Mini Surgical Simulation, Role Play, and Group and Behavioral Interviews in Resident Selection

Dotun Ogunyemi; Carolyn Alexander; Edward Tangchitnob; David Seil Kim

摘要

Background?A robust selection process is critical to residents' “cultural fit” and success in their program. Traditional selection methods have shortcomings.;Objective?We describe a novel residency interview process for obstetrics-gynecology residents that incorporates behavioral, group, and surgical simulation multiple mini interviews (MMIs).;Methods?In 2010, the Cedars-Sinai Medical Center obstetrics-gynecology residency program developed surgical simulation, role play, ethics group interview, and Accreditation Council for Graduate Medical Education competency-based behavioral interview stations.;Results?From 2010 to 2012, a total of 199 applicants were interviewed, 62 ranked in the top 20, and 18 matched into the program. The MMI scores for interview stations were used in compiling our rank list and were found to adequately differentiate candidates. The MMI mean scores for role play, ethics interview, surgical simulation, and the behavioral interview for the top 20 ranked candidates were statistically significantly higher than those for other applicants. Standardized tests minimally correlated with various interview modalities. Applicants found the interview process acceptable. Implementing these MMI stations increased the total applicant interview time for the day by 15% (from 5.5 to 6.5 hours) and increased the face-to-face interview time from 2 to 4 hours. Approximately 42 hours of coordinator time was required for the yearly interview cycle.;Conclusions?A multifaceted interview process utilizing MMI, group interview, and surgical simulation MMI is feasible and acceptable. The approach may decrease subjectivity and reliance on traditional interview methods and facilitate the selection of “compatible” residents into the program.;What was known and gap Traditional resident selection processes have focused on intellectual attainment and may have undervalued other important attributes and elements of “cultural fit.”;What is new A multiple mini interview (MMI) for resident selection, including surgical simulation, role play, and behavioral interview stations.;Limitations Single program study limits generalizability; interview stations and survey tools lack validity evidence.;Bottom line The MMI reduces subjectivity and reliance on standardized scores and increases selection based on cultural fit.;Introduction The traditional resident selection processes rely on curricula vitae, United States Medical Licensing Examination (USMLE) scores, letters of recommendation, and personal interviews. However, residents' success in their training program is based on “cultural fit” within the institution, trainability on the Accreditation Council for Graduate Medical Education (ACGME) competencies, sound judgment, and the ability to work in teams. Inherent problems of traditional interviews are the variability in the interviewers' communication skills, bias, tolerance, and personality.1–5 Many studies have shown that traditional interviews have poor interrater reliability and perceived gender and cultural bias, with inadequate reliability and questionable validity.1–6 The multiple mini interview (MMI) is a standardized, validated selection process that consists of several stations, each of which assesses different aspects of the applicants; the MMI is used in medical schools in Canada and has spread to other nations.1–8 The behavioral format utilizes questions that relate to past behaviors and performance as a way to identify latent professionalism characteristics, and this approach is predictive of future behavior.9 To identify desirable attributes in residency applicants (cultural fit, communication skills, teamwork, trainability, and professionalism), we developed a multifaceted interview process. Our objective is to describe this novel MMI that incorporates (1) an ACGME competency-based behavioral interview; (2) an ethics group interview; (3) role play; and (4) surgical simulation. Our hypothesis is that a competency-based MMI process,

机译：背景？强大的选择过程对居民的“文化适应性”和项目成功与否至关重要。传统的选择方法有缺点。;目的：我们描述一种结合了行为，小组和手术模拟多次迷你面试（MMI）的，面向妇产科居民的新型住院医师面试过程。方法：2010年，锡达斯-西奈医学中心产科-妇科住院医师程序开发了手术模拟，角色扮演，道德操守面试，以及基于研究生医学教育胜任力的行为面试站认可委员会;;结果？2010年至2012年，共有199名申请人接受了采访，其中62名位居榜首20和18相匹配的程序。面试站的MMI分数被用于编制我们的排名列表，并且被发现可以充分区分候选人。在排名前20位的候选人中，MMI的角色扮演，道德面试，手术模拟和行为面试平均得分在统计学上显着高于其他申请人。标准化测试与各种面试方式的相关性最低。申请人认为面试过程可以接受。实施这些MMI工作站将当天的申请人总面试时间增加了15％（从5.5小时增加到6.5小时），而面对面面试时间也从2小时增加到4小时。年度面试周期大约需要42个小时的协调员时间。结论：利用MMI，小组面试和手术模拟MMI进行多方面面试的过程是可行且可以接受的。这种方法可能会降低主观性和对传统面试方法的依赖，并有助于选择“合适的”居民进入该计划。;已知的问题和差距传统的居民选拔过程侧重于智力素养，并且可能低估了“ “什么是新的？居民选择的多重迷你访谈（MMI），包括手术模拟，角色扮演和行为访谈站。”局限性单项计划研究限制了推广性;访谈站和调查工具缺乏有效性证据。;底线MMI降低了主观性和对标准化评分的依赖，并增加了基于文化适应度的选择。简介传统的居民选择过程依赖于履历，美国医学许可考试（USMLE）评分，推荐信和个人访谈。但是，居民在培训计划中的成功取决于机构内部的“文化契合度”，对研究生医学教育认可委员会（ACGME）能力的可培训性，明智的判断以及团队合作的能力。传统访谈的内在问题是访谈者的沟通技巧，偏见，宽容和个性方面的差异。1-5[5]许多研究表明，传统访谈的人际信度差，性别和文化偏见低，信度和效度不足。 1–6多次迷你面试（MMI）是经过标准化且经过验证的甄选过程，由多个工作站组成，每个工作站都会评估申请人的不同方面; MMI在加拿大的医学院校中使用，并已传播到其他国家。1-8行为形式利用与过去的行为和表现相关的问题来识别潜在的专业特征，这种方法可以预测未来的行为。9为了确定驻地申请人的理想属性（文化适应性，沟通技巧，团队合作，可培训性和专业精神），我们开发了多方面的面试过程。我们的目标是描述这种新颖的MMI，其中包括：（1）ACGME基于能力的行为面试; （2）道德团体访谈; （3）角色扮演; （4）手术模拟。我们的假设是基于能力的MMI流程，

Mini Surgical Simulation, Role Play, and Group and Behavioral Interviews in Resident Selection

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