Volume 16: Issue 2

Background The Computer-Based Assessment for Sampling Personal Characteristics (CASPer) is a situational judgment test (SJT) that assesses noncognitive skills like professionalism, communication, and empathy. There are no reports of the effects of race/ethnicity and sex on CASPer scores among residency applicants.

Objective We examined the effects of race/ethnicity, sex, and United States vs international medical school attendance on CASPer performance.

Methods Our anesthesiology residency program required all applicants for the 2021-2022 Match cycle to complete an online video and text-based SJT (CASPer). We compared these results, reported as z-scores, with self-identified race/ethnicity, sex, United States vs international medical school attendance, and United States Medical Licensing Examination (USMLE) Step 1 scores.

Results Of the 1245 applicants who completed CASPer, 783 identified as male. The racial/ethnic distribution was 512 White, 412 Asian, 106 Black, 126 Hispanic, and 89 Other/No Answer. CASPer z-scores did not differ by sex. White candidates scored higher than Black (0.18 vs -0.57, P<.001) and Hispanic (0.18 vs -0.52, P<.001) candidates. Applicants attending US medical schools scored higher than those attending international medical schools (z-scores: 0.15 vs -0.68, P<.001). There was no correlation between CASPer z-scores and USMLE Step 1 scores.

Conclusions Our results suggest that CASPer scores favor White applicants over Black and Hispanic ones and applicants attending US medical schools over those attending international medical schools.

Background Although the selection interview is a standard admission practice for graduate medical education (GME) programs in the United States, there is a dearth of recent reviews on optimizing the trainee interview process, which has low reliability, high cost, and major risk of bias.

Objective To investigate the evidence base for different selection interview practices in GME.

Methods We searched 4 literature databases from inception through September 2022. Two investigators independently conducted title/abstract screening, full-text review, data extraction, and quality assessment. Disagreements were mediated by discussion. We used backward reference searching of included articles to identify additional studies. We included studies of different interview methods and excluded literature reviews, non-GME related publications, and studies comparing different applicant populations. We examined study characteristics, applicant and interviewer preferences, and interview format. We evaluated study quality using the Medical Education Research Study Quality Instrument (MERSQI).

Results Of 2192 studies, 39 (2%) met our inclusion criteria. The evidence base was rated as moderately low quality using MERSQI criteria. Applicants reported preferences for several one-on-one interviews lasting 15 to 20 minutes, interviews by current trainees, and interviews including social events with only trainees. Applicants had mixed perceptions of virtual versus in-person interviews and reported that virtual interviews saved costs. The multiple mini interview (MMI) required more applicant and interviewer time than individual interviews but demonstrated construct and predictive validity and was preferred by applicants and interviewers.

Conclusions Based on moderately low-quality evidence, using the MMI, training interviewers, and providing applicants with basic program information in advance should be considered for GME selection interviews.

Background Previous research demonstrates mixed reactions from residents toward competency-based medical education (CBME), and entrustable professional activities (EPAs) specifically. However, understanding what motivates residents to obtain EPAs may be vital to the longevity of CBME, given the emphasis on assessment for learning under this paradigm.

Objective This study explored resident perspectives across 3 domains: motivation for obtaining EPAs, perceived importance of EPAs, and overall thoughts on CBME curriculum.

Methods This was a sequential exploratory mixed-methods study involving 2 phases of data collection. Phase 1 was semi-structured interviews with residents enrolled in CBME at one Canadian institution from November 2019 to July 2020. Analyses included thematic and manifest content analysis. Phase 2 was an electronic close-ended survey to capture residents’ primary motivation for requesting EPAs and importance of EPAs for learning. Survey data were analyzed descriptively.

Results Of 120 eligible residents, 25 (21%) and 107 (89%) participated in the interview and survey, respectively. Program requirement was the dominant motivation for obtaining EPAs. There was variability in perceived importance of EPAs on learning. Increased resident workload, gaming the system to maximize EPA scores, and lack of shared ownership from preceptors were cited as critiques of the curriculum. Survey responses corroborated interview findings.

Conclusions Although many residents recognize the value of EPAs, the majority are not intrinsically motivated to seek out assessment under the current CBME framework.

We read with great interest the findings by Lipman and his colleagues.¹ A plethora of competitive academic prizes, medals, bursaries, and awards are regularly offered to medical students and trainees by universities, employers, training colleges, nongovernmental organizations, philanthropic endowments, and governmental funds.² Academic prizes offered to medical students could be for achieving the highest examination mark, presenting the most interesting case, or writing the best essay. This practice often continues during postgraduate training, and when selecting trainees, several training colleges award “additional points” for the applicants’ prior awards.²

Such awards are well-intentioned; it could be

What the Heck Is a Journal Impact Factor Anyway? Dissemination Measures for Educators

Artificial Intelligence in Graduate Medical Education Applications

This Is Our Lane: The Urgent Need to Train Residents to Talk About Firearm Injury Prevention for Children

The Impact of Firearm-Related Injuries

The ABCs of Cultivating Psychological Safety for Clinical Learner Growth

Remediation Methods 2.0 for Professionalism and Interpersonal and Communication Skills Milestones: An Update

Guidance for a Career in an Academic Medical Center

Using Human-Centered Design Tools to Improve Health Justice

Racial and Ethnic Disparities in Situational Judgment Testing Among Applicants to an Anesthesiology Residency Program

Understanding the Differences That Differentiate: A Model for Deciding Which Literature Review to Conduct

Evidence-Based Practices for Interviewing Graduate Medical Education Applicants: A Systematic Review

Motivations for Entrustable Professional Activity Assessment: Gaps Between Curriculum Theory and Resident Reality

How an Audit-and-Feedback-Based Educational Program Contributed to a Reduction in Environmentally Harmful Waste Anesthetic Gases Among Anesthesiology Residents

Practice Makes Perfect: Objective Structured Clinical Examinations Across the UME-to-GME Continuum Improve Care of Transgender Simulated Patients

Use of an Opt-Out vs Opt-In Strategy Increases Use of Residency Mental Health Services

The Impact of Changing From a 6+2 to a 3+1 Residency Block Schedule on Patient Access and Other Outcomes

A Qualitative Study of Internal Medicine Subspecialty Fellowship Program Directors’ Perspectives on Short-Term Hospitalist Employment Prior to Fellowship

Mobile Application to Improve Just-in-Time 2-Way Formative Feedback in Graduate Medical Education

Making a Business Case for Investing in Graduate Medical Education

The Challenge

Ghosted

To the Editor: Academic Prizes and Medals—Whom Are We Really Rewarding?

To the Editor: Mixed Signals: Where Is Transparency in Preference Signaling?

To the Editor: Better Solutions Are Needed to End the Research Arms Race

To the Editor: Blurring the Lines of Medical Student Research

The Role of ACGME International in Enhancing Opportunities of Residents for Advanced Subspecialty Training

Support for Mental Health and Well-Being in the Transition to Residency

Introduction

Rouge on the Lips of Silence

Evaluating Methodology for Increasing Diversity in US Residency Training Programs: A Scoping Review

Scoping Review of Simulation-Based Training for Social Determinants of Health Within Residency Programs

Career Outcomes Among Graduates of 2 Urban Health Primary Care Training Programs

Trends in MedEdPORTAL Faculty Development Resources for Clinician Educators

The Effect of Paging Reminders on Fellowship Conference Attendance: A Multi-Program Randomized Crossover Study

A Values Affirmation Intervention to Improve Female Residents' Surgical Performance

Improving Residents' Safe Opioid Prescribing for Chronic Pain Using an Objective Structured Clinical Examination

Integrating a Resident-Driven Longitudinal Quality Improvement Curriculum Within an Ambulatory Block Schedule

Skills for Interviewing Adolescent Patients: Sustainability of Structured Feedback in Undergraduate Education on Performance in Residency