Cooper University Hospital/Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey.
Maine Medical Center, Tufts University School of Medicine, Department of Emergency Medicine, Portland, Maine.
West J Emerg Med. 2024 Sep;25(5):715-724. doi: 10.5811/westjem.19392.
Program signaling (PS), which enables residency applicants to signal their preference for a specific program, was introduced in emergency medicine (EM) in the 2022-2023 residency application cycle. In this study we evaluated EM program directors' (PD) utilization of PS in application review and ranking. This study also explores the relationship between program characteristics and number of signals received as well as the relative importance and utilization of signals related to the number of signals received.
This is an institutional review board-approved, cross-sectional study of PDs at Accreditation Council for Graduate Medical Education-accredited EM residency programs. We used descriptive statistics to describe the characteristics of residency programs and practices around PS. Measures of central tendency and dispersion summarized continuous variables. We used chi-square analysis or the Fisher exact test for comparisons between groups for categorical variables. Comparisons for continuous variables were made using the -test for independent samples or analysis of variance.
The response rate was 41% (n = 113/277 EM programs). Most programs participated in PS (n = 261/277 EM programs, 94.2%). Mean number of signals received was 60 (range 2-203). Signals received varied based on program characteristics including geographic location and program type, duration, environment, and longevity. Most used PS in holistic review (52.2%), but other uses varied by proportion of applications that were signaled. The importance of PS in application review (mean 2.9; 1-5 scale, 1 = not important, 5 = extremely important) and rank list preparation (2.1) was relatively low compared to other application elements such as standardized letters of evaluation (4.97 for review, 4.90 for ranking).
The study provides insights into PS utilization in EM's inaugural year. We have identified patterns of signal use based on program characteristics and number of signals received that can inform signal allocation and utilization on an individual applicant and program level. A more nuanced understanding of signal use can provide valuable insight as the specialty of EM grapples with fluctuations in its applicant numbers and shifting demographics of its applicant pool.
项目信号（PS）允许住院医师申请人表达对特定项目的偏好，于 2022-2023 年住院医师申请周期在急诊医学（EM）中引入。在这项研究中，我们评估了急诊医学项目主任（PD）在申请审查和排名中对 PS 的利用。本研究还探讨了项目特征与收到的信号数量之间的关系，以及与收到的信号数量相关的信号的相对重要性和利用情况。
这是一项经机构审查委员会批准的、对经研究生医学教育认证委员会认证的急诊医学住院医师项目 PD 的横断面研究。我们使用描述性统计来描述 PS 周围住院医师项目的特征和实践情况。中心趋势和离散度的度量总结了连续变量。对于分类变量，我们使用卡方分析或 Fisher 精确检验进行组间比较。对于连续变量，我们使用独立样本 t 检验或方差分析进行比较。
回复率为 41%（n=277 个 EM 项目中的 113 个）。大多数项目参与了 PS（n=261/277 EM 项目，94.2%）。收到的信号平均数量为 60（范围 2-203）。收到的信号数量因地理位置和项目类型、项目持续时间、环境和年限等项目特征而异。大多数人在整体审查中使用 PS（52.2%），但其他用途因信号应用比例而异。PS 在申请审查中的重要性（平均 2.9；1-5 级，1=不重要，5=非常重要）和排名准备（2.1）相对较低，与标准化推荐信等其他申请要素相比（审查 4.97，排名 4.90）。
本研究提供了 EM 引入的第一年 PS 使用情况的见解。我们根据项目特征和收到的信号数量确定了信号使用模式，这可以为个体申请人和项目层面的信号分配和利用提供信息。对信号使用的更细致的了解可以为该专业提供有价值的见解，因为急诊医学的申请人数量波动和申请人群体的人口统计学变化。
