This study determined the correlation between creative thinking aptitude, measured by the Torrance Test of Creative Thinking–Figural (TTCT–F), and five-year academic achievement. The TTCT–F was administered to 135 first-year medical students at a Tokyo-based medical school in 2018. Participants’ academic records—annual GPAs over five years—were averaged, and data were analyzed in 2023. Pearson correlation coefficients examined the relationship between the TTCT–F Creativity Index and the five-year average GPA; multiple linear regression assessed the predictive value of TTCT–F components on GPA; canonical correlation analysis explored multivariate relationships. The Creativity Index demonstrated a weak, non-significant correlation with the five-year average GPA. Fluency, Originality, and Elaboration components were not significantly correlated, while Abstractness of Titles demonstrated a moderate positive correlation. Linear regression indicated that Abstractness of Titles significantly predicted GPA, accounting for approximately 8% of the variance. Canonical correlation analysis revealed a moderate multivariate association between TTCT–F components and academic performance. Certain aspects of creative thinking, particularly abstract reasoning, may relate to academic success in medical education. Further research is needed to clarify the role of creative thinking in medical training and whether it warrants greater integration into curricula.

Participants

We conducted a retrospective cohort study, administering the Torrance Test of Creative Thinking Figural (TTCT–F) in 2018 as a proctored and timed test to a cohort of 135 first-year medical students at Juntendo University Faculty of Medicine in Chiba, Japan. The participants took the test simultaneously and were between the ages of 18 and 23 years old at the time. The cohort comprised 42 women (31.1%) and 93 men (68.9%) (see Table 1). The study was approved by the Juntendo University Institutional Review Board and conducted in accordance with ethical guidelines to ensure participant confidentiality and data anonymity. All participants provided informed consent before participation and allowed access to their academic records for research purposes. No exclusion criteria were applied, and all first-year medical students in the cohort were eligible to participate. Data were collected and stored in compliance with ethical guidelines to ensure confidentiality and anonymity.

Instrumentation

We collected participants’ five-year average GPAs from 2018 to 2023. In cases where students were absent from the TTCT-F or where GPA records were incomplete, the missing data were handled using listwise deletion to maintain data integrity in statistical analyses. Our main tool was a Japanese translation of the TTCT–F, a standardized instrument designed to assess creativity through figural tasks. In 2011, Scholastic Testing Service Inc. (Bensenville, Illinois, USA) granted permission to a member of the present research team to translate and use the Torrance Tests of Creative Thinking – Figural (TTCT-F) for research purposes. Additionally, members of the research team obtained formal certification in TTCT scoring and interpretation from the Torrance Center for Creativity and Talent Development at the University of Georgia in 2012 and 2018.

 The TTCT has two versions: a Verbal (TTCT–V) and a Figural (TTCT–F) test. The TTCT–F, which relies on images, is less biased for non-native English speakers, as the verbal test relies heavily on language and understanding of social and cultural context (Kim, 2006). The TTCT–V is more difficult to translate while maintaining the original meaning, as translation is subject to interpretation. Since the TTCT–F only required translation of the instructions, this was less likely to affect the outcome. A comparison of the two tests further confirms the comprehensiveness and validity of the TTCT–F (Kim, 2006; Kim, 2017; Torrance, 1977). We thus chose it to assess creative aptitude.

The TTCT–F has the following components:

• *Fluency *– assesses the ability to generate many ideas or solutions based on the number of drawings or ideas a person can create from a given stimulus.

• *Originality *– assesses the ability to produce unique and uncommon ideas, based on the novelty of responses compared with others.

• Elaboration – assesses the ability to add detail and further develop an idea by evaluating how well participants expand upon their initial ideas or drawings.

• Abstractness of Titles – assesses the ability to produce abstract and symbolic titles for drawings, reflecting deeper thinking and the ability to connect the drawing to broader or less obvious concepts.

• Resistance to Premature Closure – assesses the ability to keep an open mind and avoid hasty conclusions; by measuring how willing a person is to explore different possibilities rather than quickly concluding their drawings.

Additionally, three main scores were reported to reflect overall creative performance: the Sum Score, Average Standard Score, and Creativity Index Score. Here’s what each means:

1. Sum Score

This is the total raw score across the main TTCT creativity traits listed above.

The Sum Score gives a comprehensive raw score of the individual’s performance across all creative dimensions.

2. Average Standard Score

Each TTCT trait is standardized based on age-specific normative data. The Average Standard Score is the mean of the standardized scores across the subscales. It accounts for differences in age, allowing for comparison across individuals.

This score helps place an individual's creativity level relative to a normative population.

The data set reflects the average standard score for college-aged students.

3. Creativity Index Score

The Creativity Index Score is a composite score combining:

- the five norm-referenced creativity trait scores, plus

- two criterion-referenced measures:

- Creative Strengths (based on checklist behaviors such as emotional expressiveness, storytelling, humor, etc.)

- Checklist Score (a count of those strengths)

This score is intended to be a broad indicator of creative potential and development, incorporating both quantitative and qualitative aspects.

For more information on how TTCT-F scoring works, please refer to the following:

Torrance, E. P., & Safter, H. T. (2008). Scoring manual for the Torrance Tests of Creative Thinking – Figural A and B. Scholastic Testing Service, Inc.

Procedure

In 2018, 135 first-year Japanese medical students were gathered in one room under the supervision of faculty and administrators, including trained staff certified by the University of Georgia to administer the TTCT. A Japanese translation of the TTCT–F was provided by a third-party Japanese company specializing in TTCT administration and scoring. The test consisted of three sections: picture construction, picture completion, and lines. Each section was allotted 10 minutes, with 35–40 minutes allocated for the full test, including introduction, explanations, and wrap-up. After the TTCT–F, all related documents were collected, and scores were calculated by the company that provided the translation. The scores were then double-checked and verified by a TTCT-certified faculty member.

Over the next five years (2018–2023), after completion of the TTCT–F, participants’ academic records, specifically their annual GPAs, were collected from university records to calculate the five-year GPA. All data were anonymized to ensure participants’ confidentiality.

Note

Scoring of the Torrance Tests of Creative Thinking – Figural Form A (TTCT-F) was conducted in accordance with the guidelines outlined in the official scoring manual (Torrance & Safter, 2008). The test was evaluated for five norm-referenced dimensions: Fluency, Originality, Elaboration, Abstractness of Titles, and Resistance to Premature Closure, as well as 13 criterion-referenced Creative Strengths.

All scoring was performed by trained scorers certified by the Torrance Center for Creativity and Talent Development at the University of Georgia to ensure reliability and validity of the results.