Patel Hares, Yakkanti Ram, Bellam Krishna, Agyeman Kofi, Aiyer Amiethab
University of Kentucky, College of Medicine, USA.
Department of Orthopedic Surgery, University of Miami, USA.
J Med Educ Curric Dev. 2022 Mar 29;9:23821205221084936. doi: 10.1177/23821205221084936. eCollection 2022 Jan-Dec.
The announcement of Step 1 shifting to a Pass/Fail metric has prompted resident selection committees (RSCs) to pursue objective methods of evaluating prospective residents. Regardless of the program's specialty or affiliated hospital/school, RSCs universally aim to recognize and choose applicants who are an "optimal fit" to their programs. An optimal fit can be defined as a candidate who thrives in the clinical and academic setting, both contributing to and benefiting from their respective training environments.
The objective of this scoping review is to evaluate alternative, innovative methods by which RSCs can evaluate applicants and predict success during residency. Objective methods include: Step 2 scores, Traditionally Used Metrics (core clerkship scores), interview performance, musical talent, sports involvement, AOA membership, research publications, unprofessional behavior, Dean's letters, Rank list, judgement testing, and specialty-specific shelf exams..
A scoping review was performed in compliance with the guidelines indicated by the PRISMA Protocol for scoping review. 9308 results were identified in the original PubMed search for articles with the key words "Resident Success". Abstract screening and application of inclusion and exclusion criteria yielded 97 articles that were critically appraised via review of full manuscript.
Of the articles that focused on personality traits, situational judgement testing, and specialty specific pre-assessment, all of them demonstrated some level of predictability for resident success. Standardized Letter of Recommendations, Traditionally Used Metrics, and STEP 2 did not show a unanimous consensus in demonstrating predictability of a resident's success, this is because some articles suggested predictability and some articles disputed predictability.
The authors found personality traits, situational judgement testing, and specialty specific assessments to be predictive in selecting successful residents. Further research should aim to analyze exactly how RSCs utilize these assessment tools to aid in screening their large and competitive applicant pools to find residents that will be successful in their program.
美国医师执照考试第一步改为及格/不及格评分制的消息促使住院医师选拔委员会（RSCs）寻求客观的方法来评估未来的住院医师。无论项目的专业或附属医院/学校如何，RSCs的普遍目标是识别并选择最适合其项目的申请者。最佳匹配可以定义为在临床和学术环境中表现出色，既能为各自的培训环境做出贡献，又能从中受益的候选人。
本范围综述的目的是评估RSCs可以用来评估申请者并预测其住院医师培训期间成功率的替代创新方法。客观方法包括：第二步考试成绩、传统使用的指标（核心临床实习成绩）、面试表现、音乐天赋、体育活动参与情况、美国医学协会（AOA）会员资格、研究出版物、不专业行为、院长推荐信、排名列表、判断力测试以及特定专业的结业考试。
按照PRISMA范围综述协议指南进行范围综述。在最初的PubMed搜索中，以“住院医师成功”为关键词，共识别出9308条结果。通过摘要筛选和应用纳入及排除标准，得到97篇文章，并通过全文审查进行了严格评估。
在关注人格特质、情境判断测试和特定专业预评估的文章中，所有这些都在一定程度上显示出对住院医师成功的预测性。标准化推荐信、传统使用的指标和第二步考试在证明住院医师成功的预测性方面并未达成一致共识，这是因为一些文章表明具有预测性，而一些文章则对预测性提出了质疑。
作者发现人格特质、情境判断测试和特定专业评估在选拔成功的住院医师方面具有预测性。进一步的研究应旨在准确分析RSCs如何利用这些评估工具来帮助筛选庞大且竞争激烈的申请者群体，以找到在其项目中会取得成功的住院医师。
