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Improving Our Ability to Predict Resident Applicant Performance: Validity Evidence for a Situational Judgment Test.

Michael J Cullen1, Charlene Zhang2, Brittany Marcus-Blank3

  • 1Department of Graduate Medical Education, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Teaching and Learning in Medicine
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Summary

Situational judgment tests (SJTs) effectively predict physician residents' performance on Accreditation Council for Graduate Medical Education (ACGME) competencies and multisource professionalism assessments (MPAs). SJTs offer incremental validity beyond USMLE scores, supporting holistic candidate reviews.

Keywords:
Graduate medical educationpersonal characteristicsresident selectionworkplace assessment

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Area of Science:

  • Medical Education
  • Professionalism Assessment
  • Physician Training

Background:

  • Assessing professionalism and interpersonal skills is crucial for physicians but challenging in medical education.
  • Situational judgment tests (SJTs) are a promising tool for measuring these noncognitive competencies.
  • SJTs are used internationally for medical school and postgraduate selection but are under-investigated in US residency programs.

Purpose of the Study:

  • To determine if an SJT measuring professionalism predicts resident performance on ACGME competencies and multisource professionalism assessments (MPAs).
  • To evaluate the SJT's ability to predict both current and future resident performance.
  • To assess the SJT's incremental validity over USMLE scores.

Main Methods:

  • Developed an SJT assessing seven professionalism dimensions.
  • Administered the SJT to residents across 21 programs at 2 institutions in 2017.
  • Analyzed SJT and USMLE score validity in predicting ACGME competencies and MPAs over time (June 2017, Sept 2017, June 2018).

Main Results:

  • SJT scores significantly predicted overall ACGME milestone performance (r = .13–.17) and MPA performance (r = .19–.21) at both assessment periods.
  • The SJT also predicted specific ACGME competencies including patient care, systems-based practice, learning and improvement, communication skills, and professionalism.
  • SJT scores demonstrated incremental validity over USMLE scores for predicting ACGME performance and MPA performance.

Conclusions:

  • SJTs show potential for assessing noncognitive attributes in residency applicants.
  • The SJT's incremental validity highlights the need for holistic candidate reviews incorporating both cognitive and noncognitive measures.
  • SJTs can enhance the selection process for residency programs by providing a more comprehensive assessment of candidates.