1
|
Caretta-Weyer HA, Eva KW, Schumacher DJ, Yarris LM, Teunissen PW. Postgraduate Selection in Medical Education: A Scoping Review of Current Priorities and Values. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S98-S107. [PMID: 37983402 DOI: 10.1097/acm.0000000000005365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE The process of screening and selecting trainees for postgraduate training has evolved significantly in recent years, yet remains a daunting task. Postgraduate training directors seek ways to feasibly and defensibly select candidates, which has resulted in an explosion of literature seeking to identify root causes for the problems observed in postgraduate selection and generate viable solutions. The authors therefore conducted a scoping review to analyze the problems and priorities presented within the postgraduate selection literature to explore practical implications and present a research agenda. METHOD Between May 2021 and February 2022, the authors searched PubMed, EMBASE, Web of Science, ERIC, and Google Scholar for English language literature published after 2000. Articles that described postgraduate selection were eligible for inclusion. 2,273 articles were ultimately eligible for inclusion. Thematic analysis was performed on a subset of 100 articles examining priorities and problems within postgraduate selection. Articles were sampled to ensure broad thematic and geographical variation across the breadth of articles that were eligible for inclusion. RESULTS Five distinct perspectives or value statements were identified in the thematic analysis: (1) Using available metrics to predict performance in postgraduate training; (2) identifying the best applicants via competitive comparison; (3) seeking alignment between applicant and program in the selection process; (4) ensuring diversity, mitigation of bias, and equity in the selection process; and (5) optimizing the logistics or mechanics of the selection process. CONCLUSIONS This review provides insight into the framing and value statements authors use to describe postgraduate selection within the literature. The identified value statements provide a window into the assumptions and subsequent implications of viewing postgraduate selection through each of these lenses. Future research must consider the outcomes and consequences of the value statement chosen and the impact on current and future approaches to postgraduate selection.
Collapse
Affiliation(s)
- Holly A Caretta-Weyer
- H.A. Caretta-Weyer is associate professor and associate residency director, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California; ORCID: https://orcid.org/0000-0002-9783-5797
| | - Kevin W Eva
- K.W. Eva is associate director and senior scientist, Centre for Health Education Scholarship, and professor and director, educational research and scholarship, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: http://orcid.org/0000-0002-8672-2500
| | - Daniel J Schumacher
- D.J. Schumacher is professor of pediatrics, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: http://orcid.org/0000-0001-5507-8452
| | - Lalena M Yarris
- L.M. Yarris is professor and vice chair of faculty development, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Pim W Teunissen
- P.W. Teunissen is professor of workplace learning in health care, School of Health Professions Education, and gynecologist, Department of Obstetrics & Gynecology, Maastricht University and Maastricht University Medical Center, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-0930-0048
| |
Collapse
|
2
|
Aranda-Michel E, Trager LE, Han JJ, Aggarwal R, Cevasco M, Kelly RF, Sultan I. Considerations for a Holistic Model in Evaluating Medical Students for Cardiothoracic Surgical Residency. Semin Thorac Cardiovasc Surg 2022; 35:705-710. [PMID: 35714822 DOI: 10.1053/j.semtcvs.2022.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022]
Abstract
Program directors are tasked with selecting whom they think will be the best fit for residency and the next leaders of the field. While numerical metrics have played a vital role in this process, recent changes to student evaluation are reducing the availability of these metrics. This poses unique challenges for both applicants and program directors. Here we discuss how this will likely shift the focus on other parts of the application and the consequences (good and bad) of doing so.
Collapse
Affiliation(s)
- Edgar Aranda-Michel
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lena E Trager
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jason J Han
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Rishav Aggarwal
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Marisa Cevasco
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rosemary F Kelly
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Ibrahim Sultan
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
| |
Collapse
|
3
|
Velez DR, Johnson SW, Sticca RP. How to Prepare for the American Board of Surgery In-Training Examination (ABSITE): A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:216-228. [PMID: 34429278 DOI: 10.1016/j.jsurg.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Performance on ABSITE is an important factor when monitoring resident progress. It predicts future performance and has lasting effects. Understanding the highest-yield preparation strategies can help residents in their study efforts and optimize performance. METHODS A literature search was conducted searching PubMed, EMBASE and JAMA Network in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed for the terms "ABSITE" and "American Board of Surgery In-Training Examination". Only studies discussing individual study habits from May 2011 to May 2021 were included. RESULTS 19 studies were included in qualitative synthesis. Year-round clinical study failed to show significant correlation to ABSITE performance although year-round ABSITE review was more consistently correlated. During a dedicated study period, increased time and increased total practice questions completed are associated with improved performance. The correlation of individual resources such as ABSITE review books, textbooks, audio podcasts and ABSITE preparatory courses to improved ABSITE performance was not proven. CONCLUSIONS Residents should optimize study strategies based on methods that have consistently shown to improve performance. Recommendations for best preparation strategies are provided.
Collapse
Affiliation(s)
- David Ray Velez
- University of North Dakota School of Medicine and Health Sciences, Department of Surgery, Grand Forks, North Dakota.
| | - Stefan Walter Johnson
- University of North Dakota School of Medicine and Health Sciences, Department of Surgery, Grand Forks, North Dakota
| | - Robert Peter Sticca
- University of North Dakota School of Medicine and Health Sciences, Department of Surgery, Grand Forks, North Dakota
| |
Collapse
|
4
|
Panda N, Bahdila D, Abdullah A, Ghosh AJ, Lee SY, Feldman WB. Association Between USMLE Step 1 Scores and In-Training Examination Performance: A Meta-Analysis. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1742-1754. [PMID: 34323860 DOI: 10.1097/acm.0000000000004227] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE On February 12, 2020, the sponsors of the United States Medical Licensing Examination announced that Step 1 will transition to pass/fail scoring in 2022. Step 1 performance has historically carried substantial weight in the evaluation of residency applicants and as a predictor of subsequent subject-specific medical knowledge. Using a systematic review and meta-analysis, the authors sought to determine the association between Step 1 scores and in-training examination (ITE) performance, which is often used to assess knowledge acquisition during residency. METHOD The authors systematically searched Medline, EMBASE, and Web of Science for observational studies published from 1992 through May 10, 2020. Observational studies reporting associations between Step 1 and ITE scores, regardless of medical or surgical specialty, were eligible for inclusion. Pairs of researchers screened all studies, evaluated quality assessment using a modified Newcastle-Ottawa Scale, and extracted data in a standardized fashion. The primary endpoint was the correlation of Step 1 and ITE scores. RESULTS Of 1,432 observational studies identified, 49 were systematically reviewed and 37 were included in the meta-analysis. Overall study quality was low to moderate. The pooled estimate of the correlation coefficient was 0.42 (95% confidence interval [CI]: 0.36, 0.48; P < .001), suggesting a weak-to-moderate positive correlation between Step 1 and ITE scores. The random-effects meta-regression found the association between Step 1 and ITE scores was weaker for surgical (versus medical) specialties (beta -0.25 [95% CI: -0.41, -0.09; P = .003]) and fellowship (versus residency) training programs (beta -0.25 [95% CI: -0.47, -0.03; P = .030]). CONCLUSIONS The authors identified a weak-to-moderate positive correlation between Step 1 and ITE scores based on a meta-analysis of low-to-moderate quality observational data. With Step 1 scoring transitioning to pass/fail, the undergraduate and graduate medical education communities should continue to develop better tools for evaluating medical students.
Collapse
Affiliation(s)
- Nikhil Panda
- N. Panda is a clinical fellow of surgery, Massachusetts General Hospital and Harvard Medical School, and a postdoctoral researcher, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dania Bahdila
- D. Bahdila is a doctoral candidate, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, and Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer Abdullah
- A. Abdullah is a doctoral candidate, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, and Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Auyon J Ghosh
- A.J. Ghosh is a clinical fellow of medicine and postdoctoral researcher, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sun Yeop Lee
- S.Y. Lee is research assistant, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - William B Feldman
- W.B. Feldman is associate physician and research fellow, Division of Pulmonary and Critical Care Medicine and the Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
5
|
Velez DR. Prospective Factors that Predict American Board of Surgery In-Training Examination Performance: A Systematic Review. Am Surg 2021; 87:1867-1878. [PMID: 34763542 DOI: 10.1177/00031348211058626] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION American Board of Surgery In-Training Examination (ABSITE) performance has become an important factor when monitoring resident progress. Understanding which prospective factors predict performance can help identify residents at risk. METHODS A literature search was conducted searching PubMed, EMBASE, and JAMA Network from June 2011 to June 2021, in accordance with the PRISMA guidelines. Searches were performed for the terms "ABSITE" and "American Board of Surgery In-Training Examination." Prospective factors such as prior examination performance, clinical evaluations, and demographics were evaluated. RESULTS A final 35 studies were included. The prospective factor most consistently found to predict ABSITE performance is performance on prior knowledge-based examinations such as the USMLE step exams. The ACGME Medical Knowledge 1 milestone evaluation also appears to correlate to ABSITE performance, although clinical evaluations, in general, do not. Demographics have no significant correlation to ABSITE performance. DISCUSSION Using performance on prior knowledge-based examinations programs may be able to identify residents at risk for failing ABSITE. It may be possible to initiate early intervention before rather than only remediation after poor performance.
Collapse
Affiliation(s)
- David R Velez
- Department of Surgery, 3579University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA
| |
Collapse
|
6
|
Dudas LM, Khan US, Borgstrom DC. Mastering the Match: Recruiting a Successful Surgery Resident. CURRENT SURGERY REPORTS 2021; 9:27. [PMID: 34729254 PMCID: PMC8552621 DOI: 10.1007/s40137-021-00304-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The objective of general surgery residency is to produce competent surgeons. At a minimum this requires being procedurally and clinically capable and able to pass the board exams. Recruitment is designed to select those residents who can successfully do so. But there is more to being a successful resident than that. In this review, we attempt to define a "successful resident" and how to attract them to your program. RECENT FINDINGS Resident applicants are still most concerned with matching to a program that will prepare them for a surgery career. Though there is variation of importance for different applicants, resident life, comradery, and relationships with faculty or mentors do factor into residency ranking. The program website remains the most utilized resource for applicants. However, social media (SM) has an increasing role in applicants' evaluation of a program. SM and the preinterview gathering seem to expose the subjective aspects of a program most effectively. Additional assessments evaluating personality, grit or career goals may assist in screening applicants for good "fit." SUMMARY In order to recruit successful residents, it is necessary to determine which applicant attributes are important to the program. Additionally, a program must maintain an updated website with clearly delineated resident expectations and program strengths. The screening and interview process must be maximized to target residents with career goals complimentary to available program opportunities. If SM is utilized, post should be frequent with relevant information pertaining to both resident life and educational or clinical opportunities.
Collapse
Affiliation(s)
- Lauren M. Dudas
- Department of Surgery, Division of Trauma, Emergency Surgery & Surgical Critical Care, West Virginia University, 1 Medical Center Drive, PO Box 9238, Morgantown, WV 26506 USA
| | - Uzer S. Khan
- Department of Surgery, Allegheny Health Network, Pittsburgh, PA USA
| | - David C. Borgstrom
- Department of Surgery, Division of Trauma, Emergency Surgery & Surgical Critical Care, West Virginia University, 1 Medical Center Drive, PO Box 9238, Morgantown, WV 26506 USA
| |
Collapse
|
7
|
A simulation-based selection process for trying to identify medical students who will become outstanding general surgery residents. Am J Surg 2020; 220:76-82. [DOI: 10.1016/j.amjsurg.2019.10.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/05/2019] [Accepted: 10/22/2019] [Indexed: 11/23/2022]
|
8
|
Lyons J, Bingmer K, Ammori J, Marks J. Utilization of a Novel Program-Specific Evaluation Tool Results in a Decidedly Different Interview Pool Than Traditional Application Review. JOURNAL OF SURGICAL EDUCATION 2019; 76:e110-e117. [PMID: 31668694 DOI: 10.1016/j.jsurg.2019.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 10/04/2019] [Accepted: 10/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There are almost twice as many applicants as there are general surgery internships, each utilizing a common application with standard components. These elements are frequently not useful in determining affinity for a program or overall ability, and resultant poor fit may be partially responsible for program attrition. Alternative evaluation instruments would be beneficial to both programs and applicants. METHODS An application review committee comprised of resident representatives, faculty representing all program-affiliated institutions, and program leadership completed a written evaluation developed by a third party (SurgWise Consulting) that specializes in industrial and organizational psychology. The responses were compiled to create a standardized assessment tool. This assessment was sent to applicants who were subsequently ranked according to fit with our program. The pool of applicants was separately evaluated using our traditional application review. Two residents independently graded each applicant on a 5-point Likert scale to evaluate common application elements; applicants were subsequently assigned an overall score. RESULTS The assessment was completed by 507 (99%) of 512 qualifying applicants. Separately, 378 applications were reviewed by the traditional method for a total of 756 reviews. Of the 96 applicants identified by the assessment tool to invite for interviews, 22 (23%) qualified for interview invitations according to the traditional review method. The assessment produced 74 applicants that otherwise would not have been interviewed. CONCLUSION Traditional application review strategies have many shortcomings. A competency-based assessment tool in the residency application selection process identifies a pool of applicants not identified by traditional review methods.
Collapse
Affiliation(s)
- Joshua Lyons
- University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - John Ammori
- University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jeffrey Marks
- University Hospitals Cleveland Medical Center, Cleveland, Ohio.
| |
Collapse
|
9
|
Aljamal Y, Pakonen J, Martin R, Heller S, McKenzie T, Farley DR. Factors that Predict an Intern's First ABSITE Score are Known by September. JOURNAL OF SURGICAL EDUCATION 2018; 75:e72-e77. [PMID: 30245062 DOI: 10.1016/j.jsurg.2018.08.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 07/14/2018] [Accepted: 08/23/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Previous studies offer conflicting relevance of a variety of factors to predict resident performance on the The American Board of Surgery In-Training Exam (ABSITE). With numerous stellar applicants scoring poorly on their first ABSITE, we sought to identify key factors that might allow us to tailor pre-emptive study efforts in the fall and early winter to enhance scores. METHODS General Surgery residents in our program from 2009 through 2016 were included in our cohort study. Specific trainee data (sex, prelim vs categorical, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, ABSITE scores, clinical rotations, biannual objective structured clinical examination OSCE-type scores, and in-house prep test [IHPT], etc.) were collected retrospectively. The data were analyzed using JMP pro 10 and MedCalc. RESULTS ABSITE scores of our 110 trainees did not vary by sex or by categorical vs preliminary residents. USMLE step 1 and 2, IHPT and one objective structured clinical examination (OSCE) station (Sim-Based Trauma Exam) scores were positively correlated with ABSITE scores (p < 0.05; correlation coefficient (CC) = 0.6 [strong] for IHPT, 0.5 [moderate] for step 1 and 2 and [weak] 0.3 for Sim-Based Trauma Exam). The mean (standard deviation) ABSITE %tile score for residents scoring above 230 (USMLE 1 or 2) vs <230 were different: 81 (3) vs 56 (4) (p < 000.1). Of residents scoring lower than 230 in USMLE 1 or 2, their ABSITE performance had a strong positive linear correlation with their performance in the IHPT (CC = 0.7) and SBTA (CC = 0.5). Residents rotating twice on the Acute Care Surgery services before the ABSITE scored higher than those with 1 or zero rotations (p < 0.05). CONCLUSIONS USMLE steps 1 and 2 are useful parameters in our program to predict subsequent resident ABSITE performance. An in-house 60-minute preparation test in September, a 6-minute simulation-based trauma assessment in July, and rotation schedule with 2 stints on Acute Care Surgery were surprisingly useful early intern year tools to predict ABSITE scores.
Collapse
Affiliation(s)
- Yazan Aljamal
- Mayo Clinic Multidisciplinary Simulation Center, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Department of General Surgery, Mayo Clinic, Rochester, Minnesota.
| | - Jessica Pakonen
- Department of General Surgery, Mayo Clinic, Rochester, Minnesota.
| | - Rebecca Martin
- Department of General Surgery, Mayo Clinic, Rochester, Minnesota.
| | - Stephanie Heller
- Department of General Surgery, Mayo Clinic, Rochester, Minnesota.
| | - Travis McKenzie
- Department of General Surgery, Mayo Clinic, Rochester, Minnesota.
| | - David R Farley
- Department of General Surgery, Mayo Clinic, Rochester, Minnesota.
| |
Collapse
|
10
|
Stover W, Gill S, Schenarts K, Chahine AA. Defining the Applicant Pool for Postgraduate Year-2 Categorical General Surgery Positions. JOURNAL OF SURGICAL EDUCATION 2018; 75:870-876. [PMID: 29242045 DOI: 10.1016/j.jsurg.2017.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 10/02/2017] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE In the spring of 2010, a categorical general surgery postgraduate year (PGY)-2 position became available at our academic medical center secondary to attrition of a PGY-1 resident. We sought to study the unique characteristics of applicants to that position and to describe the selection process with hopes to stimulate additional studies about the unique challenges of recruiting applicants into advanced standing positions. DESIGN Applications were received via e-mail and reviewed to characterize the applicant pool. An Excel spreadsheet was used to organize data. Characteristics assessed included United States Medical Licensing Examination (USMLE) scores, Educational Commission for Foreign Medical Graduates status, Alpha Omega Alpha Honor Society status, sex, academic performance, number of case logs, volunteer and job experience, leadership roles, research experience including submissions, and advanced degrees. These characteristics were compared to those of the PGY-1 applicants through the Match that year. SETTING Academic medical center. PARTICIPANTS Applicants for a categorical general surgery PGY-2 position in 2010. RESULTS A total of 129 applicants provided the requested documents. There were 104 males, 25 females, no Alpha Omega Alpha Honor Society candidates, and 82 international candidates. Of all, 46 candidates experienced academic difficulties. Quantitative averages include USMLE 1: 214.17, USMLE 2: 215.74, American Board of Surgery In Training Examination (ABSITE) percentile = 51.96, ABSITE 2 = 46.00, grand total case log: 192.10. Advanced degrees included 2 MBAs, 6 MPHs, and 7 nonphysiology MSs. The selection process to fill the position started on 3/25/2010 when the announcement was published and ended on 5/11/2010 when the offer of acceptance was sent. The selected applicant integrated well with the peers and just graduated from our residency as one of the leaders of the graduating class. CONCLUSIONS Although the attrition rate in general surgery remains high, there is a dearth of literature about how best to replace residents. The hardship of replacing residents highlights the importance of studying this group to improve the recruitment process and the quality of replacement residents. The selection process was time consuming and presented its own challenges given the lack of a computerized system for screening. It lasted nearly 7 weeks requiring faculty time commitment to mine through application data/e-mails, correspond with applicants, conduct interviews, and ultimately select an applicant for the position. This is the first study to investigate the applicant pool to advanced standing positions in general surgery and we present it as a pilot study to stimulate further research efforts.
Collapse
Affiliation(s)
- Weston Stover
- Georgetown University School of Medicine, Washington, DC; Department of Surgery, UT Southwestern Medical Center, Dallas, Texas
| | - Sujata Gill
- Department of Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Kim Schenarts
- Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska
| | - A Alfred Chahine
- Department of Surgery, MedStar Georgetown University Hospital, Washington, DC; Department of Surgery, Children's National Medical System, Washington, DC; Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC.
| |
Collapse
|
11
|
Roberts C, Khanna P, Rigby L, Bartle E, Llewellyn A, Gustavs J, Newton L, Newcombe JP, Davies M, Thistlethwaite J, Lynam J. Utility of selection methods for specialist medical training: A BEME (best evidence medical education) systematic review: BEME guide no. 45. MEDICAL TEACHER 2018; 40:3-19. [PMID: 28847200 DOI: 10.1080/0142159x.2017.1367375] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Selection into specialty training is a high-stakes and resource-intensive process. While substantial literature exists on selection into medical schools, and there are individual studies in postgraduate settings, there seems to be paucity of evidence concerning selection systems and the utility of selection tools in postgraduate training environments. AIM To explore, analyze and synthesize the evidence related to selection into postgraduate medical specialty training. METHOD Core bibliographic databases including PubMed; Ovid Medline; Embase, CINAHL; ERIC and PsycINFO were searched, and a total of 2640 abstracts were retrieved. After removing duplicates and screening against the inclusion criteria, 202 full papers were coded, of which 116 were included. RESULTS Gaps in underlying selection frameworks were illuminated. Frameworks defined by locally derived selection criteria, and heavily weighed on academic parameters seem to be giving way to the evidencing of competency-based selection approaches in some settings. Regarding selection tools, we found favorable psychometric evidence for multiple mini-interviews, situational judgment tests and clinical problem-solving tests, although the bulk of evidence was mostly limited to the United Kingdom. The evidence around the robustness of curriculum vitae, letters of recommendation and personal statements was equivocal. The findings on the predictors of past performance were limited to academic criteria with paucity of long-term evaluations. The evidence around nonacademic criteria was inadequate to make an informed judgment. CONCLUSIONS While much has been gained in understanding the utility of individual selection methods, though the evidence around many of them is equivocal, the underlying theoretical and conceptual frameworks for designing holistic and equitable selection systems are yet to be developed.
Collapse
Affiliation(s)
- Chris Roberts
- a Primary Care and Medical Education, Sydney Medical School , University of Sydney , New South Wales , Australia
| | - Priya Khanna
- b The Royal Australasian College of Physicians , New South Wales , Australia
| | - Louise Rigby
- c Health Education and Training Institute , New South Wales , Australia
| | - Emma Bartle
- d School of Dentistry , University of Queensland , Queensland , Australia
| | - Anthony Llewellyn
- e Hunter New England Local Health District , New Lambton , Australia
- f Health Education and Training Institute, University of Newcastle , Newcastle Australia
| | - Julie Gustavs
- b The Royal Australasian College of Physicians , New South Wales , Australia
| | - Libby Newton
- b The Royal Australasian College of Physicians , New South Wales , Australia
| | | | - Mark Davies
- h Royal Brisbane and Women's Hospital , Queensland , Australia
| | - Jill Thistlethwaite
- i School of Communication , University of Technology Sydney , New South Wales , Australia
| | - James Lynam
- j Calvary Mater Newcastle, University of Newcastle , New South Wales , Australia
| |
Collapse
|
12
|
Schaverien MV. Selection for Surgical Training: An Evidence-Based Review. JOURNAL OF SURGICAL EDUCATION 2016; 73:721-9. [PMID: 27133583 DOI: 10.1016/j.jsurg.2016.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 02/07/2016] [Accepted: 02/23/2016] [Indexed: 05/26/2023]
Abstract
PURPOSE The predictive relationship between candidate selection criteria for surgical training programs and future performance during and at the completion of training has been investigated for several surgical specialties, however there is no interspecialty agreement regarding which selection criteria should be used. Better understanding the predictive reliability between factors at selection and future performance may help to optimize the process and lead to greater standardization of the surgical selection process. METHODS PubMed and Ovid MEDLINE databases were searched. Over 560 potentially relevant publications were identified using the search strategy and screened using the Cochrane Collaboration Data Extraction and Assessment Template. RESULTS 57 studies met the inclusion criteria. Several selection criteria used in the traditional selection demonstrated inconsistent correlation with subsequent performance during and at the end of surgical training. The following selection criteria, however, demonstrated good predictive relationships with subsequent resident performance: USMLE examination scores, Letters of Recommendation (LOR) including the Medical Student Performance Evaluation (MSPE), academic performance during clinical clerkships, the interview process, displaying excellence in extracurricular activities, and the use of unadjusted rank lists. CONCLUSIONS This systematic review supports that the current selection process needs to be further evaluated and improved. Multicenter studies using standardized outcome measures of success are now required to improve the reliability of the selection process to select the best trainees.
Collapse
Affiliation(s)
- Mark V Schaverien
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| |
Collapse
|
13
|
Webb TP, Paul J, Treat R, Codner P, Anderson R, Redlich P. Surgery residency curriculum examination scores predict future American Board of Surgery in-training examination performance. JOURNAL OF SURGICAL EDUCATION 2014; 71:743-747. [PMID: 24776858 DOI: 10.1016/j.jsurg.2014.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 01/31/2014] [Accepted: 02/18/2014] [Indexed: 06/03/2023]
Abstract
IMPORTANCE A protected block curriculum (PBC) with postcurriculum examinations for all surgical residents has been provided to assure coverage of core curricular topics. Biannual assessment of resident competency will soon be required by the Next Accreditation System. OBJECTIVE To identify opportunities for early medical knowledge assessment and interventions, we examined whether performance in postcurriculum multiple-choice examinations (PCEs) is predictive of performance in the American Board of Surgery In-Training Examination (ABSITE) and clinical service competency assessments. DESIGN Retrospective single-institutional education research study. SETTING Academic general surgery residency program. PARTICIPANTS A total of 49 surgical residents. INTERVENTION Data for PGY1 and PGY2 residents participating in the 2008 to 2012 PBC are included. Each resident completed 6 PCEs during each year. MAIN OUTCOME MEASURES The results of 6 examinations were correlated to percentage-correct ABSITE scores and clinical assessments based on the 6 Accreditation Council for Graduate Medical Education core competencies. Individual ABSITE performance was compared between PGY1 and PGY2. Statistical analysis included multivariate linear regression and bivariate Pearson correlations. RESULTS A total of 49 residents completed the PGY1 PBC and 36 completed the PGY2 curriculum. Linear regression analysis of percentage-correct ABSITE and PCE scores demonstrated a statistically significant correlation between the PGY1 PCE 1 score and the subsequent PGY1 ABSITE score (p = 0.037, β = 0.299). Similarly, the PGY2 PCE 1 score predicted performance in the PGY2 ABSITE (p = 0.015, β = 0.383). The ABSITE scores correlated between PGY1 and PGY2 with statistical significance, r = 0.675, p = 0.001. Performance on the 6 Accreditation Council for Graduate Medical Education core competencies correlated between PGY1 and PGY2, r = 0.729, p = 0.001, but did not correlate with PCE scores during either years. CONCLUSIONS AND RELEVANCE Within a mature PBC, early performance in a PGY1 and PGY2 PCE is predictive of performance in the respective ABSITE. This information can be used for formative assessment and early remediation of residents who are predicted to be at risk for poor performance in the ABSITE.
Collapse
Affiliation(s)
- Travis P Webb
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Jasmeet Paul
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Robert Treat
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Panna Codner
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rebecca Anderson
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Philip Redlich
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
14
|
Correlation between trainee candidate selection criteria and subsequent performance. J Am Coll Surg 2014; 219:951-7. [PMID: 25262283 DOI: 10.1016/j.jamcollsurg.2014.07.942] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/21/2014] [Accepted: 07/25/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND The objective of trainee recruitment is to identify candidates likely to perform well as trainees and subsequent faculty. The effectiveness of this process has not been established. The goal of this study was to identify trainee selection criteria predictive of excellent performance. STUDY DESIGN Twenty-nine microsurgery fellows were enrolled from 2008 to 2012. Each candidate was interviewed and rated based on presentation, plastic surgery (PS) training experience, academic potential, personality, social skills, communication skills, and ability to be a team player. An unadjusted rank list was generated based on weighted averages, and an adjusted rank list was then generated at a faculty meeting. At the conclusion of fellowship, each fellow was rated based on the ACGME core competencies. Spearman correlation coefficients (r) were used to measure the correlations between fellow selection criteria and fellow performance. RESULTS Plastic surgery training and academic potential had, by far, the strongest correlation to overall performance (r: 0.678, p < 0.001 and r: 0.56, p < 0.002), and to all ACGME competencies. When reformulated to weight PS training and academic potential more heavily than subjective criteria, the scoring system was significantly more predictive of excellent performance (r: 0.49 vs 0.70). The unadjusted rank list was more predictive of excellent performance than the adjusted rank list (r: 0.45 vs 0.65). CONCLUSIONS Plastic surgery training experience and academic potential were better predictors of performance than any subjective information ascertained during the interview. Adjustments to the rank list based on faculty discussion resulted in lower performance candidates moving up in ranking. Ranking criteria and interview techniques must be refined to improve predictive power. It may be beneficial for semi-objective criteria to carry more weight than subjective criteria and raw scores to remain unadjusted by extraneous information.
Collapse
|