Predicting Resident Performance from Preresidency Factors: A Systematic Review and Applicability to Neurosurgical Training

Zuckerman, Scott L.; Kelly, Patrick; Dewan, Michael C.; Morone, Peter J.; Yengo‐Kahn, Aaron M.; Magarik, Jordan A.; Baticulon, Ronnie E.; Zusman, Edie E.; Solomon, Gary S.

doi:10.1016/j.wneu.2017.11.078

Cited by 45 publications

(37 citation statements)

References 34 publications

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“…This process is fraught, and there is no agreed upon standard. In a metaanalysis, Zuckerman et al 17 studied 21 articles evaluating 1276 resident applicants across five surgical subspecialties (no neurosurgical studies met the inclusion criteria). Of all the common pre-residency selection factors employed, objective standardized test scores correlated well with in-training and board examinations but correlated poorly with subsequent faculty evaluations of the trainee.…”

Section: Discussionmentioning

confidence: 99%

“…There has never been a rigorous evaluation of neurosurgery (or any other surgical specialty) trainee selection, and no superior method has been agreed upon. 1,2,17 In the Australasian system, the choice of trainees by a binational central selection panel, with subsequent allocation of that trainee to rotation through a number of training units, has led to much discussion, particularly when an underperforming trainee is recognized. While the selection process (discussed below) is arduous and transparent, not all trainees complete training, and disciplinary proceedings due to poor performance, even late in training, are not uncommon.…”

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confidence: 99%

“…Of these components, the most contentious over the previous 10 years has been the referee report. The experience of the SET Board and other authors 1,17 has been that standard written references, using either a pro forma reference or letter of recommendation, did not discriminate between applicants, with many candidates submitting pro forma references with perfect scores or overly positive written references, neither of which reflected subsequent performance in training. We report the early results of a change in practice from a pro forma written reference to a detailed telephone interview with three referees for each trainee considered for selection.…”

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confidence: 99%

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Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

Drummond

Hunn

McAlpine

et al. 2020

Neurosurgical Focus

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OBJECTIVENeurosurgical training poses particular challenges in Australia and New Zealand, given the large landmass, small population, and widely separated, often small, neurosurgical units. Such factors have necessitated a move away from autonomous, single-institution–based training to the selection of trainees by a centralized binational process. The success of this system is based on rigorous standardized evaluation of candidates’ academic achievements, anatomical knowledge, references, and interview performance. Similarly, the accreditation of hospitals to train successful candidates has been standardized. The authors review the evolution of trainee selection and the accreditation of training posts in Australia and New Zealand.METHODSThe records of the Neurosurgical Society of Australasia Surgical Education and Training Board were reviewed for documents pertaining to the selection of neurosurgical trainees and the accreditation of training posts. Application records and referee scores from 2014 to the present were reviewed to encompass process changes, in particular the change from written referee reports to standardized interviews of referees. Surgical logbook case numbers for 23 trainees completing training in 2016, 2017, and 2018 were collated and presented in an aggregated, de-identified form as a measure of adherence to accreditation standards. Written evaluations of the training experience were also sought from two trainees reflecting on the selection process, the quality of training posts, and training limitations.RESULTSWhile a time-consuming process, the method of obtaining referee reports by interview has resulted in a wider spread of scores, more able to separate high- and low-scoring applicants than other components of the selection process. Review of the training post accreditation records for the last 2 years showed that adherence to standards has resulted in loss of accreditation for one unit and shortened periods of review for units with more minor deficiencies. Two applications for accreditation have been denied. Examination of caseload data showed that trainees more than fulfill minimum requirements in accredited training posts, confirming the robust nature of this aspect of unit accreditation.CONCLUSIONSA key factor determining the success of neurosurgical training in Australia and New Zealand has been a willingness to evolve selection and other processes to overcome challenges as they become apparent. According to available analyses, the revised referee process and strict accreditation standards appear effective. The benefits and challenges of the current training system are discussed in the context of a paucity of international literature.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

Drummond

Hunn

McAlpine

et al. 2020

Neurosurgical Focus

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“…Residency program directors argue that USMLE Step 1 scores for applicants are a good predictor of later performance on specialty board exams [23]. It makes sense that a standardized test performance would predict other standardized test performance, and this bears out from other studies [23,24]. However, further studies have identified USMLE Step 2 Clinical Knowledge (CK) as a better predictor of board pass rates [25].…”

Section: Consequences Validitymentioning

confidence: 99%

Medical School Resourcing of USMLE Step 1 Preparation: Questioning the Validity of Step 1

et al. 2019

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“…Step 1 scores correlate with applicants' subsequent clinical performance during residency are sparse, with the majority observing no association [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Educational and Personal Opportunity Costs of Medical Student Preparation for the United States Medical Licensing Examination Step 1 Exam: A Single-Center Study

Cortés-Penfield

Khazanchi

Talmon

2020

Cureus

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Predicting Resident Performance from Preresidency Factors: A Systematic Review and Applicability to Neurosurgical Training

Cited by 45 publications

References 34 publications

Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

Medical School Resourcing of USMLE Step 1 Preparation: Questioning the Validity of Step 1

Educational and Personal Opportunity Costs of Medical Student Preparation for the United States Medical Licensing Examination Step 1 Exam: A Single-Center Study

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