F.E. Gallahue is associate professor and director, Department of Emergency Medicine, University of Washington, Seattle, Washington.
N.M. Deiorio is associate dean for student affairs and professor, Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Acad Med. 2020 Nov;95(11):1639-1642. doi: 10.1097/ACM.0000000000003573.
Calls to change the residency selection process have increased in recent years, with many focusing on the need for holistic review and alternatives to academic metrics. One aspect of applicant performance to consider in holistic review is proficiency in behavioral competencies. The Association of American Medical Colleges (AAMC) developed the AAMC Standardized Video Interview (SVI), an online, asynchronous video interview that assesses applicants' knowledge of professionalism and their interpersonal and communication skills. The AAMC worked with the emergency medicine community to pilot the SVI. Data from 4 years of research (Electronic Residency Application Service [ERAS] 2017-2020 cycles) show the SVI is a reliable, valid assessment of these behavioral competencies. It provides information not available in the ERAS application packet, and it does not disadvantage individuals or groups. Yet despite the SVI's psychometric properties, the AAMC elected not to renew or expand the pilot in residency selection.In this Invited Commentary, the authors share lessons learned from the AAMC SVI project about introducing a new tool for use in residency selection. They recommend that future projects endeavoring to find ways to support holistic review engage all stakeholders from the start; communicate the value of the new tool early and often; make direct comparisons with existing tools; give new tools time and space to succeed; strike a balance between early adopters and broad participation; help stakeholders understand the limitations of what a tool can do; and set clear expectations about both stakeholder input and pricing. They encourage the medical education community to learn from the SVI project and to consider future partnerships with the AAMC or other specialty organizations to develop new tools and approaches that prioritize the community's needs. Finding solutions to the challenges facing residency selection should be a priority for all stakeholders.
近年来,要求改变住院医师选拔过程的呼声越来越高,其中许多人关注的是需要进行全面评估以及寻找替代学术指标的方法。在全面评估中,需要考虑申请人表现的一个方面是行为能力的熟练程度。美国医学协会(AAMC)开发了 AAMC 标准化视频面试(SVI),这是一种在线异步视频面试,可评估申请人对专业精神的了解以及他们的人际交往和沟通技巧。AAMC 与急诊医学界合作对 SVI 进行了试点。来自 4 年研究的数据(电子住院医师申请服务 [ERAS] 2017-2020 周期)表明,SVI 是对这些行为能力的可靠、有效的评估。它提供了 ERAS 申请包中没有的信息,并且不会对个人或群体造成不利影响。尽管 SVI 具有心理测量学特性,但 AAMC还是选择不续签或扩大住院医师选拔试点。在这篇特邀评论中,作者分享了从 AAMC SVI 项目中获得的关于在住院医师选拔中引入新工具的经验教训。他们建议,未来的项目在努力寻找支持全面评估的方法时,应从一开始就让所有利益相关者参与;尽早并经常传达新工具的价值;与现有工具进行直接比较;为新工具提供时间和空间以取得成功;在早期采用者和广泛参与之间取得平衡;帮助利益相关者了解工具的局限性;并对利益相关者的投入和定价设定明确的期望。他们鼓励医学教育界从 SVI 项目中吸取经验教训,并考虑与 AAMC 或其他专业组织建立未来的合作伙伴关系,以开发优先考虑社区需求的新工具和方法。解决住院医师选拔所面临的挑战应该是所有利益相关者的优先事项。