Cutting edge selection: learning from high reliability organisations for virtual recruitment in surgery during the COVID-19 pandemic

Abstract

Introduction National selection for higher surgical training (ST3+) recruitment in the UK is competitive. The process must prioritise patient safety while being credible, impartial and fair. During the COVID-19 pandemic, all face-to-face interviews were cancelled. Selection was based on a controversial isolated self-assessment score with no evidence checking taking place. From 2021, selection will take place entirely online. Although this has cost and time advantages, new challenges emerge. Methods We review surgical selection as it transitions to an online format and suggest validated methods that could be adapted from High Reliability Organisations (HRO). Findings Virtual selection methods include video interviewing, online examinations and aptitude testing. These tools have been used in business for many years, but their predictive value in surgery is largely unknown. In healthcare, the established online Multi-Specialty Recruitment Assessment (MSRA) examines generic professional capabilities. Its scope, however, is too limited to be used in isolation. Candidates and interviewers alike may have concerns about the technical aspects of virtual recruitment. The significance of human factors must not be overlooked in the online environment. Surgery can learn from HROs, such as aviation. Pilot and air traffic control selection is integral to ensuring safety. These organisations have already established digital selection methods for psychological aptitude, professional capabilities and manual dexterity. Conclusion National selection for higher surgical training (ST3+) can learn from HROs, using validated methods to prioritise patient safety while being acceptable to candidates, trainers and health service recruiters.

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

“…Now, online courses and training programs [ 12 , 13 ] sponsored by specialty organizations [ 14 , 15 ] and industry vendors [ 16 ] can be accessed from anywhere in the world, making education more accessible and convenient. The COVID-19 pandemic further solidified the use of online programs in postgraduate education [ 17 , 18 , 19 , 20 ]. Moreover, there is a growing emphasis on interprofessional collaboration to provide more comprehensive patient care.…”

“…Moreover, there is a growing emphasis on interprofessional collaboration to provide more comprehensive patient care. This collaborative patient-centered approach to healthcare is fueled by medical technology advancements, such as telemedicine, virtual reality [ 19 , 21 , 22 , 23 , 24 ], artificial intelligence applications [ 25 , 26 , 27 ] with wearable devices for skill-based simulations [ 28 , 29 , 30 ], electronic health records [ 31 , 32 , 33 ], and translational knowledge integration—all of which increase the demands on the next generation of orthopedic surgeons and neurosurgeons who now must be versed in the clinical application of these technologies to be effective in the delivery of the best possible care to patients in an increasingly cost-constrained environment characterized by an imbalance in clinical innovation and resource commitment. The authors of this editorialized perspective article came together to highlight the ongoing challenges in their educational programs and how the underlying changes in orthopedic and neurosurgery postgraduate training may impact personalized interventional and surgical pain management specialty care delivery in the future.…”

Virtual Interview Day: An AEGD's approach and assessment of interviewing during a pandemic

“…Additional disadvantages are related to the relationship building that occurs during face‐to‐face interactions. An applicant's attentiveness and listening skills, manifested as nonverbal communication, may be more difficult to evaluate over a video connection 1,3,4,9 . Applicants are not able to get a sense of program culture when they are unable to interact with current residents and faculty in any informal setting.…”

“…Interviews that were once in person quickly transitioned to a fully online format. There are several articles in the medical literature on how residency interviews and processes changed to accommodate the virtual environment, [1][2][3][4][5][6][7][8] but to date, there are only a few articles specific to dental programs. 9,10 Virtual interviews have their advantages and disadvantages.…”

“…An applicant's attentiveness and listening skills, manifested as nonverbal communication, may be more difficult to evaluate over a video connection. 1,3,4,9 Applicants are not able to get a sense of program culture when they are unable to interact with current residents and faculty in any informal setting. Likewise, the program has less time to assess applicants' personalities.…”