Analyzing the effect of interview time and day on emergency medicine residency interview scores.

BACKGROUND: When it comes to scheduling interviews, medical students may wonder if they need a strategy to increase their likelihood of matching. Previous studies examined the temporal effects of the residency interview on overall match rate; however, there are additional factors that affect the match process, including board examination scores and letters of recommendation. Only few studies have examined the effect interview time of day has on match success. The current study examines the impact date and time of interview during the interview season have on candidates' respective interview scores. METHODS: Interview data over a three-year period (i.e., three interview cycles) was examined at a PGY-1-3, ACGME-accredited EM residency program in Philadelphia. Date of interview and time of day of interview (i.e., morning versus afternoon) was examined. A linear regression analysis was performed to determine if there is a statistically-significant difference in overall interview scores based on date during the interview season and time of day. RESULTS: There is no statistically-significant effect of time of day or date on residency interview scores. CONCLUSIONS: Our findings are congruent with other studies on the temporal effects of residency interviews on overall match rate. Findings should provide reassurance to students scheduling interviews, as time slots have not been found to have a significant relationship with overall interview score. Future studies should more holistically analyze the residency application process.

A Workshop to Reflect on Personal Resilience in Emergency Medicine Residents: Applying the Connor-Davidson Resilience Scale, Visual Explorer, and the Critical Incident Questionnaire to Support Introspection.

Burnout among emergency medicine (EM) residents is gaining increasing attention. The authors designed a workshop to assess EM residents' resilience using a validated scale to prompt personal reflection. The workshop then shifted to peer-to-peer conversations and sharing using images from Visual Explorer (VE) to further reflect on resilience. Overall, resident resilience scores were below those of the US general population, with post-graduate year (PGY)-2 year residents having the lowest scores. The workshop was well received by residents; data from the Critical Incident Questionnaire (CIQ) suggested that residents felt engaged during discussion of the images. Further study is needed to assess the correlation between resilience scores and burnout.

Assessment of Emergency Medicine Residents' Clinical Reasoning: Validation of a Script Concordance Test.

INTRODUCTION: A primary aim of residency training is to develop competence in clinical reasoning. However, there are few instruments that can accurately, reliably, and efficiently assess residents' clinical decision-making ability. This study aimed to externally validate the script concordance test in emergency medicine (SCT-EM), an assessment tool designed for this purpose. METHODS: Using established methodology for the SCT-EM, we compared EM residents' performance on the SCT-EM to an expert panel of emergency physicians at three urban academic centers. We performed adjusted pairwise t-tests to compare differences between all residents and attending physicians, as well as among resident postgraduate year (PGY) levels. We tested correlation between SCT-EM and Accreditation Council for Graduate Medical Education Milestone scores using Pearson's correlation coefficients. Inter-item covariances for SCT items were calculated using Cronbach's alpha statistic. RESULTS: The SCT-EM was administered to 68 residents and 13 attendings. There was a significant difference in mean scores among all groups (mean + standard deviation: PGY-1 59 + 7; PGY-2 62 + 6; PGY-3 60 + 8; PGY-4 61 + 8; 73 + 8 for attendings, p < 0.01). Post hoc pairwise comparisons demonstrated that significant difference in mean scores only occurred between each PGY level and the attendings (p < 0.01 for PGY-1 to PGY-4 vs attending group). Performance on the SCT-EM and EM Milestones was not significantly correlated (r = 0.12, p = 0.35). Internal reliability of the exam was determined using Cronbach's alpha, which was 0.67 for all examinees, and 0.89 in the expert-only group. CONCLUSION: The SCT-EM has limited utility in reliably assessing clinical reasoning among EM residents. Although the SCT-EM was able to differentiate clinical reasoning ability between residents and expert faculty, it did not between PGY levels, or correlate with Milestones scores. Furthermore, several limitations threaten the validity of the SCT-EM, suggesting further study is needed in more diverse settings.

The Zoom Picture Book Game: A Creative Way to Promote Teamwork in Undergraduate Medical Education.

Effective team building and leadership are crucial in running an effective and safe healthcare system with improved patient care and clinical outcomes. Currently, there is a great demand for formal leadership training throughout the extensive medical education curriculum. We constructed an interactive team-building activity utilizing gamification-theory with the Zoom game. The Zoom activity requires a team of learners to organize a set of sequential images, each of which contains a "zoomed out" section from the previous image, into the correct order within a set time frame. Given the unique and approachable nature of this team-based activity, we propose the following: 1) to introduce the Zoom game as a team-building and communication fostering exercise in undergraduate medical education and 2) to assess baseline teamwork skills of first-year medical students through an immersive gaming experience. With this in mind, 260 first-year medical students (class of 2020) at an urban-city medical school were enrolled in the Zoom Team Building Activity as part of their orientation. The students were randomly assigned to 11 teams, comprising 23-24 students and two faculty facilitators per team and completed the activity in the allotted time frame. The average time to complete the Zoom game was 24 minutes, and all the teams successfully placed the pictures in the correct order. Facilitators noted that the Zoom game strongly encouraged friendly interactions, intercollegiate high values, mutual respect, confidence, and trust among each other. Students observed take-home points such as selecting a leader, designating specific roles, and encouraging closed-loop communication. Overall, the Zoom activity game is an interactive, fun, and easily accessible team-building and communication fostering exercise in undergraduate medical education. Further studies on the Zoom game exercise would be essential to determine whether it has a continuous and enduring effect on developing team building among medical students.

Homeschooling for Quarantined Residents: A Virtual Back to the Basics Curriculum.

Introduction The COVID 19 pandemic resulted in local and institutional restrictions with significant effects on the clinical environment for graduate medical education, displacing residents from non-emergency medicine (EM) based rotations. Additionally, resident physicians considered patients under investigation (PUI) were furloughed from clinical practice. The necessity for supplemental learning in a virtual setting prompted the development of an online homeschooling curriculum that incorporated back to the basics textbook learning, application, and retention via virtual sessions for the quarantined and furloughed learners.  Methods An online homeschooling curriculum was developed to replace the cancelled clinical experiences for EM residents and for those who were quarantined utilizing Google Classroom and Zoom teleconference software. After completion of their quarantine or return to normal rotation schedule, residents were asked to evaluate the homeschooling curriculum using an anonymous survey.  Results A total of 12 residents participated in the homeschooling program over eight weeks during the spring of 2020. Of the nine residents surveyed, 88.8% percent felt the homeschooling added to their knowledge of EM, 100% found the online format easy to use, and 88.8% stated it helped maintain a sense of social connection to peers and faculty.  Conclusion An online homeschooling program was considered an effective means of providing an opportunity for synchronous and continuous education for EM resident physicians. This program could be sustainable long term to fill in knowledge gaps or supplement remediation in emergency resident education, post pandemic.