Department of Surgery, UT Health San Antonio, San Antonio, Texas.
Department of Surgery, UT Health San Antonio, San Antonio, Texas.
J Surg Educ. 2022 Nov-Dec;79(6):e103-e108. doi: 10.1016/j.jsurg.2022.07.020. Epub 2022 Aug 13.
As USMLE Step 1 moves to pass/fail, residency programs are seeking alternate interview selection processes. Attrition in general surgery is reported as high as 26%. Thus, it is important to ensure that programs are selecting and matching applicants with shared values. Situational judgment tests (SJTs) measure educational and cultural values by posing ambiguous situations and individuals rate the effectiveness of possible reactions. SJTs have previously been shown to identify job applicants with shared values while promoting diversity. Scoring categories are high, moderate, or low values congruence. We sought to explore predictive validity of the SJT relative to program attrition.
Residents who matched into our program between 2018 and 2021 completed the SJT. We tracked attrition.
UT Health San Antonio, Texas PARTICIPANTS: Fifty-six categorical general surgery residents RESULTS: Per SJT ratings, the numbers of residents who had high, moderate, and low values congruence were 27, 16, and 13, respectively. Attrition numbers for residents who scored high and moderate congruence were similar, indicating that these ratings were indistinguishable. As such, we combined those 2 categories to create a 2 × 2 matrix and used signal detection theory as a framework for analysis. Overall attrition was 16.1% (9/56). Of the 43 residents who scored high or moderate congruence, 90.7% remained in the program. There was a 9.3% chance of attrition for these residents. Of the 13 residents who scored low congruence, 38.5% attrited. While scoring as low congruence on the SJT does not definitively indicate attrition, it does indicate that attrition is 4.14 times more likely for these residents (chi-square, p = 0.0121).
One of the most important aspects of residency applicant selection and interviewing is mitigating risk by identifying applicants who carry a high risk of attrition. The SJT significantly identifies at-risk applicants.
随着美国医师执照考试（USMLE）第 1 步改为通过/不通过制，住院医师项目正在寻找替代的面试选择流程。普通外科的流失率据报道高达 26%。因此，确保项目选择和匹配具有共同价值观的申请人非常重要。情景判断测试（SJT）通过提出模棱两可的情况来衡量教育和文化价值观，然后让个人对可能的反应的有效性进行评分。SJT 先前已被证明可以识别具有共同价值观的求职者，同时促进多样性。评分类别为高、中或低价值观一致性。我们试图探索 SJT 与项目流失率的预测有效性。
2018 年至 2021 年匹配到我们项目的住院医师完成了 SJT。我们跟踪了流失情况。
德克萨斯州圣安东尼奥市 UT 健康
56 名普通外科住院医师
根据 SJT 评分，具有高、中、低价值观一致性的住院医师人数分别为 27、16 和 13。评分高和中一致的住院医师的流失人数相似，表明这些评分无法区分。因此，我们将这两个类别合并为一个 2×2 矩阵，并使用信号检测理论作为分析框架。总体流失率为 16.1%（9/56）。在评分高或中一致的 43 名住院医师中，90.7%留在了项目中。这些住院医师有 9.3%的流失率。在评分低一致的 13 名住院医师中，有 38.5%流失。虽然 SJT 评分低并不一定表明会流失，但这确实表明这些住院医师的流失风险高出 4.14 倍（卡方检验，p=0.0121）。
住院医师申请人选择和面试的最重要方面之一是通过识别具有高流失风险的申请人来降低风险。SJT 可显著识别高风险申请人。
