Still under the microscope: can a surgical aptitude test predict otolaryngology resident performance?

OBJECTIVES/HYPOTHESIS: Application to otolaryngology-head and neck surgery residency is highly competitive, and the interview process strives to select qualified applicants with a high aptitude for the specialty. Commonly employed criteria for applicant selection have failed to show correlation with proficiency during residency training. We evaluate the correlation between the results of a surgical aptitude test administered to otolaryngology resident applicants and their performance during residency.

STUDY DESIGN

Retrospective study at an academic otolaryngology-head and neck surgery residency program.

METHODS

Between 2007 and 2013, 224 resident applicants participated in a previously described surgical aptitude test administered at a microvascular surgical station. The composite score and attitudinal scores for 24 consecutive residents who matched at our institution were recorded, and their residency performance was analyzed by faculty survey on a five-point scale. The composite and attitudinal scores were analyzed for correlation with residency performance score by regression analysis.

RESULTS

Twenty-four residents were evaluated for overall quality as a clinician by eight faculty members who were blinded to the results of surgical aptitude testing. The results of these surveys showed good inter-rater reliability. Both the overall aptitude test scores and the subset attitudinal score showed reliability in predicting performance during residency training.

CONCLUSIONS

The goal of the residency selection process is to evaluate the candidate's potential for success in residency and beyond. The results of this study suggest that a simple-to-administer clinical skills test may have predictive value for success in residency and clinician quality.

LEVEL OF EVIDENCE