Letters Of Recommendation Research Articles

Assessing the Impact of a Designated Pharmacist Intervention on Drug Treatment Costs and Technical Efficiency in the Hemato-Oncology Outpatient Clinic

ObjectivesThis study aimed to investigate the impact of a designated pharmacist (DPha) intervention in a hemato-oncology unit, focusing on reducing drug treatment costs and improving technical efficiency (TE). MethodsData from an 8-month intervention in the Israeli Clalit Health Services hemato-oncology outpatient unit were analyzed. During the study, the DPha reviewed the drug therapies being administered. After the review, a recommendation letter was sent, if relevant, to the treating physician. Data on drug treatment costs and interventions were meticulously collected and analyzed from the perspective of the insurer. A simple design was used to assess the DPha intervention’s contribution to TE and cost reduction, which was used to generate credible and transparent estimates. Sensitivity analyses were conducted to assess the robustness of 2 major variables: drug prices and pharmacist salaries. ResultsOver 8 months, DPha interventions led to a $279 191 cost reduction for 91 patients, resulting in net savings of $269 420 ($2960 per patient). Noteworthy is the $411 savings for each hour worked by the pharmacist, with a major impact on medications not insurer approved for the patient’s condition ($101 151) and discontinuing inappropriate medications ($52 681). Biological drug optimization accounted for 81% of total savings. Sensitivity analyses demonstrated significant cost savings across various drug prices and pharmacist salary scenarios. ConclusionsThe study proposes a practical framework for optimizing pharmacist services and reducing the inappropriate use of costly oncology medications. Incorporating a DPha enhances TE and yields significant cost reductions, offering valuable insights for insurers, policy makers, and healthcare professionals.

Evaluating the Impact of the Standardized Letter of Recommendation on a Successful Match in Urology Residency

ObjectivesTo evaluate the contribution of the SLOR to the likelihood of matching in urology residency by applying a novel scoring system and characterize utilization in the 2022 application cycle. MethodsWe conducted an investigation of all applicants to our urology residency program during the 2022 cycle. We developed a scoring system to assess SLOR strength across all templates. Match outcomes were verified with the Society of Academic Urologists listing. Statistical analysis was performed to assess for factors predictive of a successful match. ResultsOut of 386 total applicants, 239 (61.9%) had at least one SLOR in their application. SLOR utilization was more prevalent in MD applicants, in those with higher Step 2 scores, and in those who matched (p < 0.01). The majority of SLOR scores (66.5%) were above a 3.5/5 in our cohort. Step 1 score, number of research entries, and presence of a SLOR were predictive of successful match. However, a SLOR score of < 3 was strongly associated with not matching (OR 0.021, p < 0.01). ConclusionsThe presence of a SLOR in our cohort overall was associated with a successful match. A poor SLOR score was highly deleterious to an applicant’s chance of matching in urology. Our SLOR scoring system can be used across all letter templates and demonstrates that strength of SLOR can significantly impact an applicant’s chance of matching.

Ethics of Writing Personal Statements and Letters of Recommendations with Large Language Models

Ethics of Writing Personal Statements and Letters of Recommendations with Large Language Models

Gender-based linguistic differences in letters of recommendation for rhinology fellowship over time: A dual-institutional follow-up study using natural language processing and deep learning.

This follow-up dual-institutional and longitudinal study further evaluated for underlying gender biases in LORs for rhinology fellowship. Explicit and implicit linguistic gender bias was found, heavily favoring male applicants.

Characteristics Associated with Successful Residency Match in General Surgery.

To evaluate characteristics of matched and unmatched general surgery residency (GSR) applicants. Given the recent change of the United States Medical Licensing Exam Step 1 grading to pass/fail, understanding the factors that influence GSR match success is integral to identifying potential interventions to improve match rates for diverse medical students. Retrospective review of GSR National Residency Matching Program (NRMP) applicant and Accreditation Council for Graduate Medical Education (ACGME) active resident data between 2011 and 2022. Data included application characteristics for United States ("US") and "independent" applicants, factors cited by program directors in the interview and ranking process, paths pursued if applicants went unmatched, and racial/ethnic representation. A total of 9149 US and 3985 independent applicants applied to GSR between 2011 and 2021. Matched versus unmatched applicants had higher step 1 scores (US: 236 vs 218, P = 0.005; independent: 237 vs 228, P = 0.001), higher step 2 scores (US: 248 vs 232, P = 0.006; independent: 245 vs 234, P < 0.001), more likely to belong to alpha omega alpha (US: 17.1% vs 1.6%, P = 0.002) or to attend a top 40 National Institutes of Health-funded school (US: 31.0% vs 19.4%, P = 0.002) compared to unmatched applicants. Program directors heavily factored step 1 and step 2 scores, letters of recommendation, interactions with faculty and trainees, and interpersonal skills when interviewing and ranking applicants. The proportion of active general surgery residents versus applicants was lower for Asians (12.3% vs 20.9%, P < 0.001), Black/African American (5.0% vs 8.8%, P < 0.001), Hispanic/Latino (5.0% vs 9.4%, P = 0.001), and underrepresented in medicine students (10.3% vs 19.1%, P < 0.001). In the pass/fail step 1 era, factors including step 2 score and other subjective metrics may be more heavily weighted in the GSR match process.

The role of letters of recommendation in perpetuating or challenging the social stratification of American secondary schools: a quantitative analysis of admission officer assessments in highly selective college admission

Admission to highly selective institutions offers a pathway to upward social mobility, particularly for low-resource students. However, entrenched wealth disparities in the United States present serious challenges for admission officers at highly selective institutions. Utilizing individualized holistic review (IHR), including letters of recommendation (LOR), and contextual consideration, highly selective institutions aim to account for wealth inequities. This quantitative analysis, conducted at a highly selective research university, examined 95,326 applicants across 4 years to explore if admission officers’ internal assessments of LORs relate to contextual independent variables beyond students’ control. Statistical methods, including ANOVA, Two-Way ANOVA, Chi-Square, multiple linear regression, and logistic regression, were employed, controlling for standard measures of academic readiness. Findings revealed higher LOR assessments for students facing greater contextual challenge levels, underscoring the ability of the admission process to identify high achieving students from high challenge contexts. Paradoxically, elevated LOR ratings were also observed for students from private and smaller schools, indicating a nuanced interplay of factors in the admission process. Importantly, LOR assessments significantly correlated with admission outcomes, emphasizing the pivotal role of LORs in highly selective college admissions. This study reveals the nuanced role of LORs in admissions, exposing their potential to tackle inequities. It calls for improved IHR training and heightened consideration of contextual variables, offering a crucial contribution to advancing equity in highly selective institutions, fostering more informed admission practices.

Admission Test Scores and Colleges’ Retention Rates

Most higher education institutions eliminated standardized test requirements for applicants following the COVID-19 pandemic. The impact of college admission criteria on college student retention has been the subject of extensive research in higher education. This literature suggests that admission criteria play a significant role in influencing student retention rates. However, the impacts of test-optional admissions procedures have been relatively understudied. Using a dataset of admissions requirements, institutional profiles, measures of collegiate success, financial aid, and demographics of full-time, first-year students at public or not-for-profit private 4-year institutions for the 2021-2022 academic year, we find that, of the different criteria used in admission policies, required or recommended letters of recommendation and graduation rates combined have an impact on college retention rates. Required or recommended admission test scores positively increase retention rates, albeit not robustly.

Do Program Directors of Anesthesiology Residency Programs Interpret Narrative Letters of Recommendation as Intended?

Background Letters of recommendation (LORs) are an important part of the application process for medical residency programs with most specialties preferring a narrative format. Given the inherent subjectivity of narrative LORs, the current study sought to determine whether the intended messages of narrative LORs written for applicants to anesthesiology residency programs are accurately interpreted by readers. Methodology Anonymous online surveys were sent via the Qualtrics platform to program directors (PDs) of the Accreditation Council for Graduate Medical Education-accredited anesthesiology residency programs in the Mid-Atlantic region as designated by the Electronic Residency Application Service, which consists of the states of New York, Pennsylvania, and New Jersey. Each PD participant received five surveys, each of which was attached to a de-identified LOR that was written by another PD located at an institution in the same region. Both the letter writer and study participants were asked to score LORs on a Likert-like scale. Participants were additionally asked whether the LORs, if received, would influence their decision to either offer an interview to the applicant or to rank the applicant. Finally, participants were asked to note any specific words or phrases within the LORs that they found to be particularly impactful. Results Overall, 10 of 34, 29.41%, PDs responded to the survey. There was a high correlation between the LOR intent and the respondents' assigned rating (Spearman's rho = 0.7973, p < 0.001). Responses were more accurate for "outstanding and excellent" LORs compared to the lower three categories. Results were unaffected after adjusting for respondents' years of experience as PDs. Additionally, 71.6% indicated that the LORs would influence the decision about offering an interview, and 56.5% stated that the LORs would influence a ranking decision. Conclusions Our results indicate that respondents' perception of LORs correlated strongly with the intent of the writer. Additionally, respondents seemed to value LORs for interview and ranking decisions.

High School History Teachers' Perceptions of the Teacher Competency Test (UKG) in Binawidya and Tuah Madani Districts

Every history teacher has the ability or competence as a teacher. The government created a skills testing program called the Teacher Competency Test (UKG). This research aims to determine the perceptions of high school history teachers regarding the Teacher Competency Test (UKG) in Binawidya and Tuah Madani Districts, Pekanbaru City. This study uses a qualitative method. Data was collected through observation, interviews and documentation. The subjects of this research were 6 teachers in the field of History at the high school level in Binawidya and Tuah Madani Districts, Pekanbaru City who had passed the UKG. Data analysis techniques use data reduction, data presentation, data verification and drawing conclusions. The results of research on High School History Teachers' Perceptions of the Teacher Competency Test (UKG) in Binawidya and Tuah Madani Districts are that teachers think they have various kinds of obstacles during UKG, such as problems with questions that are considered difficult, inadequate facilities and infrastructure for remote areas and a lack of socialization regarding the Competency Test program. This teacher means that in 2024 the government will have overcome this problem by forming a Regional/Ministry/Other Institution Competency Test team. These teams have members who have played a role according to their use, such as a Helpdesk which helps provide solutions to problems experienced during the Competency Test. The purpose of holding this UKG is to map teacher abilities and to meet the requirements for appointment to functional positions through transfer from other positions, promotion and re-appointment to functional positions. With the evaluation results obtained by teachers in the form of certificates and letters of recommendation, which are important and useful for their functional position.

Point/counterpoint: Should we stop writing and reading letters of recommendation for residency selection?

Point/counterpoint: Should we stop writing and reading letters of recommendation for residency selection?

“I have known….” A Corpus-driven Study of Personal Pronouns in Letters of Recommendation in an L2 Context

In recent times, there has been an upsurge of scholarly attention on hitherto occluded genres such as the Letter of Recommendation (LoR). Although several studies have been conducted on the LoR, studies on lexico-grammatical features are rare. This study, therefore, adopts a corpus-driven approach to examine the use of personal pronouns (PPs) in LoRs written by Ghanaian academics. A specialized corpus of LoR, totalling approximately twenty thousand (20, 000) running words was created for this study. The concordance tool in AntConc (v. 3.2.4.) was employed to search for all instances of PPs in the corpus. The concordance lines were manually examined to determine the referents of the PPs. The study revealed the diversity of PP resources in LoRs. It was also found that the PPs were mainly recommender-oriented, recommendee-oriented, or requester-oriented, culminating in a proposed model of discourse-internal and external participants in LoRs. Again, the study revealed that LoR is typified by singular PPs, reflecting the fact that it is mainly authored by an individual for an individual. The findings have implications for the pragmatics of PPs and the scholarship on LoR. It is thus recommended that an intercultural study of LoR be undertaken to establish variations in the use of personal pronouns. Keywords: Corpus Linguistics, L2 Context, Letter of recommendation, English for Specific Purposes

Navigating the Neurosurgery Match Process: Insights from the National Resident Matching Program – Program Director Surveys

ObjectiveNeurosurgery is one of the most competitive specialties and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program (NRMP) Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties. MethodsWe evaluated seven surveys administered from 2012 to 2022. Six biennial surveys reported on factors influencing interview and ranking processes, while all seven surveys included data about the program director (PD)’s attitude towards USMLE test scores. ResultsThe response rate of PDs decreased over the years. The most cited for interviews included specialty-specific recommendation letters (95%), USMLE Step 1 scores (91%), and interest in research (78%). A recent decline in emphasis on USMLE Step 1 scores coincided with a growing reliance on USMLE Step 2 scores. Award in basic science held significant esteem to a subset of programs. Personal characteristics dominated for ranking, with faculty interaction (89%), interpersonal skills (89%), and house staff interaction (85%) being the most important. Yet, PDs reported a difficulty in assessing interpersonal skills through virtual interviews. ConclusionOur analysis revealed the pervasive importance of specialized endorsements and academic achievements when screening applicants for the interview process. A shift in emphasis towards the USMLE step 2 became apparent. Personal characteristics, on the other hand, seemed crucial to make a match and rank high among the pool of interviewed applicants. We uncovered difficulties in assessing these characteristics through virtual interviews.

Cracking the code: interpreting content and phrases used in maternal-fetal medicine fellowship letters of recommendation

BackgroundLetters of recommendation for Maternal-Fetal Medicine(MFM) fellowship are a critical part of the applicant selection process. However, data regarding best practices for how to write LOR for MFM is limited. Similarly, within letters of recommendation, differences in the “code” or meaning of summative words/phrases used at the end of letters of recommendation are seen between surgery, pediatrics, and medicine. However, data regarding code MFM Letters of recommendation are quite limited. ObjectiveWe sought to describe what Maternal-Fetal Medicine program directors value in letters of recommendation for fellowship applicants and how PDs interpret commonly used summative words/phrases. Study DesignAfter IRB exemption, subject matter experts developed an e-survey querying the importance of various letters of recommendation “best practices” described by other specialties. Content and face validation were performed prior to dissemination. This cross-sectional survey was administered to MFM program directors in February 2023. The primary outcome was the relative importance of letters of recommendation content areas. Secondary outcomes included the strength of each summative “code” phrase. Descriptive analysis was performed and principal component analysis (PCA) was then used to reduce the list of phrases to their underlying dimensions. Statistical analysis was performed by SPSS 29.0. ResultsOf 104 MFM program directors sent the survey, 70 (67%) responded. MFM program directors reviewed an average of 78 applications (SD, 30) with 60% writing ≥3 letters/year. Ninety-one percent of respondents noted that letters of recommendation are important/very important in shaping impressions of an applicant. Respondents reported the depth of interaction with an applicant, the applicant's specific behavior traits, the applicant's abilities and a summative statement including strength of the recommendation as important content for MFM fellowship letters of recommendation. Letter length, use of bold/italics, and restating the applicant's curriculum vitae were considered not important. Following PCA with varimax rotation, 14 specific phrases used in letters of recommendation were reduced to 5 themes: high qualitative assessments, average qualitative assessments, objective metrics, exceeding expectations and grit. These themes accounted for 64.6% of the variance in the model (KMO 0.7, Bartlett's Test of Sphericity p<.01). Phrases that respondents considered positive included: “Top 5%,” “Want to keep,” and “highest recommendation,” (all mean score≥4.5/5), while “expected level,” “showed improvement,” and “2nd quartile” were negatively associated code words (all mean score <2.5/5). ConclusionMFM program directors reported that descriptions of an applicant's abilities, behavior traits, and depth of the writer's interactions with the applicant were all important components of an MFM fellowship letters of recommendation. Letter length, bold/italics, and highlights from the CV were not important. A clear “code” emerged regarding summative phrases included in letters of recommendation. Dissemination of these data might help less experienced letter writers send a clearer message and ensure all letter writers have a shared mental model.

Should my recommendation letter be written by artificial intelligence?

Should my recommendation letter be written by artificial intelligence?

SIPMAMA ( SISTEM INFORMASI PELAYANAN ADMINISTRASI KELURAHAN ) PADA KANTOR LURAH MAYANG MANGURAI BERBASIS WEB

The sub-district office of Mayang Mangurai has administrative services, namely correspondence, the problem is that they are still using Microsoft Office Word with a copy paste system. In the process of requesting a letter, you need to come to the location directly and sometimes you must go back and forth several times to complete the letter. The purpose of this study is to assist and facilitate the population administration process at the Mayang Mangurai village office. The application is built using Visual Studio Code and XAMPP, using the PHP and MYSQL programming languages. This application produces information about the village activity program, profiles, the latest village news, and online letter writing services that can be accessed by residents in Mayang Mangurai Village. The input needs of this application are Administrators who fully manage Login Data, Admin Data, Population Data and Letter Data, Admin Login Process Needs, Resident Login and Letters, the output of this application is Certificate, Domicile Letter, Business Domicile Letter, Marriage Certificate N1, SITU recommendation letter and Certificate of Heirs.

Dear Program Director: An Evaluation of Implicit Bias in Letters of Recommendation for Neurosurgery Residency.

Despite comprising half of medical students, women represent only 29.6% of neurosurgery applicants and 17% of residents, suggesting a "leak" in the career pipeline for women neurosurgeons. Surveys persistently show that neurosurgery programs identify United States Medical Licensing Examination (USMLE®) Step 1 score and letters of recommendation (LORs) as the most important factors in selecting applicants to interview. A previous study in neurosurgery found no differences in LORs. However, multiple studies in other specialties have demonstrated implicit gender bias in LORs, which may influence resident selection. Our objective is to evaluate neurosurgery residency LORs for evidence of implicit gender bias. Retrospective analysis of LORs for interviewed neurosurgery applicants at a single institution during the 2014 to 2020 National Residency Matching Program (NRMP®) match cycles. Letters were evaluated using Linguistic Inquiry & Word Count (LIWC) software (Pennebaker Conglomerates), and additional applicant data were obtained from candidate applications. LIWC (Pennebaker Conglomerates) output data included custom dictionary categories and terms that were analyzed using Prism 10 and Rstudio. Two hundred eighteen applications were reviewed for a total of 827 letters. LIWC (Pennebaker Conglomerates) analysis showed significant differences in word count (331 vs 297, difference = 34, 95% CI: 9-61, P = .008). LORs for applicants who were men were more likely to mention Alpha Omega Alpha Honor Medical Society (1.17 vs 0.778, difference = 0.4, 95% CI: 0.13-0.67, P = .023). USMLE® Step 1 scores were significantly lower for women (241 vs 247, difference = 6, 95% CI: 2-10, P = .004). There was no significant difference between letters for men and women for all categories evaluated in the linguistic evaluation. LORs are vital to the neurosurgical residency application process. The data exhibit some differences between the men and women applicants but few differences in their LORs, consistent with the results of the previous neurosurgical study.

Concerns of osteopathic medical students during the COVID-19 pandemic.

This study aims to quantify the areas of most concern in medical students in relation to their residency application in the setting of the COVID-19 pandemic and to identify risk factors for all that cause concern and specific areas of concern in a population with well-established high rates of anxiety at baseline. The COVID-19 pandemic introduced sweeping changes to medical education that had wide-ranging effects on medical students and their applications for medical residencies. In August 2020, we utilized a cross-sectional study to quantify student's areas of concern related to residency application related to the COVID-19 pandemic. We asked participants to rate their levels of concern in 15 different aspects related to medical residency applications and the perceived impact that COVID-19 had on each. The survey was distributed to 984 osteopathic medical students, with 255 complete responses. The three areas of greatest impact were shadowing opportunities (4.15), volunteer opportunities (4.09), and conferencing opportunities (4.09). The most salient demographic variables were year in school, sex, and locale. Females reported higher levels of concern across all categories in the study compared to males, with statistical significance across all categories (all p<0.05, Range d=0.16 to 0.43), except for letters of recommendation and sub-internships. The areas of most concern identified in our study were consistent with prior studies and may implicate the pressures that female medical students may feel compared to their male counterparts. The underlying cause(s) may be subject to future research.

Factors associated with infectious diseases fellowship academic success

ABSTRACT Background A multitude of factors are considered in an infectious disease (ID) training program’s meticulous selection process of ID fellows but their correlation to pre and in-fellowship academic success as well as post-fellowship academic success and short-term outcomes is poorly understood. Our goal was to investigate factors associated with subsequent academic success in fellowship as well as post-fellowship short-term outcomes. Methods In 2022, we retrospectively analyzed deidentified academic records from 39 graduates of the Mayo Clinic Rochester ID Fellowship Program (1 July 2013- 30 June 2022). Data abstracted included demographics, degrees, honor society membership, visa/citizenship status, medical school, residency training program, United States Medical Licensure Exam (USMLE) scores, letters of recommendation, in-training examination (ITE) scores, fellowship track, academic rank, career choice, number of honors, awards, and abstracts/publications prior to fellowship, during training, and within 2 years of graduation. Results Younger fellows had higher USMLE step 1 scores, pre and in-fellowship scholarly productivity, and higher ITE performance. Female fellows had significantly higher USMLE step 3 scores. Prior research experience translated to greater in-fellowship scholarly productivity. Higher USMLE scores were associated with higher ID ITE performance during multiple years of fellowship, but USMLE step 2 clinical knowledge and 3 scores were associated with higher pre and in-fellowship scholarly productivity and receiving an award during fellowship. The USMLE step 1 score did not correlate with fellowship performance beyond year 1 and 2 ITE scores. Conclusions Multiple aspects of a prospective fellow’s application must be considered as part of a holistic review process for fellowship selection. USMLE step 2 CK and 3 scores may predict fellowship performance across multiple domains.

Policy variation in the external evaluation of research for tenure at U.S. universities

Abstract There is a robust literature documenting differences in peer review processes for scholarly outlets. Knowledge of this variability has provoked thoughtful debate about the best approach for promoting rigor and innovation in scientific research (e.g. single-blind vs. double-blind review, or more recently, double-blind vs. open review). We aim to expand this conversation to external peer review processes specified in rank and tenure guidelines. We qualitatively analyze a corpus of publicly available rank and tenure procedures at research-intensive universities in the United States. Results indicate significant variation in (1) the required minimum and maximum number of external reviews, (2) the candidate’s role in the reviewer selection process, (3) the level of ensured anonymity for reviewers, and (4) attention to potential conflict of interest scenarios. We argue that many of the debates about best practices in research evaluation for journals and funding agencies are also relevant for rank and tenure procedures. Moreover, rank and tenure policies may be subject to unique tensions, such as cases where external reviews are formally cast as disinterested assessments by referees but informally understood as letters of recommendation by sponsors. We discuss the relevance of our findings for existing work on the perceived clarity of evaluation criteria—especially how guideline ambiguity can be linked to inequality and how labor issues can conflict with idealized assessment principles.

Forecasting Futures: Predicting University Admissions with Machine Learning

The process of university admissions is inherently complex, often relying on various factors such as academic records, standardized test scores, extracurricular activities, recommendation letters, and personal statements. In recent years, machine learning (ML) techniques have shown promising results in predicting admission outcomes, aiding both prospective students and admissions committees in decision-making processes. Keywords: University admission, Machine learning, Predictive modelling, Classification, Regression, Data pre-processing.