Selection Training Research Articles

Recommendation Letter Language for Applicants Selected to Interview at Integrated Cardiothoracic Surgery Residency: A Qualitative Assessment by Gender

ObjectiveCardiothoracic (CT) surgery remains a male-dominated specialty. Letters of recommendation (LORs) influence trainee selection and are vulnerable to biases. We aimed to qualitatively assess differences in LORs to integrated residency based on applicant gender. MethodsLORs for applicants who interviewed at a single integrated CT residency program during one cycle were selected and pooled by applicant gender. Gendered and identifying references were redacted. Letters were analyzed by a thematic analysis approach and managed through NVivo software. Results30 LORs across eight male applicants and 43 LORs across 11 female applicants were analyzed. There was no noticeable difference between the frequency of positive attributes assigned to each gender. Research accomplishments was the most emphasized competency, with no gender-based difference identified. LORs for female applicants tended to be longer and include stronger positive adjectives. For male applicants, descriptions of external recognition were almost exclusively via mention of scholarships or research, whereas female applicants were more likely to receive word-of-mouth recognition. Letter writers often attested to male applicants’ commitment to cardiothoracic surgery, whereas female applicants received more commentary around effective patient care. ConclusionLetters for men tended to focus on research accolades and career commitment, while letters for women were longer and more likely to emphasize patient care or faculty endorsement. Future studies may discern whether this phenomenon reflects stronger applicant-writer relationships for female applicants, or a disadvantageous approach by letter writers for female applicants that relies on subjective rationale.

Critical Assessment of Fellowship Director Gender and Ethnic Diversity across the Five Major Plastic Surgery Fellowships.

Subspecialty fellowship directors are essential to the selection and mentorship of trainees. The purpose of this study is to evaluate the gender and racial/ethnic diversity of fellowship directors across fellowship programs in plastic and reconstructive surgery (PRS). In December 2023, listings of fellowship programs/directors were surveyed from respective professional society websites across the 5 primary PRS fellowships: hand (American Society for Surgery of the Hand), craniofacial (American Society of Craniofacial Surgeons), microsurgery (American Society for Reconstructive Microsurgery), aesthetic (The Aesthetic Society), and burn (American Burn Association). Fellowship director demographics from each program were researched and identified. In total, 248 fellowship directors were identified: 94 hand, 34 craniofacial, 62 microsurgery, 38 aesthetic, and 20 burn. There was a significantly greater percentage of male versus female directors across all fellowships (87.5% versus 12.5%; P < 0.01). Men were noted to have a significantly higher average h-index score (20.4 versus 15.0; P = 0.045) but constituted a lower proportion of assistant professorships (32.3% versus 12.9%; P < 0.01). Relative to directors from racial/ethnic minority backgrounds, White directors constituted a significantly greater percentage of fellowship directors (72.9% versus 27.1%; P < 0.01) and had a greater number of years passed since completing their most recent training (21.7 versus 17.1; P = 0.030). Across PRS fellowship programs, women and racial/ethnic minorities are disproportionately underrepresented in leadership. Targeted initiatives to promote diversity in PRS fellowship directors should be considered as medicine works toward a surgical workforce more reflective of the patient population.

Pointing to success: a discussion of the role of professional achievements in the selection of specialist surgical trainees

In Australia and New Zealand, competitive selection processes for surgical specialty training programs often use a standardized curriculum vitae (CV) to assess criteria such as professional achievements. This review aims to assess the predictive validity, standardization, and implicit biases of these selection methods, as well as their implications for trainees and the diversity of surgical cohorts. The 2023 CV scoring criteria were collected for all available specialty surgical programs in Australia and New Zealand. In 2023, each of the 11 surgical craft programs published publicly available standardized CV scoring criteria. In this study, scored items that constitute 'professional achievements' were recorded and tabulated. Observational analysis of the collected data was then conducted. In 2023, each of the 11 specialty surgical craft programs published publicly available structured CVs, of which 10/11 allocated points for professional achievements. Designated points for professional achievements were classified as awards, scholarships, committee positions, and prior training courses: 4/11 programs offered points for scholarships/grants, 6/11 programs offered points for academic and/or non-academic prizes, and 8/11 programs offered points for professional development courses. Observational analysis of these findings suggests that professional achievements are desired in training program applicants. Variability in medical school opportunities and inherent heterogeneity reduce the CV's efficacy, unfairly disadvantaging some applicants. Observational analysis of hence highlights the need for future research to assess potential updates in CV parameters to enhance predictive validity, reduce bias, and promote diversity.

High-stakes Technical Performance Assessments Across the Continuum of Surgical Training.

The aim of this article to outline proposals for the use of high stakes technical performance assessments, defined as assessments of technical skill that take place outside of the operating theatre, across the continuum of surgical training. Technological advancements have allowed for the assessment of operative technical skill outside of the workplace environment, developed and evaluated in line with modern concepts of assessment validity. With the introduction of competency-based education principles across surgical training curricula, increasing scrutiny is being placed on the validity and reliability of assessments used to inform high-stakes training decisions regarding selection, progression through training, autonomy granting and end-of-training certification. The role of performance assessments, conducted outside of the workplace environment, is yet to be fully established. This article discusses the use of high-stakes performance assessments across the continuum of surgical training, with reference to relevant theories of surgical skill acquisition and assessment, along with contemporary evidence from the performance science literature. Assessments of increasing professional authenticity are required across the continuum of surgical training. In an attempt to capture inherent ability rather than skill at the time of trainee selection, assessments should be of deliberately low levels of professional authenticity. Assessment in early surgical training should focus on ensuring competence in core surgical skills, and then assessing for canonical competence across a series of commonly encountered procedures. Baseline competence in these procedures should ideally be assessed prior to the transition to (supervised) lead operator, with a view to ensuring patient safety and improving the efficiency of in-theatre training. Assessment later in training relies more heavily on the workplace, with simulation offering a complimentary role in ensuring a minimum competency standard in procedures less likely to be encountered in the workplace. High-stakes performance assessments can play an important role as part of a programmatic approach to surgical training and certification. They can and should be designed with an appropriate level of professional authenticity to ensure adequate and appropriate representation of the assessment construct.

Does basic physician trainee selection predict successful progression in the Royal Australasian College of Physicians adult medicine training programme? A retrospective cohort study.

The optimal selection process for basic physician trainees (BPTs) is unclear. To assess an adult BPT selection process, including a standardised recruitment interview assessing clinical decision-making and situational judgement. A retrospective multi-year cohort study of applicants who were selected for interview during the annual recruitment for 2011-2015 clinical years in an adult basic physician training network in NSW. The predictive capacity of the final recruitment assessment score was compared with success in the Royal Australasian College of Physicians (RACP) adult medicine clinical examination within 2 years. Four hundred thirty-six applicants were selected for interview (84-91 in each year). Summary mean post-interview scores ranged from 1.25 to 10, with the median ranging between 7 and 8. Median scores were higher in those who passed the examination than those who did not (7.75 vs 6.43, P < 0.0001). Those who did not sit for the examination in the relevant year or never sat for the examination had similar median scores (7 vs 6.75, P = 0.11). Those not deemed eligible for recruitment were less likely to pass the clinical examination within 2 years than those on the eligibility list (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.25-0.57). Applicants with mean scores lower than 8 were less likely to pass than those in the top band (8.1-10); scores between 6.1 and 8 OR 0.42 (95% CI = 0.26-0.68), 4.1-6 OR 0.23 (95% CI = 0.13-0.41) and 2.1-4 OR 0.24 (95% CI = 0.10-0.60). The predictive capacity of the selection process for success in the RACP clinical examination within the minimum time period is high.

A scoping review of Fit in medical education: a guaranteed success, or a threat to inclusivity?

Finding applicants that fit in with educational environments is a goal of many educators in hopes that it will lead to successful training. "Fit" is used colloquially to describe a general feeling, however the field of study has grown to include specific terms describing the compatibility between people and their environments, organizations, and jobs. Despite common use, the term is used often but non-specifically in medical education. This review aims to examine the current literature of fit in medical education, how fit is defined, measured and whether it correlates to educational outcomes. A systematic database search was conducted in 2024 with Medline, Embase, APA PsychINFO, ERIC and Education Source from 1970 to April 23, 2024. Key search terms included fit, student, medicine, clinical, education. Relevant data included definitions of fit, measurement tools, and correlation with educational outcomes. The standard six-step scoping review framework and PRISMA-ScR reporting guidelines were used. The search identified 1960 non-duplicate articles, 11 of which were included in the review after screening. Fit was specifically defined in only three articles and was measured primarily through personality and value testing with interviews and surveys. Educational outcomes correlated positively with fit, however were studied in just three articles. Person-organization fit may correlate positively with medical education outcomes however there is limited research in this field. Further research should explore methods in evaluating for fit in trainee selection while focusing on the risk of discrimination based on intrinsic biases.

Reviewing the Forgotten Classes for Domain Adaptation of Black-Box Predictors

For addressing the data privacy and portability issues of domain adaptation, Domain Adaptation of Black-box Predictors (DABP) aims to adapt a black-box source model to an unlabeled target domain without accessing both the source-domain data and details of the source model. Although existing DABP approaches based on knowledge distillation (KD) have achieved promising results, we experimentally find that these methods all have the minority class forgetting issue, which refers that the trained model completely forgets some minority classes. To address this issue, we propose a method called Reviewing the Forgotten Classes (RFC), which including two main modules. Firstly, we propose a simple but effective component called selection training (ST). ST selects classes that the model tends to forget according to the learning status of the model and obtains clean samples of the selected classes with the small-loss criterion for enhanced training. ST is orthogonal to previous methods and can effectively alleviate their minority class forgetting issue. Secondly, we find that neighborhood clustering (NC) can help the model learn more balanced than KD so that further alleviate the minority class forgetting issue. However, NC is based on the fact that target features from the source model already form some semantic structure, while DABP is unable to obtain the source model. Thus, we use KD and ST to warm up the target model to form a certain semantic structure. Overall, our method inherits the merits of both ST and NC, and achieves state of the art on three DABP benchmarks.

Review of Māori equity in surgical trainee selection.

The Royal Australasian College of Surgeons (RACS) aims to achieve Māori health equity and cultural safety within the surgical workforce. The RACS Māori Health Strategy and Action Plans encourage Surgical Education and Training (SET) selection criteria that recognizes and credit applicants who identify as Māori or demonstrate competence in Māori health issues. This study investigates the current SET selection criteria for Māori entering surgical specialties. The selection criteria for each surgical speciality for the proposed 2024 intake were examined through a documentary analysis. Criteria were reviewed for applicability to Māori identification and/or cultural competency. Criteria related to Māori identification and/or cultural competency make up 6%, 2%, and 1.5% of Otolaryngology and Head and Neck, General, and Vascular Surgery total SET selection score respectively. Criteria related to Māori identification and/or cultural competency make up 9% and 0.1% of Orthopaedic and Plastics and Reconstructive Surgery ranking scores for interview eligibility respectively. Cardiothoracic Surgery, Paediatric Surgery, Neurosurgery and Urology specialties do not incorporate any criteria appertaining to Māori. Allocation of research-related points determined by authorship may disincentivize Māori trainees. Some surgical specialties fail to recognize or credit Māori identification and cultural competency in SET selection criteria. There is a need for regular auditing to ensure SET criteria align with the RACS aspirations for Māori health equity and cultural safety within the surgical workforce.

Trainee selection; moving to evidence-based processes

Trainee selection; moving to evidence-based processes

The Role of Trainee Selection in the Effectiveness of Vocational Training: Evidence from a Randomized Controlled Trial in Nepal

The Role of Trainee Selection in the Effectiveness of Vocational Training: Evidence from a Randomized Controlled Trial in Nepal

IMPLEMENTASI METODE SIMPLE ADDITIVE WEIGHTING (SAW) UNTUK SISTEM REKOMENDASI SELEKSI PESERTA PELATIHAN CEMPOR DISPORA KOTA BANDUNG

The utilization of information technology has become a positive trend. Its usefulness is not only as a medium of information or concerning business, but information technology has also been used by agencies or organizations. An agency or organization has begun to use technology as a tool that can help management in making a decision where the decision is very important to do. The CEMPOR Dispora Bandung City organization when selecting trainees still uses a manual method by filling in the criteria filled in by the committee. This method only relies on assessments made in the field. A recommendation system must be created to assist the Cempor Dispora committee in determining the selected trainees for the next training session in a more systematic and structured manner. This will help the company make decisions. This research recommendation system selects trainees using the Simple Additive Weighting (SAW) method to evaluate the accuracy of the method. Calculating the number of participants' average scores for this training activity and speeding up the participant selection process are the capabilities of this web-based trainee selection recommendation system. As a result of Confusion Matrix Testing, the system has an accuracy of 95.00%.

Entrepreneurship training: Why trainee selection is as vital as training design and delivery

Entrepreneurship training: Why trainee selection is as vital as training design and delivery

Educator's blueprint: Holistic applicant file review in undergraduate and postgraduate medical education.

Medical schools and graduate medical education programs are tasked each year with selecting the next class of trainees, often from large applicant pools with enormous quantities of data to be processed. Review of applicant files must therefore be efficient, equitable, and effective in maximizing the likelihood of trainee success and alignment with institutional missions and values. In this article, we discuss 10 strategies to optimize the file review process for trainee selection. Using these strategies, educators can ensure rigorous and accountable file review processes for their training programs.

Evaluasi Program Magang Oleh Training Section Dalam Meningkatkan Kinerja Trainee Di Royal Ambarrukmo Yogyakarta

Various strategies and activities carried out by the Human Resources Department (HRD) to enhance Trainee performance during the internship program, such as appropriate Trainee selection, development of suitable training programs, monitoring and evaluation of Trainee performance, and the establishment of a sustainable internship program, can be the focus of this final project. Additionally, it can also discuss the impact of the internship program and the role of the Training Section in creating a conducive work environment for Trainees to contribute maximally to the companyThis research utilizes a qualitative method with data collection through interviews and questionnaires. The researcher will distribute several questionnaires to the Trainees and conduct interviews with the Training Section. Purposive sampling is employed in this study, where 10 Trainees from each department will be intentionally selected to represent their respective departments. The total sample obtained is 40 out of a population of 128.After conducting questionnaires, interviews, and observations with 40 Trainees, the three main components of the internship program that can enhance Trainee performance are job description, training and development programs, and performance monitoring and evaluation. The Trainee's performance is assessed based on 10 components, with the highest being improvement achieved and the lowest being initiatives.

Trainee selection of tasks in postgraduate medical education: Is there a role for 'cherry-picking' to optimise learning?

Learning is optimised when postgraduate trainees engage in clinical tasks in their zone of proximal development (ZPD). However, workplace learning environments impose additional non-learning goals and additional tasks that may lead to trainees engaging in tasks that do not fall within their ZPD. We do not fully understand how trainees select clinical tasks in the workplace learning environment. If we knew the goals and factors they consider when selecting a task, we could better equip trainees with strategies to select tasks that maximise learning. We explored how postgraduate trainees select clinical tasks using echocardiography interpretation as a model. Canadian General Cardiology residents and Echocardiography fellows were invited to participate in semi-structured interviews. Aligning with a theory-informed study, two independent researchers used a deductive, directed content analysis approach to identify codes and themes. Eleven trainees from seven Canadian universities participated (PGY4 =4, PGY5 =3, PGY6 =1 and echocardiography fellows =3). Goals included learning content, fulfilling assessment criteria and contributing to clinical demands. Trainees switched between goals throughout the day, as it was too effortful for them to engage in tasks within their ZPD at all times. When trainees had sufficient mental effort available, they selected higher complexity tasks that could advance learning content. When available mental effort was low, trainees selected less complex tasks that fulfilled numerically based assessment goals or contributed to clinical demands. Trainees predominantly used perceived complexity of the echocardiogram as a factor to select tasks to achieve their desired goals. Postgraduate trainees select tasks within their ZPD that enable them to maximise learning when they perceive to have sufficient mental effort available and workplace affordances are adequate. These findings can inform individual and systemic strategies to maximise learning when selecting tasks.

USMLE Step 2 CK Scores and Radiology Residency Applications: Does it Affect Diversity in Selection of Trainees?

As residency programs in diagnostic radiology aspire to broaden trainee diversity, reliance on certain criteria may affect the selection of candidates from underrepresented groups. With the conversion of reporting of the United States Medical Licensing Examination (USMLE) Step 1 scores to pass/fail, programs may rely more on numerical USMLE Step 2 Clinical Knowledge (CK) scores. The purpose of our investigation is to assess the effects of Step 2 CK scores on the selection of underrepresented minority (URM) and female candidates. Applications from United States senior allopathic medical students to a radiology residency program from the 2021-2023 National Residency Matching Program cycles were analyzed. Subjects were classified as male or female and URM or non-URM by self-identification. Step 2 CK scores were compared and the use of cutoff scores was examined for disparate effects. 1017 subjects fulfilled the entry criteria. There were 721 males and 296 females, with 164 URM and 853 non-URM candidates. Comparing males to females, there was no significant difference in the mean score (p=0.21) and no disparate effects of cutoff scores. There was a significant difference between the mean score of URM versus non-URM candidates of eight points (p<0.00011). The use of cutoffs showed a disparate effect on URM candidates with a cutoff score of 250 (average score for 2022 matched applicants) excluding 71% of URM candidates while excluding only 46% of non-URM candidates. Reliance on USMLE Step 2 CK scores to screen applications for radiology residency can disadvantage URM candidates. Females are not adversely affected.

'Selection into training will always be an inexact process': A survey of Directors of Physician Education on selection into Basic Physician Training in Australia and New Zealand.

Despite being one of the largest medical specialty training programmes in Australasia, there is no standardised method for selection into Basic Physician Training (BPT), and limited data exist regarding current practices. To address existing knowledge gaps, we aimed to create a 'snapshot' of current BPT selection practices and explore the perspectives of Directors of Physician Education (DPEs) regarding trainee selection. An electronic survey of DPEs from adult and paediatric medicine BPT sites in Australia and New Zealand was undertaken in January-February 2022. A combination of free text, multiple-choice and yes/no answers were analysed using descriptive statistics and qualitative content analysis. A total of 70 responses were received, achieving a response rate of 35% (70/198). Selection practices were found to be heterogenous across BPT sites. Respondents had varying opinions regarding the utility of selection tools and desirable candidate attributes. A heavy reliance upon interviews and the reported use of subjective assessments raise concerns for selection process bias. BPT sites should critically evaluate their selection methods, and more research in this field is needed to establish best practice.

Supervising and supporting trainees with disabilities in the Veterans Administration Healthcare System: An overlooked but critical need and opportunity.

Trainees with disabilities are chronically underrepresented in psychology and face many barriers throughout their training. Directors of Clinical Training and supervisors within the Veterans Administration Healthcare System (VAHCS), one of the largest employers of trainees with disabilities, have a unique opportunity to address this area of critical need. However, they must first understand the barriers facing psychology trainees with disabilities in VAHCS settings, including discrimination in trainee selection, barriers to obtaining reasonable accommodations, and attitudinal and cultural barriers. In this article, we illustrate how those barriers may present in VAHCS settings specifically and provide suggestions and frameworks for how the VAHCS can create accessible, disability-affirmative training environments in which trainees can truly thrive. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Who will excel in advanced endoscopy? A study assessing the criteria and perceptions of experts with regard to selection of ERCP and EUS trainees.

Background and study aims Training program directors (TPDs) and experts play a crucial role in selecting ERCP/EUS trainees and determining the workforce in endoscopy. Additionally, prospective trainees should know what TPDs/experts expect from them. Nonetheless, the criteria and perceptions used in this selection have not been clarified. The aim of this study was to identify TPD/expert values/beliefs regarding personal attributes needed for selecting trainees that can excel and those which may lead to disqualification; compare perspectives between TPDs/experts and trainees regarding the selection process and critical trainee characteristics; and investigate the general approach and satisfaction regarding current application process for ERCP/EUS training. Methods We conducted a web-based survey to collect general opinion and data regarding the application process and trainee selection and disqualification from training. European TPDs/experts and trainees were invited to participate. Results Thirty-six TPDs/experts and 25 trainees from 18 countries responded. The application process is mainly driven by individual request (86.1 %). Almost half of TPDs/experts felt only moderately (38.9 %) to slightly (8.3 %) satisfied with the current application process. TPDs/experts value a diversity of trainee characteristics, but mainly traits such as "honesty," "being a team player," and "self-awareness" (72.2 % each). Technical skills ranked seventh as considered "extremely important." "Disregard for patient welfare" and "lack of work ethic" were the most common reasons for disqualification. TPDs/experts and trainees agreed in most questions. Conclusions This survey outlines trainee selection criteria for ERCP/EUS training. Non-technical skills are the most valued by TPDs/experts. While knowledge and technical expertise are clearly important, understanding that professional attitudes are highly regarded may help direct the application process more effectively.

Perspectives on simulation-based assessment of operative skill in surgical training

Introduction The perspectives of the wider surgical community toward simulation-based assessment (SBA) in training is a gap in the literature. This study aims to explore the factors associated with the acceptable use of SBA in surgical training, through the perceptions and experiences of a broad range of stakeholder representatives, building on findings from a review of the published literature. Materials and methods Ten semi-structured interviews were conducted, using a sequential transformative qualitative methods approach, with representatives from identified key stakeholder groups; executive management, risk management, a practicing surgeon, an anaesthesiologist, a theatre-nursing representative, a representative from simulation industry, a patient, a medical student, a junior surgical trainee, and a senior surgical trainee. Interview transcripts underwent reflexive thematic analysis using an inductive and constructivist framework (NVIVO software, NVIVO 12, QSR International). Results Four themes emerged: the ‘need’ for SBA, the concept of a ‘minimum standard’, the ‘optimum design’ of an SBA framework, and ‘fairness’. SBA is a potential solution to challenges in the current training environment. It emerged that it should not replace trainer judgement, but could ensure that trainees meet a minimum operative competency standard. SBA should be used to identify underperforming trainees early in training to provide targeted remediation. The application of SBA in high-stakes settings such as trainee selection, autonomy granting, and end-of training certification has perceived benefits over current assessment methods. Conclusions This study builds on findings from prior research to explore factors regarding the acceptable use of simulation as an assessment method in surgical training, including perspectives from a broad range of stakeholder representatives. Findings can inform the development of simulation-based assessment curricula in surgical training.