Influence of anesthesiology residentsʼ noncognitive skills on the occurrence of critical incidents and the residentsʼ overall clinical performances

Rhoton, M. F.; Barnes, A; Flashburg, M; Ronai, A. K.; Springman, Scott R.

doi:10.1097/00001888-199106000-00011

Cited by 26 publications

(10 citation statements)

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“…These have received growing attention in the past few years as investigators have begun to explore their significance for both assessment of trainees 15 16 and the safety of anaesthetic practice. [17][18][19] Though we have fewer data relating to how knowledge is acquired in regional anaesthesia, we are also able to offer, for further testing, an initial model. This seems to progress through the following stages: (i) the acquisition of anatomical fact; (ii) exposure to practical procedures under supervision; (iii) reflection and linking in new knowledge from experience to existing theoretical material; (iv) by means of working independently, continuation of this process; and (v) the incorporation of knowledge into personal 'routines' and styles, with the flexibility to adapt to cases which are out of the ordinary.…”

Section: Discussionmentioning

confidence: 99%

What defines expertise in regional anaesthesia? An observational analysis of practice †

Smith

Pope

Goodwin

et al. 2006

British Journal of Anaesthesia

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Section: Discussionmentioning

confidence: 99%

What defines expertise in regional anaesthesia? An observational analysis of practice †

Smith

Pope

Goodwin

et al. 2006

British Journal of Anaesthesia

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“…In addition, standardized test results and undergraduate grade point average are not related to performance during residency (Warrick & Crumrine, 1986). Rather, nontechnical skills (Fletcher et al, 2002) such as conscientiousness, confidence, and composure, which are generally not assessed during the resident selection process, may be the best predictors of a resident's future clinical performance (Rhoton et al, 1991). Lack of these skills may also predict ineffective behaviors in response to a critical incident (Altmaier et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Personality testing may improve resident selection in anesthesiology programs

Merlo

Matveevskii

2009

Medical Teacher

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Background: Current methods of selecting future residents for anesthesiology training programs do not adequately distinguish those who will succeed from the pool of seemingly well-qualified applicants. Some residents, despite high exam scores, may struggle in the operating room (OR) in stressful situations. Aims: This study examined whether specific neuropsychological and personality measures can distinguish high competency residents from low-competency residents to aid in resident selection. Methods: Twenty-five residents enrolled in an anesthesiology program at a major academic institution were identified for participation. Thirteen were evaluated as ''high competency'' residents and 12 as ''low competency'' by the department's clinical competency committee. Groups were evaluated on measures of fine motor dexterity, executive functioning, processing speed, attention, and personality. Results: There were no significant differences between groups on measures of fine-motor dexterity, executive functioning, processing speed, or attention. High competency residents scored significantly higher than low-competency residents on measures of cooperation, self-efficacy, and adventurousness, and lower on measures of neuroticism, anxiety, anger, and vulnerability. Conclusion: Although measures of fine-motor dexterity, executive functioning, processing speed, and attention do not appear to distinguish between high-and low-competency residents in anesthesiology, specific personality characteristics may be associated with success in an anesthesiology training program.

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“…For example, Rhoton et al demonstrated that, in addition to knowledge, conscientiousness and confidence were the two most important factors predicting the overall clinical skills of anesthesia residents. 23 In this study the interns performed equally well in all clinical areas of the ABSITE. The performances of junior and senior residents on the VASC subsection of the ABSITE were significantly higher than their scores on all other clinical sections of the examination.…”

Section: Discussionmentioning

confidence: 99%

Development of Vascular Surgery Skills During General Surgery Training

Kwolek¹,

Donnelly²,

Endean³

et al. 1999

Vascular Surgery

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Purpose: We previously have shown that performance on the National Board of Medical Examiners (NBME) part II examination does not reflect clinical skills. Many training programs use the American Board of Surgery In-Service Training Examination (ABSITE) as the only objective measure of clinical knowledge. This study evaluates the utility of the ABSITE and an objective structured clinical examination (OSCE) in measuring vascular clinical skills during general surgery residency training. Methods: Residents' mean scores on the vascular section of an OSCE were compared with their mean overall scores on the OSCE by using a two-way analysis of variance (ANOVA). Residents' performance on each clinical section of the ABSITE (body as a whole; gastrointestinal, cardiovascular, and respiratory systems; genitourinary/head and neck/musculoskeletal, and endocrine) and a vascular subsection (VASC) were evaluated by using ANOVA. Results: Mean vascular scores were significantly lower than mean overall scores for residents at all levels of training (P < 0.0001). Fischer's PLSD (plausible least significant difference) post hoc test revealed that significant improvement occurred between the (continued on next page) (Abstract continued) intern and junior years (P < 0.05), but not between the junior and senior years. In contradistinction, VASC ABSITE scores were better than all other scores for both junior and senior residents, but not for interns (senior: VASC = 96%, other = 79%, P = 0.04; junior: VASC = 84%, other = 64%, P = 0.02; intern: VASC = 63%, other = 50%, P = 0.12). Conclusions: It is assumed that residents completing residency training are competent to perform clinical vascular examinations. Our findings paradoxically showed that although residents scored highest on the clinical vascular section of the ABSITE, they scored lowest on the vascular section of the OSCE. Although both tests found evidence of improvement between the intern and junior years, neither test found a significant improvement in vascular performance between the junior and senior years. These results emphasize that ABSITE scores do not necessarily correlate with clinical competence, and they demonstrate the need for providing more objective measures of clinical performance.

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Influence of anesthesiology residentsʼ noncognitive skills on the occurrence of critical incidents and the residentsʼ overall clinical performances

Cited by 26 publications

References 0 publications

What defines expertise in regional anaesthesia? An observational analysis of practice †

What defines expertise in regional anaesthesia? An observational analysis of practice †

Personality testing may improve resident selection in anesthesiology programs

Development of Vascular Surgery Skills During General Surgery Training

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