a Primary Care and Medical Education, Sydney Medical School , University of Sydney , New South Wales , Australia.
b The Royal Australasian College of Physicians , New South Wales , Australia.
Med Teach. 2018 Jan;40(1):3-19. doi: 10.1080/0142159X.2017.1367375. Epub 2017 Aug 28.
Selection into specialty training is a high-stakes and resource-intensive process. While substantial literature exists on selection into medical schools, and there are individual studies in postgraduate settings, there seems to be paucity of evidence concerning selection systems and the utility of selection tools in postgraduate training environments.
To explore, analyze and synthesize the evidence related to selection into postgraduate medical specialty training.
Core bibliographic databases including PubMed; Ovid Medline; Embase, CINAHL; ERIC and PsycINFO were searched, and a total of 2640 abstracts were retrieved. After removing duplicates and screening against the inclusion criteria, 202 full papers were coded, of which 116 were included.
Gaps in underlying selection frameworks were illuminated. Frameworks defined by locally derived selection criteria, and heavily weighed on academic parameters seem to be giving way to the evidencing of competency-based selection approaches in some settings. Regarding selection tools, we found favorable psychometric evidence for multiple mini-interviews, situational judgment tests and clinical problem-solving tests, although the bulk of evidence was mostly limited to the United Kingdom. The evidence around the robustness of curriculum vitae, letters of recommendation and personal statements was equivocal. The findings on the predictors of past performance were limited to academic criteria with paucity of long-term evaluations. The evidence around nonacademic criteria was inadequate to make an informed judgment.
While much has been gained in understanding the utility of individual selection methods, though the evidence around many of them is equivocal, the underlying theoretical and conceptual frameworks for designing holistic and equitable selection systems are yet to be developed.
专业培训的选拔是一个高风险和资源密集型的过程。虽然关于医学院校的选拔有大量文献，并且在研究生阶段也有个别研究，但关于研究生培训环境中的选拔系统和选拔工具的效用似乎证据不足。
探讨、分析和综合与研究生医学专业培训选拔相关的证据。
核心书目数据库包括 PubMed；Ovid Medline；Embase、CINAHL；ERIC 和 PsycINFO 进行了检索，共检索到 2640 篇摘要。在去除重复项并根据纳入标准进行筛选后，对 202 篇全文进行了编码，其中 116 篇被纳入。
揭示了潜在选拔框架中的差距。由本地衍生的选拔标准定义的框架，并且在很大程度上侧重于学术参数，似乎正在让位于一些环境中基于能力的选拔方法的证据。关于选拔工具，我们发现多种迷你面试、情景判断测试和临床问题解决测试具有良好的心理测量学证据，尽管大部分证据主要限于英国。关于简历、推荐信和个人陈述的稳健性的证据存在争议。过去表现的预测因素的证据仅限于学术标准，缺乏长期评估。关于非学术标准的证据不足，无法做出明智的判断。
虽然在理解个别选拔方法的效用方面已经取得了很大进展，但尽管其中许多方法的证据存在争议，但尚未制定用于设计整体和公平的选拔系统的潜在理论和概念框架。
