore, Casper isn’t made up of right or wrong answers.

Since there are no right or wrong answers, quartiles represent what percentage of other applicants you scored higher than in the typed response section.

* You will not receive feedback or results at this point in time for the video response section of the Casper test.

While there are clues to what raters are specifically looking for, in general, it’s best to answer questions from the most ethical and equal standpoint, ensuring laws are abided by, and each person in the scenario has equal representation. One thing raters are definitely looking for are any potential red flags, such as anything in the response that could be construed as unethical, unprofessional, harmful, or dangerous.

According to Acuity Insights, you might end up in a higher quartile based on these five reasons:

  • Effort: You explained your position clearly and used the full allotted time to answer as thoroughly as possible compared to peers in the first quartile.
  • Empathy: You meaningfully considered all perspectives in the scenario.
  • Equity: You showed a great deal of respect and fairness in regards to the needs of others in the scenario.
  • Communication: You articulated your points very well.
  • Familiarity with the medium: You successfully navigated each aspect of the test, indicating you took ample time to familiarize yourself with Casper requirements.

Raters are trained to focus on the content of your answer, not on your grammar or spelling. That said, it’s important to ensure you are able to get your points across clearly. If your answer is full of glaring grammar and spelling errors, the rater may not be able to understand what you are trying to say, and they therefore won’t be able to give you a good score.

Although each video section has two questions after each scenario and each typed section has three questions after each scenario, your score is based on your overall performance in that scenario. So if you run out of time and miss a question, it’s possible that you will not incur a penalty—as long as your initial response is professional, appropriate, and comprehensive. Still, it’s important to answer all of the questions if you can.

3| Who Assesses Your Test

Casper raters are independent contractors hired by Acuity Insights. Before they are permitted to score Casper responses, each rater completes training and accreditation. According to Acuity Insights, they have many quality assurance measures in place to ensure your responses are evaluated fairly and carefully by the raters.

Acuity Insights says that their group of raters reflects the diversity of the population. Raters are “extensively trained, put through implicit bias training, vetted, and understand the importance of their work as a rater and the impact it has on an applicant’s future.”

Each section of the Casper test is scored by a different rater who has no idea who you are or how you responded to the other scenarios. Your Casper score consists of numerous independent and objective assessments of you. No rater will ever score an applicant more than once.

Casper raters are required to complete a training session and accreditation before they are permitted to score Casper responses. Casper raters come from a range of different backgrounds, industries, and professions, but they share a common interest in helping to identify well-rounded applicants who will make outstanding professionals.

Raters must reside in the same country as the test takers they’re evaluating and have knowledge and experience of the culture of the country. In an effort to build a diverse group of raters, Acuity Insights encourages people from all walks of life to apply.

4| Obtaining Your Casper Score

Unfortunately, you won’t be able to see your score after you complete the test. You will, however, be able to see which of four quartiles you landed in. Your quartile indicates how well you performed relative to your peers. All Casper scores are divided into four equal parts—25% of applicants score in the first quartile, which is the lowest quartile, 25% score in the second, 25% in the third, and 25% in the fourth, which is the highest quartile.

If you find out you scored in the third quartile, it means that while 25% of test takers were rated higher than you, you still rated higher than 50% of your peers.

Your Casper score is automatically submitted to the medical schools you’re applying to, similar to the way you don’t see your letters of recommendation before they are sent.

Your Casper score is made available to the programs on your distribution list two to three weeks after you take the test. You will be able to see your quartile score approximately one month after taking the test—after your score has already been submitted to the schools you’re applying to.

You won’t receive an email saying your score has been delivered, but in the Reservations section of your Acuity Insights account, you will see “Completed – Results delivered,” which means your score has been delivered. If you see “Completed – Results pending,” your Casper score has not yet been delivered yet. It may take a while for individual programs to update the status of your Casper score in their system.

Your Casper score is only valid for one application cycle. If your medical school application is unsuccessful and you need to reapply the following year, you will need to take the Casper test again.

Still have questions about the Casper format or other aspects of the test? We answer 19 Casper Test FAQs in another Casper guide.


Bottom Line

Casper is designed to provide admissions committees with an evaluation of the kind of person you are beyond your hard skills, grades, and other credentials. Very few aspects of the medical school application inform admissions committees about your soft skills and bedside manner. Someone who looks excellent on paper may be completely ineffectual when it comes to dealing with patients in a professional and ethical way—and that’s where Casper comes in.

Casper raters are not looking for a right or wrong answer—they’re looking for mature, professional, ethical responses that touch on as many dimensions of the question as possible. Assessors want to see that you have recognized and considered the wide-reaching implications of the scenario for everyone involved, just as professional physicians have to do every day.

Yes—you can prepare! Review our 15 Casper preparation strategies that will help you succeed on test day.

Infographic CASPer Test Checklist


Prepare for Casper With Med School Insiders

Although you can’t study for Casper, you can and should prepare for it. Med School Insiders offers Comprehensive Medical School Admissions Packages that will help you with every aspect of the medical school application process—including Casper. We’ll walk you through the entire process, provide you with sample questions, and prepare you with the methods you need to crush your Casper test.

Browse our wide range of free resources, which includes articles and guides on the Casper test, the MCAT, the medical school application process, residency applications, and more.


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