Melissa Held,Connecticut Children's Medical Center,Hartford,CT,Anton M. Alerte,University of Connecticut,Hartford,CT
In the era of entrustable professional activities (EPAs) and holistic approaches to evaluating medical students for residency candidacy, faculty/educators have struggled to identify factors that can be used as reliable markers to predict successful transition into post graduate medical education. Our research question centered around identifying factors not already routinely used in the evaluation of candidates for post graduate education (Board scores, letters of recommendation, MSPEs) that could predict successful transition from medical school into intern year in Pediatrics.
This was a pilot study using mixed methodology. We first conducted interviews with residency leadership members in a single pediatric residency program. There were 3 separate interview sessions each with the head residency program director, associate program directors and Chief residents using a semi-structured format. Interviews were audiotaped and transcribed. Interview questions asked included 1.) the qualities and skills that made an exemplary intern, 2.) identification of 2-3 specific PL-1s in the program that epitomized those qualities and skills, and 3.) what specifically about those individuals that made them unique. Qualitative analysis was used to identify themes.
PL-1 pediatric residents in the program were then asked to complete two questionnaires, the Maslach Burnout Inventory and the Big Five Personality Test. Demographic information was also collected including medical school, any other degrees or training completed prior to entering this residency program, whether the PL-1 had a specific role model prior to starting residency, and whether the resident had children of their own.
All members of the residency program leadership participated (n=7) and 16/20 (80%) PL-1 residents completed surveys. Authors categorized comments into 9 themes including “ seeking feedback,” “self-directed,” lack of “other” traits,” “independent seekers of knowledge,” and “organizational skills.” These themes could be grouped under all seven competencies including Medical knowledge, Personal and Professional Development, Interpersonal and Communication skills, Professionalism, Practice-based Learning and Improvement, Systems-based practice and Patient Care. Three themes were specifically discussed and received more dialogue time in all three residency leader interviews and included “Feedback,” “Professional behaviors” and “Self-directed learner.” A unique theme named “lack of “other” negative traits” emerged from focus group interviews. When compared with their peers, the three “successful” PL-1’s identified by the residency leaders showed overall, no statistical significance when comparing their Maslach Burnout scores and Big Five Personality test scores. The areas that started to approach significance from the Big Five Personality scoring included “agreeableness” and “conscientiousness” (p=0.11 for both).
Although there were not statistically significant differences between 3 specific “exemplary” PL-1s in our program with those of their peers, two areas began to approach significance and we may see differences with a larger study cohort. Many qualities and skills identified in “exemplary” PL-1s are traits that can be taught, enhanced or counseled by medical student educators helping to transition senior students to their resident roles.