A Model for Exploring Compatibility Between Applicants and Residency Programs: Right Resident, Right Program.

Holistic review of residency applications is touted as the gold standard for selection, yet vast application numbers leave programs reliant on screening using filters such as United States Medical Licensing Examination scores that do not reliably predict resident performance and may threaten diversity. Applicants struggle to identify which programs to apply to, and devote attention to these processes throughout most of the fourth year, distracting from their clinical education. In this perspective, educators across the undergraduate and graduate medical education continuum propose new models for student-program compatibility based on design thinking sessions with stakeholders in obstetrics and gynecology education from a broad range of training environments. First, we describe a framework for applicant-program compatibility based on applicant priorities and program offerings, including clinical training, academic training, practice setting, residency culture, personal life, and professional goals. Second, a conceptual model for applicant screening based on metrics, experiences, attributes, and alignment with program priorities is presented that might facilitate holistic review. We call for design and validation of novel metrics, such as situational judgment tests for professionalism. Together, these steps could improve the transparency, efficiency and fidelity of the residency application process. The models presented can be adapted to the priorities and values of other specialties.

Simulated employment interviews: A collaborative approach to gaining understanding of the graduate midwife employment process.

Graduating midwives unsuccessful in gaining employment in their preferred model/location; or finding a job within a year of graduation are more likely to leave the profession. Obtaining post-graduate midwifery employment is competitive with midwifery students needing to confidently sell themselves to potential employers. Whilst midwifery students may be prepared with the requisite midwifery skills and knowledge, there is no guarantee of attaining a midwifery position upon graduation. Increasingly employers are requiring 'soft skills' including communication, teamwork, reflexivity and personal attributes of the individual to be able to effectively respond within different contexts. Demonstrating these skills within an employment interview requires confidence and knowledge in how to prepare. Designed with health service partners, simulated employment interviews were introduced into the final year of a Bachelor of Midwifery program as part of a suite of employability strategies connected to the student lifecycle. An exploratory evaluation study of students 'experiences of a simulated employment interview was undertaken. The simulated interview emulated real employment interviews with students receiving immediate written and oral feedback. Evaluation through surveys, focus groups and individual interviews provided rich data around the effectiveness of this approach. Students, health service partners and academics found the simulated employment interview provided a valuable learning experience, assisting students to reflect, explore and further develop skills sought by employers. Collaboration with health service partners created an authentic process enabling students to receive feedback relevant to the real world of practice. Students were able to work through anxiety, gain confidence and exposure to employers in preparation for employment interviews.

Job titles need to reflect modern times and go gender neutral.

The chance to update nursing and midwifery titles can not only help streamline the confusing array of roles, but ensure that trusts employ bona fide registrants, suggests Sam Foster, Chief Nurse, Oxford University Hospitals.

Imaginary alternatives: The effects of mental simulation on powerless negotiators.

This research demonstrates that people can act more powerfully without having power. Researchers and practitioners advise people to obtain alternatives in social exchange relationships to enhance their power. However, alternatives are not always readily available, often forcing people to interact without having much power. Building on research suggesting that subjective power and objective outcomes are disconnected and that mental simulation can improve aspirations, we show that the mental imagery of a strong alternative can provide some of the benefits that real alternatives provide. We tested this hypothesis in one context of social exchange-negotiations-and demonstrate that imagining strong alternatives (vs. not) causes powerless individuals to negotiate more ambitiously. Negotiators reached more profitable agreements when they had a stronger tendency to simulate alternatives (Study 1) or when they were instructed to simulate an alternative (Studies 3-6). Mediation analyses suggest that mental simulation enhanced performance because it boosted negotiators' aspirations and subsequent first offers (Studies 2-6), but only when the simulated alternative was attractive (Study 5). We used various negotiation contexts, which also allowed us to identify important boundary conditions of mental simulations in interdependent settings: mental simulation no longer helped when negotiators did not make the first offer, when their opponents simultaneously engaged in mental simulation (Study 6), and even backfired in settings where negotiators' positions were difficult to reconcile (Study 7). An internal meta-analysis of the file-drawer produces conservative effect size estimates and demonstrates the robustness of the effect. We contribute to social power, negotiations, and mental simulation research. (PsycINFO Database Record

Validez predictiva e impacto adverso de la entrevista conductual estructurada en el sector público / Predictive validity and adverse impact of the structured behavioral interview in the public sector

En este trabajo se estudia el papel de la entrevista conductual estructurada (ECE) en los procedimientos de selección del sector público, cuya legislación insta a comprobar si los procedimientos selectivos están vinculados con el desempeño y si se cumple el principio de igualdad de oportunidades entre sexos. Para ello se ha analizado en una muestra de 379 candidatos si existían diferencias de género en la puntuación de la entrevista. Por otro lado, se midió el desempeño de las 125 personas contratadas, lo que permitió estudiar la validez predictiva de la ECE. Los resultados son similares a los obtenidos por investigaciones precedentes -la ECE predice de manera significativa el desempeño y no produce impacto de género. Finalmente se discuten las implicaciones de estos resultados (AU)

This paper studies the role of the structured behavioral interview (SBI) in the selection procedures of the public sector. The Spanish legislation calls on to examine whether selection procedures are linked to performance and whether the principle of equal opportunities regarding gender is respected. Hence, it was analyzed if there were gender differences in the interview scores in a sample of 379 candidates. Furthermore, performance of 125 hired subjects was assessed, allowing us to measure the predictive validity of the SBI. Results are similar to those obtained by previous research -SBIs are a significant predictor of performance and they do not produce adverse gender impact. Finally, implications of these results are discussed (AU)

Spirituality, hope, and self-sufficiency among low-income job seekers.

Self-sufficiency (SS) is an important social welfare policy goal in the United States, yet little is known about the process that leads to SS. To address this gap in the literature, this study examined the relationship between spirituality, hope, and SS among a sample of low-income job seekers (N = 116). It was hypothesized that spirituality would be related to hope, and that hope, in turn, would be related to SS. Using survey data from two workforce development agencies, this hypothesis was confirmed-hope fully mediated the relationship between spirituality and SS. Of the two factors through which hope is commonly operationalized-agency and pathways-supplemental analysis suggested that spirituality only affects SS through the agency channel. To help foster hope in direct practice settings, it is suggested that social workers might employ spiritually modified cognitive-behavioral therapy protocols. Macrostructural interventions that block the pathway component of hope are also suggested to help reverse exclusion from labor market entry. As such, hope needs to be addressed comprehensively-intrapsychically and macrostructurally-to effect bottom-up change for SS. Engendering hope may assist clients overcome some of the many challenges they encounter on the journey to SS.

Virtual reality job interview training for individuals with psychiatric disabilities.

Services are available to help support existing employment for individuals with psychiatric disabilities; however, there is a gap in services targeting job interview skills that can help obtain employment. We assessed the feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) in a randomized controlled trial. Participants were randomized to VR-JIT (n = 25) or treatment-as-usual (TAU) (n = 12) groups. VR-JIT consisted of 10 hours of simulated job interviews with a virtual character and didactic online training. The participants attended 95% of laboratory-based training sessions and found VR-JIT easy to use and felt prepared for future interviews. The VR-JIT group improved their job interview role-play performance (p ≤ 0.05) and self-confidence (p ≤ 0.05) between baseline and follow-up as compared with the TAU group. VR-JIT performance scores increased over time (R = 0.65). VR-JIT demonstrated initial feasibility and efficacy at improving job interview skills and self-confidence. Future research may help clarify whether this intervention is efficacious in community-based settings.

Helping people with HIV/AIDS return to work: a randomized clinical trial.

OBJECTIVE: New treatments introduced in the mid-1990s led many people with HIV/AIDS who previously had been disabled by their disease to contemplate workforce reentry; many remain unemployed, and little is known concerning interventions that might help them return to work. We report the results of a randomized clinical trial of an intervention designed to help people with HIV/AIDS reenter the workforce. DESIGN: We tested a mixed (group-individual) modality intervention that incorporated elements of Motivational Interviewing (Miller & Rollnick, 2002), skills building from Dialectical Behavior Therapy (Linehan, 1993), and job-related skills (Price & Vinokur, 1995). A total of 174 individuals participated in either the intervention or in standard of care and were followed for 24 months. RESULTS: Compared with individuals referred for standard of care, participants in the intervention engaged in more workforce-reentry activities over time and, once employed, were more likely to remain employed. Dose-response analyses revealed that among intervention participants, participants who attended more than 1 individual session engaged in more workforce-reentry activities than individuals who attended 1 or fewer individual sessions, whereas frequency of group session participation did not effect a difference between participants who attended more than 6 group sessions and participants who attended 6 or fewer group sessions. CONCLUSION: Theoretically based workforce-reentry assistance programs can assist disabled people with HIV/AIDS in their return-to-work efforts.

A six year head-to-head comparison of osteopathic and allopathic applicants to a university-based, allopathic general surgery residency.

OBJECTIVE: The number of osteopathic physicians is increasing as is the number applying to allopathic general surgery residency programs. A lack of knowledge of osteopathic schooling leads to a potential applicant bias in favor of allopathic applicants, but the 2 groups have not been compared head to head. DESIGN: Applications over a 6-year period to an allopathic general surgery residency program were reviewed. Demographics, examination scores, employment, education, and research experience were catalogued into a database. Allopathic applicants were compared with osteopathic applicants utilizing statistical analysis. SETTING: A university teaching hospital. PARTICIPANTS: Allopathic and osteopathic applicants to an allopathic general surgery residency program. RESULTS: A total of 1290 applications were reviewed; 1155 allopathic and 135 osteopathic applications. Other than race, the 2 cohorts are similar in age, gender, and citizenship. The groups are not significantly different with regard to the number of letter of recommendations, volunteer activities, scholarly works, and advanced degrees. Graduates of both proceed directly to residency. A significantly higher percentage of allopathic graduates reported their United States medical licensing examination (USMLE) scores, yet when osteopaths released their USMLE transcript, they scored significantly higher on the USMLE Step 1 examination and required fewer attempts to pass. These differences do not apply to the USMLE Step 2 examination. CONCLUSIONS: No single screening tool exists for selecting a successful general surgery resident. We are seeing increased numbers of osteopathic applicants. Many criteria used to evaluate applicants do not apply to osteopathic applicants, but our comparison of common selection variables on the Electronic Residency Application Service (ERAS) application did not demonstrate an overall difference. While our analysis demonstrated a statistically higher USMLE Step 1 score by osteopathic applicants, they may only self-report favorable data.

Obstructive sleep apnea screening during commercial driver medical examinations: a survey of ACOEM members.

OBJECTIVE: To survey American College of Occupational and Environmental Medicine (ACOEM) members regarding recent consensus guidelines for screening commercial drivers for Obstructive Sleep Apnea (OSA). METHODS: A brief survey instrument was distributed electronically by the American College of Occupational and Environmental Medicine to its members during February 2008 to April 2008. RESULTS: Most (92%) of the 552 examiners opined that screening commercial drivers for OSA was important. Nevertheless, only 42% reported screening using consensus guidelines or another specific protocol. Common reasons for not applying the guidelines included unaware (36%), too complicated (12%), client retention (10%), and driver inconvenience (10%). Most would consider using the guidelines going forward but 39% wanted additional evidence and another 21% only if they became the "community standard." CONCLUSIONS: More education regarding OSA and drivers is needed. A Federal mandate and eliminating "doctor shopping" would likely increase examiners' compliance with screening.

Development of an evidence-based application and rubric for evaluating applicants' qualifications for promotion to professor.

OBJECTIVE: Every promotion committee is challenged by the need to make value judgments on the quantity and quality of peer work. Decisions based upon subjective assessments may not do justice to the applicant's or the institution's needs. The purpose of this article is to (1) describe the process a college promotion committee used to increase the objectivity brought to this activity, (2) present the tools developed that facilitated the collection and evaluation of faculty work, and (3) describe their usage in a promotion cycle. METHODS: The Professor Promotion Committee met weekly for 6 months engaging in lengthy and comprehensive discourse to capture the breadth of scholastic and service activities normally engaged in by faculty. RESULTS: The committee's work culminated in the development of 4 electronic applications soliciting specific evidence aligned with faculty work and 1 scoring rubric tied directly to the e-applications. More than 55 activities were identified, divided into 4 levels of accomplishment using quantitative and qualitative criteria and weighted according to their centrality to faculty work and relative importance to the institution. Each activity was assigned to one of the following categories: teaching/academic support, scholarship/research, service, and professional development. A consensus score based upon the evidence was used to generate promotion discussions. CONCLUSIONS: The committee believes the online application aids applicants in recognizing the breadth and depth of promotable work. It provides them the opportunity to structure their work in ways that enhance their chances for promotion. The evidence-based rubric helps to reduce subjectivity in the evaluation process.