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Situational Judgment Tests Offer an Unbiased and Effective Tool to Assess Competencies in General Surgery Residency
Usman Y Panni1, Tiffany K Brocke1, Angela Colbeck1
1Department of Surgery, Washington University in St. Louis, St. Louis, MO.
Objective:
To evaluate the effectiveness of an online, surgery-specific situational Judgement test (SurgSJT), by SurgWise™, in identifying the general surgery residency candidates for interview and to compare its performance with traditional application review process at a single residency program.
Design:
The study was conducted as a prospective observational study. A cohort of applicants was randomly selected to complete the SurgSJT. Results of the SurgSJT were blinded from faculty reviewers and not used in interview selection process. Statistical tests performed included descriptive statistics, chi-square test, univariate and multivariable logistic regression analysis.
Setting:
The study was performed at the general surgery residency program at Washington University in St. Louis.
Participants:
A total of 312 applicants from the 2023-2024 general surgery residency application cycle were included. Each participant completed the SurgWise™ SurgSJT and was assigned to performance tier compared to other applicants nationally i.e., top 25th percentile (best performance), middle 50th percentile (average performance), or bottom 25th percentile (poor performance). Additionally, applicants were categorized as low, average, or high performers for each of the ten individual competencies assessed on the SurgSJT.
Results:
Of the applicants, 29.2% ranked in the top 25th percentile group on the SurgSJT, 52.9% in the middle 50, and 17.9% in the bottom 25th. Among the 97 applicants invited to interview, 45.3% were in the top 25th percentile group, while only 12.3% were in the bottom tier (p < 0.001). Applicants who were invited to interview also scored significantly higher in "self-directed learning" (p = 0.038). SurgSJT scores showed no significant variation by gender or underrepresented minority (URM) status. On multivariable analysis, SurgSJT performance, Step 2 CK score ≥ 250, and attending an LCME-Accredited private medical school status were independently associated with interview selection.
Conclusion:
SurgSJT offers a reliable and objective tool for evaluating competencies relevant to residency training. When used in conjunction with traditional metrics, SurgSJT can enhance the equity and effectiveness of the general surgery residency selection process.
