John C Burkhardt1, Kendra P Parekh2, Fiona E Gallahue3, Kory S London4, Mary A Edens5, A J Humbert6, M Tyson Pillow7, Sally A Santen8, Laura R Hopson9. 1. Assistant Professor, Departments of Emergency Medicine and Learning Health Sciences, University of Michigan Medical School. 2. Associate Professor, Department of Emergency Medicine, Vanderbilt University School of Medicine. 3. Residency Program Director and Associate Professor, Department of Emergency Medicine, University of Washington. 4. Associate Residency Program Director, Director of Clinical Operations, Jefferson Methodist ED, Associate Director of Quality Assurance and Practice Improvement, and Assistant Professor, Department of Emergency Medicine, Thomas Jefferson University. 5. Residency Program Director and Associate Professor, Department of Emergency Medicine, Louisiana State University Health Sciences Center Shreveport. 6. Residency Program Director and Associate Professor of Clinical Emergency Medicine, Indiana University School of Medicine. 7. Vice Chair of Education, and Associate Professor, Department of Emergency Medicine, Baylor College of Medicine. 8. Senior Associate Dean for Assessment, Evaluation and Scholarship, and Professor, Department of Emergency Medicine, Virginia Commonwealth University School of Medicine. 9. Associate Chair of Education, Emergency Medicine Residency Program, and Associate Professor of Emergency Medicine, University of Michigan Medical School.
Abstract
BACKGROUND: Emergency medicine (EM) residency programs want to employ a selection process that will rank best possible applicants for admission into the specialty. OBJECTIVE: We tested if application data are associated with resident performance using EM milestone assessments. We hypothesized that a weak correlation would exist between some selection factors and milestone outcomes. METHODS: Utilizing data from 5 collaborating residency programs, a secondary analysis was performed on residents trained from 2013 to 2018. Factors in the model were gender, underrepresented in medicine status, United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge (CK), Alpha Omega Alpha (AOA), grades (EM, medicine, surgery, pediatrics), advanced degree, Standardized Letter of Evaluation global assessment, rank list position, and controls for year assessed and program. The primary outcomes were milestone level achieved in the core competencies. Multivariate linear regression models were fitted for each of the 23 competencies with comparisons made between each model's results. RESULTS: For the most part, academic performance in medical school (Step 1, 2 CK, grades, AOA) was not associated with residency clinical performance on milestones. Isolated correlations were found between specific milestones (eg, higher surgical grade increased wound care score), but most had no correlation with residency performance. CONCLUSIONS: Our study did not find consistent, meaningful correlations between the most common selection factors and milestones at any point in training. This may indicate our current selection process cannot consistently identify the medical students who are most likely to be high performers as residents.
BACKGROUND: Emergency medicine (EM) residency programs want to employ a selection process that will rank best possible applicants for admission into the specialty. OBJECTIVE: We tested if application data are associated with resident performance using EM milestone assessments. We hypothesized that a weak correlation would exist between some selection factors and milestone outcomes. METHODS: Utilizing data from 5 collaborating residency programs, a secondary analysis was performed on residents trained from 2013 to 2018. Factors in the model were gender, underrepresented in medicine status, United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge (CK), Alpha Omega Alpha (AOA), grades (EM, medicine, surgery, pediatrics), advanced degree, Standardized Letter of Evaluation global assessment, rank list position, and controls for year assessed and program. The primary outcomes were milestone level achieved in the core competencies. Multivariate linear regression models were fitted for each of the 23 competencies with comparisons made between each model's results. RESULTS: For the most part, academic performance in medical school (Step 1, 2 CK, grades, AOA) was not associated with residency clinical performance on milestones. Isolated correlations were found between specific milestones (eg, higher surgical grade increased wound care score), but most had no correlation with residency performance. CONCLUSIONS: Our study did not find consistent, meaningful correlations between the most common selection factors and milestones at any point in training. This may indicate our current selection process cannot consistently identify the medical students who are most likely to be high performers as residents.
Authors: Dowin Boatright; David Ross; Patrick O'Connor; Edward Moore; Marcella Nunez-Smith Journal: JAMA Intern Med Date: 2017-05-01 Impact factor: 21.873
Authors: Michael S Beeson; Eric S Holmboe; Robert C Korte; Thomas J Nasca; Timothy Brigham; Chad M Russ; Cameron T Whitley; Earl J Reisdorff Journal: Acad Emerg Med Date: 2015-06-25 Impact factor: 3.451