Abstract
IntroductionAlthough emergency medicine (EM) residency program directors (PD) have multiple sources to evaluate each applicant, some programs await the release of the medical student performance evaluation (MSPE) to extend interview offers. While prior studies have demonstrated that MSPE content is variable and selectively positive, no prior work has evaluated the impact of the MSPE on the likelihood to invite (LTI) applicants for a residency interview. This study aimed to evaluate how information in the MSPE impacted LTI, with the hypothesis that changes in LTI would be relatively rare based on MSPE review alone.MethodsWe conducted a prospective, observational study analyzing applications to three EM residency programs during the 2019–2020 match cycle. Reviewers assessed applications and rated the LTI on a five-point Likert scale where LTI was defined as follows: 1 = definitely no; 2 = probably no; 3 = unsure; 4 = probably yes; and 5 = definitely yes. The LTI was recorded before and after MSPE review. A change in LTI was considered meaningful when it changed the overall trajectory of the applicant’s likelihood to receive an invitation to interview.ResultsWe reviewed a total of 877 applications with the LTI changing ≥1 point on the Likert scale 160 (18.2%) times. The LTI was meaningfully impacted in a minority of applications – 48 total (5.5 %, p< 0.01) – with only 1 (0.11%) application changing from 1 or 2 (definitely/probably no) to 4 or 5 (probably/definitely yes) and 34 (3.8%) changing from 3 (unsure) to 4 or 5 (probably/definitely yes). Thirteen (1.5%) applications changed from 4 or 5 (probably/definitely yes) to 3 (unsure or probably/definitely no).ConclusionReview of the MSPE resulted in a meaningful change in LTI in only 5.5% of applications. Given the time required for program leadership to review all parts of the variably formatted MSPEs, this finding supports a more efficient application review, where the PD’s focus is on succinct and objective aspects of the application, such as the Standardized Letter of Evaluation.
Highlights
Emergency medicine (EM) residency program directors (PD) have multiple sources to evaluate each applicant, some programs await the release of the medical student performance evaluation (MSPE) to extend interview offers
Review of the MSPE resulted in a meaningful change in likelihood to invite (LTI) in only 5.5% of applications
Given the time required for program leadership to review all parts of the variably formatted MSPEs, this finding supports a more efficient application review, where the PD’s focus is on succinct and objective aspects of the application, such as the Standardized Letter of Evaluation. [West J Emerg Med. 2021;22(5)1102–1109.]
Summary
Emergency medicine (EM) residency program directors (PD) have multiple sources to evaluate each applicant, some programs await the release of the medical student performance evaluation (MSPE) to extend interview offers. Given the average of 101 hours per year spent on application review by PDs, they desire objective and comparative data to differentiate between applicants as efficiently as possible.[4] In EM, 83% of PDs cite the MSPE as one of many factors used to decide which applicant to invite.[5] The potential value of the MSPE lies in the fact that it is the only place in the application where a PD can view narrative information outlining a student’s performance in both the pre-clinical and clinical curriculums, personal and professional attributes, and performance compared to peers at their institution.[1] in addition to the variability in the structure of the MSPE between institutions, prior work has demonstrated that MSPE content is selectively laudatory.[6] The variability and overall positive tone may have contributed to prior survey data showing that EM PDs ranked the MSPE as 13th of the 16 most important application components with regard to resident selection.[7] this survey was done prior to the most recent MSPE taskforce recommendations instituted in 2016, the most recent National Resident Matching Program survey of PDs in EM in 2018 continued to show that specialty letters of recommendation (i.e., the SLOE) are prioritized over the MSPE in selecting applicants for interview, with the SLOE ranked as the first most influential factor out of 33 total factors surveyed and tthe MSPE ranked 23rd out of those 33 factors.[5]
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