Many jurisdictions legally mandate reasonable adjustments in personnel selection, including within health professions, to support individuals with disabilities, such as neurodevelopmental conditions. These measures often depend on applicants having formal diagnoses or a willingness to disclose their needs, overlooking the natural heterogeneity in cognition, learning, and behaviour. Consequently, traditional selection methods may inadvertently disadvantage certain candidates, Thus, more inclusive personnel selection practices are needed. We aimed to evaluate the effect of co-designed interview modifications on differential performance between neurodivergent and neurotypical participants in a process evaluation. The co-design approach was employed to enhance an existing online interview that utilised the Multiple Mini Interview (MMI) methodology in an asynchronous digital format. The interview was evaluated in two configurations: standard and modified. The modified version enhanced the standard version by incorporating a practice portal and accessibility features identified by neurodivergent volunteers. A total of 292 individuals, comprising 148 neurotypical and 146 participants self identifying as neurodivergent, took part in mock MMIs scored by independent assessors using a seven-point Likert scale. Participants who self identified as neurodivergent achieved significantly higher mean scores on the modified interview compared to the standard format (mean scores; 141.6 vs. 121.4 points; p<0.0001). In contrast, no statistically significant inter-group differences were observed for neurotypical participants for those taking the standard or modified interview. Scoring differences between neurodivergent and neurotypical participants reduced when the modified interview was used; no statistically significant intergroup difference in mean scores was observed in this condition (141.6 vs. 136.6; p=0.06). Inter-rater reliability for a random sample of double-blind scored interviews (10%) was high (ICC 0.8; p<0.001). Furthermore, 92% of neurodivergent participants reported that the optimised features facilitated the interview process, 70% perceived the outcomes as fair and objective, and 70% reported experiencing reduced anxiety compared to the unmodified interview. These findings provide evidence that interview modifications can substantially reduce pre-existing disadvantages neurodivergent test-takers may face when participating in online, digital interviews. Such enhancements should be universally implemented to promote greater equity in personnel selection processes.

A Callwood (AC) and L Gillam (LG) are co-founders of the company Sammi-Select, funded by UKRI as a spinout company from the University of Surrey. AC was awarded funding from UKRI to complete this R&D as part of a Woman in Innovation Award 2023 grant. Ivan Brewis is employed by Sammi-Select as a software developer

This study was funded by UKRI grant number: 10055468: Generating Neuro-Inclusive Selection (GENIUS)

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This study involves human participants and received a favorable ethical opinion (FEO) from the University of Surrey Research Ethics Committee (FHMS 21-22 164 EGA). All relevant ethical guidelines have been followed. Participants gave informed consent.

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All data produced in the present study are available upon reasonable request to the authors