Zuckerman Scott L, Kelly Patrick D, Dewan Michael C, Morone Peter J, Yengo-Kahn Aaron M, Magarik Jordan A, Baticulon Ronnie E, Zusman Edie E, Solomon Gary S, Wellons John C
Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
World Neurosurg. 2018 Feb;110:475-484.e10. doi: 10.1016/j.wneu.2017.11.078. Epub 2017 Nov 23.
Neurosurgical educators strive to identify the best applicants, yet formal study of resident selection has proved difficult. We conducted a systematic review to answer the following question: What objective and subjective preresidency factors predict resident success?
PubMed, ProQuest, Embase, and the CINAHL databases were queried from 1952 to 2015 for literature reporting the impact of preresidency factors (PRFs) on outcomes of residency success (RS), among neurosurgery and all surgical subspecialties. Due to heterogeneity of specialties and outcomes, a qualitative summary and heat map of significant findings were constructed.
From 1489 studies, 21 articles met inclusion criteria, which evaluated 1276 resident applicants across five surgical subspecialties. No neurosurgical studies met the inclusion criteria. Common objective PRFs included standardized testing (76%), medical school performance (48%), and Alpha Omega Alpha (43%). Common subjective PRFs included aggregate rank scores (57%), letters of recommendation (38%), research (33%), interviews (19%), and athletic or musical talent (19%). Outcomes of RS included faculty evaluations, in-training/board exams, chief resident status, and research productivity. Among objective factors, standardized test scores correlated well with in-training/board examinations but poorly correlated with faculty evaluations. Among subjective factors, aggregate rank scores, letters of recommendation, and athletic or musical talent demonstrated moderate correlation with faculty evaluations.
Standardized testing most strongly correlated with future examination performance but correlated poorly with faculty evaluations. Moderate predictors of faculty evaluations were aggregate rank scores, letters of recommendation, and athletic or musical talent. The ability to predict success of neurosurgical residents using an evidence-based approach is limited, and few factors have correlated with future resident performance. Given the importance of recruitment to the greater field of neurosurgery, these data provide support for a national, prospective effort to improve the study of neurosurgery resident selection.
神经外科教育工作者努力挑选最优秀的申请者，但事实证明，对住院医师选拔进行正式研究颇具难度。我们开展了一项系统综述，以回答以下问题：哪些客观和主观的住院前因素能够预测住院医师的成功？
检索了1952年至2015年期间的PubMed、ProQuest、Embase和CINAHL数据库，查找有关神经外科及所有外科亚专业中住院前因素（PRF）对住院医师成功结局（RS）影响的文献。由于专业和结局的异质性，构建了显著发现的定性总结和热图。
从1489项研究中，有21篇文章符合纳入标准，这些文章评估了五个外科亚专业的1276名住院医师申请者。没有神经外科研究符合纳入标准。常见的客观PRF包括标准化测试（76%）、医学院表现（48%）和阿尔法欧米伽阿尔法荣誉学会会员身份（43%）。常见的主观PRF包括综合排名分数（57%）、推荐信（38%）、研究（33%）、面试（19%）以及体育或音乐天赋（19%）。RS的结局包括教员评价、培训期间/资格考试、总住院医师身份以及研究产出。在客观因素中，标准化测试分数与培训期间/资格考试相关性良好，但与教员评价相关性较差。在主观因素中，综合排名分数、推荐信以及体育或音乐天赋与教员评价呈中等相关性。
标准化测试与未来考试成绩相关性最强，但与教员评价相关性较差。教员评价的中等预测因素是综合排名分数、推荐信以及体育或音乐天赋。采用循证方法预测神经外科住院医师成功的能力有限，且很少有因素与未来住院医师表现相关。鉴于招聘对神经外科更广泛领域的重要性，这些数据为开展全国性、前瞻性的努力以改进神经外科住院医师选拔研究提供了支持。
