Overseas Hospitals' Personality Assessment Practices in Talent Selection: Tools, Trends, and Leadership Applications

During the 2015 Spring Festival, a discussion on personality assessment tools took place on Sina Weibo, Douban, and Zhihu. Here, we summarize the personality assessment tools adopted by hospitals abroad.

Unlike in Chinese hospitals, where presidents are primarily physicians appointed through administrative channels, Western hospitals in Europe and America maintain a separation between the management team and the medical staff. The relationship between physicians and administrators is collaborative, with hospital presidents not overseeing the specific clinical work of the medical staff. Since presidents do not directly manage physicians, they are not required to be physicians themselves; however, they must have completed coursework in hospital administration or received relevant training. Consequently, many hospital CEOs in these regions come from academic, research, economic management, business administration, or even legal backgrounds. Influenced by this structure, Western hospitals extensively use personality assessment tools with a management focus for employee recruitment, succession planning, and leadership development. Some of these tools have been specifically customized for the healthcare sector (e.g., OPQ-32). In contrast to the MBTI, 16PF, and LSI assessments commonly used in Chinese hospitals, Western institutions tend to favor tools such as Hogan, Facet-5, and OPQ-32.

In terms of tool selection, China places greater emphasis on assessments conducted at the time of hiring, whereas Europe and the United States primarily utilize assessments focused on leadership.

Hogan Personality Inventory (HPI)

Hogan Personality Inventory (HPI) was developed from the “Hogan Personality Assessment” published by Dr. Robert Hogan in the 1970s, making it one of the earliest personality measurement tools designed specifically for business organizations. The assessment evaluates personality across domains including affectivity, interpersonal style, experience, attitudes, and motivation, with a primary focus on leadership and leadership styles. The HPI also helps identify key personality strengths and gaps, subsequently prioritizing areas with potential for development.

Publicly available information indicates that the Cleveland Clinic in the United States has been utilizing HPI over the past several years to help department leaders strengthen leadership development and conduct succession planning. Since 2010, other institutions adopting HPI have included NewYork-Presbyterian Hospital, Brigham and Women’s Hospital, Northwestern Memorial Hospital, Duke University Health System, and UW Medicine (Seattle).

Similar to the Mayo Clinic, the Cleveland Clinic is a healthcare institution that adheres to the practice of selecting its CEO from among its physicians. Other institutions upholding this tradition include the MD Anderson Cancer Center. Approximately one-tenth of hospitals across the United States have explicitly adopted this practice. Dr. Delos M. Cosgrove, who was appointed CEO in 2004, was himself the Cleveland Clinic’s most renowned cardiothoracic surgeon. In 1991, he pioneered arterial valvuloplasty, enabling cardiac surgeons to repair rather than replace heart valves, a approach particularly suitable for older patients. In 1996, he performed the world’s first minimally invasive heart valve surgery. Under his leadership, the Cleveland Clinic’s cardiology and heart surgery program has ranked first in U.S. News & World Report’s annual rankings since 1995.

Although Delos M. Cosgrove began his career as a physician, his emphasis on management appears to surpass that of many CEOs with MBA backgrounds. He not only rigorously focused on operational excellence and launched numerous initiatives to enhance patients’ hospitalization experiences, but also engaged McKinsey & Company to refine the Cleveland Clinic’s strategic positioning and invited Harvard Business Review to conduct a case study on the institution. Upon assuming leadership, he formally distilled “Quality, Innovation, Teamwork, and Service” as the four cornerstones of the Cleveland Clinic.

Delos M. Cosgrove places strong emphasis on teamwork, team-based learning, and leadership development. Just as he values training in clinical competence, his goal is to emulate GE’s Crotonville by establishing Cleveland Clinic’s own management academy to cultivate individuals with managerial potential. This initiative also supports the clinic’s ongoing international expansion. According to publicly available information, the academy uses HPI assessment results as the foundation and guide for each member’s leadership development.

In a Harvard Business Review case study, Delos M. Cosgrove stated, “I am always thinking about and cultivating the next generation of leaders. Everyone should engage in succession planning and appointment, and nurture their successors. This is crucial to an organization’s survival and health.” Publicly available information indicates that Cleveland Clinic uses HPI for successor selection.

Brigham and Women’s Hospital (BWH), which recently received the 2014–2015 Best Hospital Award, has integrated members of its Health Process Improvement (HPI) assessment and selection optimization teams since 1998. Improving workflow processes has consistently been a key priority for successive presidents of Brigham and Women’s Hospital, many of whom were recruited externally. Since 1993, the hospital has established a Center for Clinical Workflow Optimization dedicated to quality enhancement and performance improvement. The center periodically adjusts its focal themes, with specific initiatives closely aligned to the priority areas of each phase, such as patient safety, the Balanced Scorecard, and lean management. In 2010, Elizabeth G. Nabel, a renowned cardiologist and biomedical researcher, assumed the presidency of Brigham and Women’s Hospital after serving as Director of the National Heart, Lung, and Blood Institute (NHLBI). She has consistently promoted the development of matrix-network collaborations through process-oriented approaches, involving research laboratories, departments, hospitals, and professional organizations. Publicly available information indicates that, starting in 2010, all members of approximately 40 process optimization teams and the leaders of about 30 lean management improvement teams were selected based on HPI test results.

Based on personal assessment data provided by physician colleagues at the Cleveland Clinic, Brigham and Women’s Hospital, Northwestern Memorial Hospital, and Duke University Health System, combined with publicly available materials, we find that the Hogan Personality Inventory (HPI) leadership assessment evaluates seven dimensions. It provides scores for each HPI dimension, benchmarks these against a sample of more than 4,000 senior executives from various countries, interprets the behavioral and leadership implications associated with the assessee’s score on each dimension, and finally offers development recommendations tailored to the assessee’s capabilities.

• Self-Adjustment – Scoring items include: empathy, absence of anxiety, absence of guilt, calmness, composure, no complaints of physical discomfort, trust in others, and healthy family relationships. The adaptability dimension reflects an individual’s level of poise and calmness, or conversely, the degree of emotional volatility and irritability. Individuals with high scores appear confident, possess strong emotional regulation skills, and are optimistic; those with low scores appear tense, irritable, and negative. Leadership development initiatives often focus on sub-dimensions such as composure, active listening, learning agility and coachability, relationship management, and stress management.




• Ambition—Scoring items include: competitiveness, self-confidence, resilience, leadership, self-identity, and absence of social anxiety. The Ambition dimension assesses the extent to which an individual exhibits leadership qualities, pursues status, and emphasizes achievement. Individuals with high scores appear more competitive and eager for promotion; those with low scores tend to display less confidence in communication and show little interest in advancement. Improvement plans for leadership capabilities are often designed around sub-dimensions such as action orientation, career advancement, initiative, and results delivery.




• Sociability—Scoring items include: enjoyment of parties, preference for crowds, sensation-seeking, desire for self-expression, and entertaining others. The sociability dimension assesses the degree to which an individual exhibits talkativeness and social confidence. Individuals with high scores appear extroverted, interesting, and impulsive, and they dislike working independently; those with low scores appear reserved and quiet, avoid attracting attention, and are comfortable working independently. Areas for leadership improvement are often designed around sub-dimensions such as proactivity in interpersonal interactions, energy level, approachability, networking capabilities, and team orientation.




• Interpersonal Sensitivity—Scoring criteria include: approachability, sensitivity, caring, likability, and benign intent. The interpersonal sensitivity dimension reflects an individual’s social competence, skills, and awareness. Individuals with high scores appear friendly, enthusiastic, and well-liked; those with low scores appear independent, frank, and direct. Leadership development initiatives often target sub-dimensions such as empathy, cooperativeness, consultative decision-making, interactions with subordinates, and nonconformity.




• Conscientiousness—Scoring items include: morality, competence, virtue, lack of independence, avoidance of impulsive actions, impulse control, and trouble avoidance. The Conscientiousness dimension relates to an individual's self-control and sense of responsibility. Individuals with high scores appear organized, reliable, and thorough; they adhere to rules and regulations and are easy to manage. Those with low scores tend to be more impulsive and flexible; they may resist strict rules and tight management but can exhibit greater creativity and spontaneity. Leadership development initiatives often focus on sub-dimensions such as handling ambiguity, flexibility, structured planning, attention to detail and deadlines, and adherence to regulations.




• Inquisitiveness—Scoring criteria include scientific ability, curiosity, sensation seeking, intellectual games, idea generation, and culture. The Inquisitiveness dimension reflects the degree to which an individual exhibits curiosity, adventurousness, and imagination. Individuals with high scores tend to be quick-witted and visionary but are prone to boredom and may overlook details; those with low scores tend to be practical, focused, and capable of sustaining attention for extended periods. Leadership development initiatives are often designed around sub-dimensions such as creativity, innovation management, curiosity, vision, and attraction to problem-solving.




• Learning Style—Scoring items include: education, mathematical ability, memory, and reading. The learning style dimension reflects an individual’s preference for academic activities and the extent to which they view education as a goal of learning. Individuals with high scores tend to enjoy reading and learning, whereas those with low scores show little interest in formal education and prefer learning through practical work experience. Directions for improving leadership capabilities are often designed around sub-dimensions such as staying current, rapid learning, learning styles, preparedness for expression, and learning motivation.

Facet 5

Facet5 is a personality model derived from the Big Five personality theory. The Big Five personality traits are regarded as fundamental structural dimensions of personality within psychological measurement. These five factors provide a rich conceptual framework that integrates all research findings and theories in personality psychology. Currently, multiple assessment scales are designed based on the Big Five personality traits, including the ADEPT-15 model developed by Hewitt Associates, a renowned human resources consulting firm.

The Big Five personality theory categorizes individuals into:

• Extraversion: Sociable vs. unsociable, fun-loving vs. serious, emotionally expressive vs. reserved; characterized by enthusiasm, sociability, assertiveness, activity, adventurousness, and optimism.




• Neuroticism or Emotional Stability: Worry versus calmness, insecurity versus security, self-pity versus self-satisfaction; includes traits such as anxiety, hostility, depression, self-consciousness, impulsiveness, and vulnerability.




• Openness: Imagination versus pragmatism, seeking change versus adhering to convention, autonomy versus compliance. Characterized by imagination, aesthetic sensitivity, emotional richness, nonconformity, creativity, and intellectual curiosity.




• Agreeableness: Warmth vs. Coldness, Trust vs. Suspicion; characterized by helpfulness and cooperation. It encompasses qualities such as trust, altruism, straightforwardness, modesty, and empathy.




• Conscientiousness: Order vs. disorder, careful and meticulous vs. careless, self-disciplined vs. weak-willed. It includes traits such as competence, fairness, organization, dutifulness, achievement striving, self-discipline, deliberation, and restraint.

Generally, Facet5 analyzes and describes personality traits to examine various aspects of executive leadership from different perspectives. Taking the Mayo Clinic’s extensive use of the Facet5 Strategic Leadership Assessment as an example: the assessment comprises 84 software-based questions across seven dimensions (Envisioning the Future, Brainstorming, Respecting Individuals, Goal Setting, Monitoring Performance, Providing Feedback, and Focusing on Development). After scoring and analysis, the four most critical areas for improvement are identified.

• - Innate Skills: The strengths you bring to the workplace




• - Potential Skills: You don't seem to be performing at your best




• - Areas of Weakness: Tasks you are not proficient in and areas others believe you need to improve




• - Skills Acquired: Skills that have been improved; although you are not proficient in them, you still perform well.

Publicly available information indicates that the most prominent example of Facet5 implementation in U.S. hospitals is the Mayo Clinic. The initiative was championed by former COO Robert K. Smoldt, who holds an MBA, and he applied the Facet5 assessment to both leadership development and team building. Another notable example is Children’s Hospital of Philadelphia (CHOP). Steven Altschuler, CEO of CHOP and the highest-paid healthcare executive in the United States, also leveraged the Facet5 assessment to construct a physician personality model. This model evaluates new employees’ personalities across dimensions such as proactive reliability, planning rigor, curiosity, adaptability, ambition, need for control, cooperativeness, empathy, sensitivity, enthusiasm, resilience, decisiveness, and extraversion.

OPQ32 Test

The OPQ32 assessment, a new generation of OPQ evaluations launched by SHL in 2000, primarily utilizes occupational personality testing to clearly and concisely delineate an individual’s leadership style. It explicitly articulates the various aspects of personal style associated with each leadership function, providing a graphical overview and descriptive analysis of preferred leadership styles. Publicly available information indicates that its most typical application is for leadership development and succession planning at Mount Sinai Hospital. In China, this assessment has gained considerable familiarity due to its adoption by Huawei Technologies.

Compared with other industries that have gradually aligned with international standards, personality assessments are relatively less commonly conducted in domestic hospitals. The popular MBTI is a relatively outdated assessment questionnaire; however, in recent years, an increasing number of domestic hospitals have adopted the 16PF for personality assessments.

MBTI Assessment

The MBTI assessment most widely used by hospitals in China is also a relatively outdated system internationally. The logic of the assessment is that personality consists of four dimensions, each with two directions, totaling eight aspects.

• Extraversion (E) and Introversion (I)




• Sensing (S) and Intuition (N)




• Thinking (T) and Feeling (F)




• Judging (J) and Perceiving (P)

Four dimensions, combined in pairs, yield sixteen distinct types. Each type has its own characteristics. For example, ESFPs are extroverted, amiable, receptive, and enjoy sharing joy with others. They prefer taking action with others and facilitating events, a tendency that extends to their learning style. They anticipate future developments and engage enthusiastically. They excel in interpersonal skills and possess sound common sense, demonstrating great flexibility to adapt immediately to people and environments. They are enthusiasts of life, people, and material comforts.

16 Personality Factor Questionnaire (16PF)

The 16 Personality Factor Questionnaire (16PF) is a personality assessment tool developed by Professor Raymond Cattell at the University of Illinois. It has been the most rapidly adopted questionnaire in Chinese hospitals in recent years. Based on his explanatory theoretical framework of personality, Cattell designed the 16PF to describe individual personality traits across 16 dimensions. The names and symbols of these 16 factors or subscales are as follows: Warmth (A), Reasoning (B), Emotional Stability (C), Dominance (E), Liveliness (F), Rule-Consciousness (G), Social Boldness (H), Sensitivity (I), Vigilance (L), Abstractedness (M), Privateness (N), Apprehension (O), Openness to Change (Q1), Self-Reliance (Q2), Perfectionism (Q3), and Tension (Q4).

【By Zhao Yang, Director of Medical Consulting and Operations at CK Hutchison Holdings, with extensive experience as a management consultant.】

The views expressed in this article are solely those of the author and do not represent the position of VCBeat.