The effect of assessor professional background on interview evaluation during residency selection: A mixed-methods study.

BACKGROUND: Residency interviewer scores are greatly variable and seems to be influenced by personal characteristics of assessors, although factors contributing to variability remain unclear. The study sought to determine how different professional backgrounds influence assessors' scores. METHODS: Fifty-five general surgery applicants rotated through an interview station assessing teamwork. They were scored by surgeons, human-resource managers, pilots, athletes. Pearson's correlation and a repeated-measures ANOVA were used to determine correlations between professions. Structured interviews were used to probe for scoring rationale. RESULTS: Interview scores differed significantly between professions (F (3, 159) = 11.12, p < 0.001. Qualitative analysis revealed that due to the challenge of distinguishing between similarly performing candidates, assessors rely on global impressions informed by personal values. CONCLUSION: Assessor variability is ubiquitous, in part due to the subjective nature of interviews and is associated with personal values. When selecting assessors, programs should choose diverse assessors to assess to ensure a reliable selection process.

Self-Assessment in General Surgery Applicants: An Insight Into Interview Performance.

INTRODUCTION: Selecting medical students for residency is a competitive process, with a narrow range of scores separating middle-ranked applicants. Self-assessment is a fundamental skill for any competent physician with a demonstrated correlation to diagnostic ability, examination scores, and technical skills, but has yet to be investigated in residency selection. The objective of this study was to investigate the relationship between self-assessment and interview performance as a potential adjunct to discriminate between applicants. METHODS: At the University of Ottawa in 2020, 55 applicants completed a 9-station interview circuit assessing different characteristics or skills important for a career in general surgery, followed by a self-assessment questionnaire evaluating their perceived performance at each station. Pearson's correlation was used to determine the relationship between self-assessment scores (SASs) and interviewer scores (ISs). RESULTS: There was a negative correlation between SASs and ISs for all interview stations. High performers underestimated their interview performance, and low performers overestimated their performance. Seven of the nine stations reached statistical significance (r = 0.60-0.73, P < 0.001). There was significant variability in the SAS of middle-ranked applicants, with a range three times greater than the range of ISs and demonstrating distinct self-assessment skills in candidates with very similar scores. CONCLUSIONS: Although we strive to select applicants who will succeed in residency to become competent physicians, self-assessment skills may be a useful adjunct during the interview process to assist in discriminating between applicants with similar scores.

Longer Trials of Non-operative Management for Adhesive Small Bowel Obstruction Are Associated with Increased Complications.

BACKGROUND: Current guidelines for the management of adhesive small bowel obstruction suggest a limited trial of non-operative management, often of 3-5 days. A longer delay to operation may worsen post-operative outcomes in patients who ultimately require operation. Our objective was to evaluate the impact of time to operation on post-operative outcomes in patients who undergo operation following a trial of non-operative management for adhesive small bowel obstruction. METHODS: We used health administrative data to identify patients with adhesive small bowel obstruction who underwent operative management following a trial of non-operative management from 2005 to 2014 in the province of Ontario, Canada. We used multivariable logistic regression to examine the relationship between the time from admission to operation with rates of 30-day mortality, serious complication, and bowel resection. RESULTS: Three thousand five hundred sixty-three patients underwent operation after a trial of non-operative management for adhesive small bowel obstruction. Older patients, patients with a high comorbidity burden, and patients with a lower socioeconomic status were more likely to experience a longer pre-operative period. After adjusting for covariates, each additional day from admission to operation increased odds of serious complication (OR = 1.07, 95% CI = 1.03-1.11) and bowel resection (OR = 1.06, 95% CI = 1.03-1.98). Longer times to operation were not associated with greater adjusted odds of 30-day mortality. CONCLUSION: Each additional day from admission to operation is associated with greater odds of adverse outcomes. Clinical practice guidelines should emphasize strategies that identify patients who will ultimately require operation.