ABSTRACT
Purpose/Background: In response to the COVID-19 pandemic, interviews for colorectal surgery residency were conducted virtually. It is unknown if virtual interviews provide an adequate substitution for in-person interviews Hypothesis/Aim: Determine applicants' views of in-person vs virtual residency interviews. Methods/Interventions: Two surveys were developed to assess colorectal surgery applicants' experience with either in-person or virtual colorectal residency interviews. The surveys were administered to applicants in the 2019 cycle who interviewed in-person (distributed February 2021) and to applicants in the 2020 cycle who interviewed virtually (distributed November 2020). The surveys consisted of 38 questions addressing various elements of the effectiveness of the interview experience: information received during the interview, ability to learn about programs and cities, and ability to determine fit with programs. Responses on a 5-point Likert scale were dichotomized by combining the top two (agree and strongly agree) and bottom three (strongly disagree, disagree and neutral). Data collected from the two groups were compared via two-sample t-test, Chi-square and Fisher's exact test as appropriate. Statistical significance was determined at p<0.05. Results/Outcome(s): There were 119 responses to the two surveys, 42 who interviewed in-person and 77 who interviewed virtually. There was no difference in race or medical education between the two groups. A higher proportion of applicants who interviewed virtually applied to >25 programs (75% vs 56%, p=0.05), with a correspondingly higher mean number of interviews completed (13.7 vs 11.4 respectively, p=0.07). An overwhelming majority of applicants (virtual: 92% vs in-person: 97%;p=0.35) agreed that programs provided them with useful information during the interview. Nevertheless, applicants who interviewed virtually were significantly less likely to agree that they developed a good impression of the institution (73% vs 94%, p=0.01) or the city (47% vs 72%, p=0.02). A significantly higher proportion of virtual interviewees lacked the opportunity to meet privately with current colorectal residents (41% vs 19%, p=0.03). In addition, a significantly lower proportion of virtual interviewees agreed that the interviews allowed them to develop “rapport” (69% vs 91%, p=0.02) or determine if a program was the “right fit” (71% vs 97%, p<0.01). Limitations: This is a retrospective survey that was conducted with different applicant pools at different time periods. Response rates for the two applicant groups varied. Conclusions/Discussion: Virtual interviewees for colorectal surgery residency were less likely to develop a good impression about programs and their host cities. They also had challenges in determining if a program was the “right fit”. As we consider future formats for interviews, the effectiveness of virtual interviews needs to be carefully considered and requires further investigation with process improvement.
ABSTRACT
Introduction: The COVID-19 pandemic forced general surgery residency programs to conduct virtual interviews, limiting traditional evaluation of applicants. We piloted a novel, completely virtual simulated skills assessment for interviewees. We aimed to assess feasibility of virtual skill assessments and determine whether differing domains of skills were successfully assessed. Methods: During their interview, applicants to 1 general surgery residency program in 2020 completed a simulated surgical skills test assessing suturing, knot tying, anatomy, interpretation of chest x-ray and arterial blood gas, emotional intelligence through a challenging standardized patient interaction, and communication through a Lego building task. Applicants were scored on each station and assigned a quartile ranking (1 through 4) based on their relative scores. Results: Surgical skills were assessed in 109 general surgery applicant interviews. A principal components factor analysis was conducted on the 6 items with varimax rotation, Kaiser-Meyer-Olkin = 0.57, all Kaiser-Meyer-Olkin values for individual items > 0.5. Three factors had eigenvalues > 1 and in combination explained 66.38% of the data. The clustered items for the same factor suggest that factor 1 represents medical knowledge and the ability to convey it, factor 2 represents technical skills, and factor 3 represents emotional intelligence. See Table 1 for factor loadings after rotation. Conclusion: As we consider a new era of virtual resident interviews, this research provides evidence that a large group of applicants can undergo a completely virtual skills assessment and that these 6 items likely assess a broad range of domains: medical knowledge, technical skills, and nontechnical skills. [Formula presented]
ABSTRACT
Study Objectives: Alcohol is associated with increased risk of hypertension and diabetes, which are associated with increased morbidity and mortality from COVID-19, as are opioids and methamphetamine. Our institution has a Screening, Brief Intervention, and Referral to Treatment (SBIRT) program in 18 emergency departments (EDs), 14 inpatient hospitals, and 5 primary care sites to universally address substance use with patients as part of usual care. As our region has a high prevalence of COVID-19, we had to minimize staff presence in the ED, including health coaches and social workers who normally work with patients with a positive SBIRT screen. The COVID-19 crisis demanded innovation;we implemented a “Telephonic SBIRT” (T-SBIRT) model to continue to address patients’ substance use in the context of physical and mental health while minimizing in-person interactions. Methods: Due to regulations regarding “non-essential” staff, 11 SBIRT Health Coaches were removed from their ED and primary care sites. Health Coaches were assigned to T-SBIRT where a central phone number forwards to the mobile phone of the remote health coach on duty. Shifts cover 8am-12am, 7 days per week. We developed a flyer with the services, hours, and phone number and broadly disseminated to ED chairs, primary care providers, nurse managers, all hospital social workers, the Health Home team, and others via virtual meetings and email. We developed a HIPAA-compliant Research Electronic Data Capture (REDCap) form for Health Coaches to use to document services, including the questions for AUDIT (alcohol) and DAST-10 (drug) full screens and checkboxes for brief interventions, referrals to treatment, and virtual resources provided (AA/NA, BottleCap for reducing alcohol use, tobacco cessation, etc). We developed a system via REDCap where the Health Coach emailed the caller the resource list from a central email address in real time. Finally, we developed a REDCap form to virtually obtain HIPAA consent to enroll participants in our substance use disorder care navigation program (Project CONNECT). Results: In 13 weeks, we had 422 phone calls, 228 (54%) incoming, 190 (45%) outgoing, and 4 (1%) voicemails. 108 (26%) of calls were with patients, 13 (3%) with family/friends, 224 (53%) with staff members, and 79 (19%) with treatment providers. Calls stemmed from 14 hospitals, 2 primary care practices, and Health Home. We worked with 69 unique staff members and 94 unique patient cases, 75 (81%) male, 20 (19%) female, and 7 (8%) in Spanish. We provided 73 full screens, (91% high-risk), 47 brief interventions, referrals for 84 patients, emailed virtual resources to 40 individuals, and enrolled 16 patients in Project CONNECT. Conclusion: We were able to have a health coach provide T-SBIRT services for patients from sites that do not normally have a health coach, and cover weekends and later hours. Since calls received were for patients with high-risk substance use in need of a referral to substance use disorder treatment, more frontline provider education is needed on the ability of the T-SBIRT Team to address the full spectrum of substance use, not just high-risk substance use. In conclusion, T-SBIRT is a model that we plan to sustain to continually expand reach, and to provide services to address substance use as part of usual care with patients at more locations than we could otherwise physically staff.