Selection bias: Examining the feasibility, utility, and participant receptivity to incorporating simulation into the general surgery residency selection process

Am J Surg. 2017 Jun;213(6):1171-1177. doi: 10.1016/j.amjsurg.2016.09.029. Epub 2016 Sep 30.


Background: Opportunities exist to revise the current residency selection process to capture desirable candidate competencies. We examined the extent to which components of the American College of Surgeons/Association for Surgical Education simulation-based medical student curriculum combined with a teamwork activity could be used as potential screening method.

Methods: Students participated in a workshop consisting of training/evaluation of knot tying, suturing, airway management, gowning/gloving, and teamwork. Surveys were given to medical students (MS) and faculty/resident/staff (FRS) to examine their opinions about the residency screening process, the most critical competencies to assess, and the effectiveness of each station for candidate evaluation.

Results: Communication (FRS, 4.86 ± .35; MS, 4.93 ± .26), leadership (FRS, 4.41 ± .80; MS, 4.5 ± .76), judgment (FRS, 4.62 ± .74; MS, 4.67 ± .62), professionalism (FRS, 4.64 ± .73; MS, 5.00 ± .00), integrity (FRS, 4.71 ± .78; MS, 4.87 ± .35), and grit/resilience (FRS, 4.71 ± .78; MS, 4.53 ± .74) were considered most valuable for candidate screening. The simulation-based curriculum for evaluation of residency candidates was rated lowest by both groups. Open response comments indicated positive perceptions of this process.

Conclusions: Employing simulation to assess candidates may be most beneficial for examining nontechnical attributes. Future work should continue to explore this area.

Keywords: Interview; Nontechnical skills; Residency; Selection; Simulation.

MeSH terms

  • Clinical Competence
  • Curriculum
  • Female
  • General Surgery / education*
  • Humans
  • Internship and Residency*
  • Male
  • Pilot Projects
  • Selection Bias*
  • Simulation Training*