Should my recommendation letter be written by artificial intelligence?

SummaryLetters of recommendation are increasingly important for the residency match. We assessed whether an artificial intelligence (AI) tool could help in writing letters of recommendation by analyzing recommendation letters written by 3 academic staff and AI duplicate versions for 13 applicants. The preferred letters were selected by 3 blinded orthopedic program directors based on a pre-determined set of criteria. The first orthopedic program director selected the AI letter for 31% of applicants, and the 2 remaining program directors selected the AI letter for 38% of applicants, with the staff-written versions selected more often by all of the program directors (p < 0.05). The first program director recognized only 15% of the AI-written letters, the second was able to identify 92%, and the third director identified 77% of AI-written letters (p < 0.05).

Task-shifting and the recruitment and retention of eye care workers in under-served areas: a qualitative study of optometrists' motivation in Ghana and Scotland.

AIM: To assist policy-makers in improving access to eye care in under-served areas by analysing the relationship between motivational factors affecting the uptake of task-shifting in eye care and the recruitment and retention of optometrists in remote and rural areas. BACKGROUND: The World Health Organization recommends two key strategies in tackling preventable blindness in under-served areas: improving human resources for health and task-shifting. The relationship between task-shifting and recruitment and retention of eye care workers in under-served areas is unknown. Ghana and Scotland are two countries from different levels of economic development that have notably expanded the roles of optometrists and struggle with rural recruitment and retention. METHODS: Motivation was explored through semi-structured interviews with 19 optometrists in Ghana and Scotland with experience in remote and rural practice. Framework analysis was used to analyse interviews, explore the relationship between task-shifting and recruitment and retention and create recommendations for policy. FINDINGS: The main motivational considerations included altruism, quality of life, learning and career opportunities, fulfilling potential, remuneration, stress of decision-making and collaboration. Motivational and demotivational factors for task-shifting and recruitment/retention shared many similar aspects. DISCUSSION: Recruitment and retention in remote and rural areas require staff be incentivised to take up those positions, motivated to remain and given the adequate resources for personal and professional fulfilment. Task-shifting also requires incentivisation, motivation to continue and the resources to be productive. Many motivational factors influencing recruitment/retention and task-shifting are similar suggesting these two strategies can be compatible and complementary in improving access to eye care, although some factors are culture and context specific. Understanding optometrists' motivation can help policy-makers improve rural recruitment and retention and plan services.

Occupational health screening during Gurkha Central Selection: a retrospective cohort study.

OBJECTIVE: The selection process to the British Army's Brigade of Gurkhas is rigorous, demanding and competitive. The ethos of recruitment to the Gurkhas is grounded in an overarching tenant: that selection is free, fair and transparent. The aim of this study was to retrospectively review reasons for potential recruits (PRs) to be deemed medically unsuitable or deferred suitability on medical grounds for selection to the Brigade of Gurkhas. METHODS: A retrospective review was conducted by extracted data from published post-exercise reports for the past four years to ascertain numbers of PRs deemed medically fit, medically unsuitable or deferred suitability on medical grounds. The International Classification of Disease version 11 (ICD-11) codes were retrospectively assigned to code medical reasons for non-progression. Rates of medical non-progression were compared by year. RESULTS: A total of 3154 PRs were analysed between 2018 and 2021. There was no significant difference between PRs deemed medically fit and those deemed medically suitable or deferred on medical grounds over the study period (p=0.351). There was a significant difference in the ratio of PRs deferred on medical grounds and those deemed medically unsuitable over the study period (p<0.05). CONCLUSION: Selection to the Gurkhas is extremely competitive. These data demonstrate that, overall, reasons for medical deferral or unsuitability have remained constant despite the impact of a global pandemic. These data reinforce the central tenant of Gurkha selection; that it continues to be free, fair, and transparent.

Civil service organization as a political determinant of health: Analyzing relationships between merit-based hiring, corruption, and population health.

A growing literature finds that the way governments are organized can impact the societies they serve in important ways. The same is apparent with respect to civil service organizations. Numerous studies show that the recruitment of civil servants based on their credentials rather than on nepotism or patronage reduces corruption in government. Political corruption in turn appears to harm population health. Up to this time, however, civil service organization is not a recognized determinant of health and is little discussed outside of political science disciplines. To provoke a broader conversation on this subject, the following study proposes that meritocratic recruitment of civil servants improves population health. To test this proposition, a series of regression models examines comparative data for 118 countries. Consistent with study hypotheses, meritocratic recruitment of civil servants corresponds longitudinally with both lower rates of corruption and lower rates of infant mortality. Results are similar after robustness checks. Findings with regard to life expectancy are more mixed. However, additional tests suggest meritocratic recruitment contributes to life expectancy over a longer span of time. Findings also offer more support for a direct pathway from meritocratic recruitment to population health rather than via changes in corruption levels per se, although this may depend on a country's level of economic development. Overall, this study offers first evidence that civil service organization, particularly the recruitment of civil servants based on the merits of their applications rather than on whom they happen to know in government, is a positive determinant of health. More research in this area is needed.

Explainability does not mitigate the negative impact of incorrect AI advice in a personnel selection task.

Despite the rise of decision support systems enabled by artificial intelligence (AI) in personnel selection, their impact on decision-making processes is largely unknown. Consequently, we conducted five experiments (N = 1403 students and Human Resource Management (HRM) employees) investigating how people interact with AI-generated advice in a personnel selection task. In all pre-registered experiments, we presented correct and incorrect advice. In Experiments 1a and 1b, we manipulated the source of the advice (human vs. AI). In Experiments 2a, 2b, and 2c, we further manipulated the type of explainability of AI advice (2a and 2b: heatmaps and 2c: charts). We hypothesized that accurate and explainable advice improves decision-making. The independent variables were regressed on task performance, perceived advice quality and confidence ratings. The results consistently showed that incorrect advice negatively impacted performance, as people failed to dismiss it (i.e., overreliance). Additionally, we found that the effects of source and explainability of advice on the dependent variables were limited. The lack of reduction in participants' overreliance on inaccurate advice when the systems' predictions were made more explainable highlights the complexity of human-AI interaction and the need for regulation and quality standards in HRM.

Residency Application Selection Committee Discriminatory Ability in Identifying Artificial Intelligence-Generated Personal Statements.

OBJECTIVE: Advances in artificial intelligence (AI) have given rise to sophisticated algorithms capable of generating human-like text. The goal of this study was to evaluate the ability of human reviewers to reliably differentiate personal statements (PS) written by human authors from those generated by AI software. SETTING: Four personal statements from the archives of two surgical program directors were de-identified and used as the human samples. Two AI platforms were used to generate nine additional PS. PARTICIPANTS: Four surgeons from the residency selection committees of two surgical residency programs of a large multihospital system served as blinded reviewers. AI was also asked to evaluate each PS sample for authorship. DESIGN: Sensitivity, specificity and accuracy of the reviewers in identifying the PS author were calculated. Kappa statistic for correlation between the hypothesized author and the true author were calculated. Inter-rater reliability was calculated using the kappa statistic with Light's modification given more than two reviewers in a fully-crossed design. Logistic regression was performed with to model the impact of perceived creativity, writing quality, and authorship or the likelihood of offering an interview. RESULTS: Human reviewer sensitivity for identifying an AI-generated PS was 0.87 with specificity of 0.37 and overall accuracy of 0.55. The level of agreement by kappa statistic of the reviewer estimate of authorship and the true authorship was 0.19 (slight agreement). The reviewers themselves had an inter-rater reliability of 0.067 (poor), with only complete agreement (four out of four reviewers) on two PS, both authored by humans. The odds ratio of offering an interview (compared to a composite of "backup" status or no interview) to a perceived human author was 7 times that of a perceived AI author (95% confidence interval 1.5276 to 32.0758, p=0.0144). AI hypothesized human authorship for twelve of the PS, with the last one "unsure." CONCLUSIONS: The increasing pervasiveness of AI will have far-reaching effects including on the resident application and recruitment process. Identifying AI-generated personal statements is exceedingly difficult. With the decreasing availability of objective data to assess applicants, a review and potential restructuring of the approach to resident recruitment may be warranted.

Operator selection for human-automation teaming: The role of manual task skill in predicting automation failure intervention.

Humans working in modern work systems are increasingly required to supervise task automation. We examined whether manual aircraft conflict detection skill predicted participants' ability to respond to conflict detection automation failures in simulated air traffic control. In a conflict discrimination task (to assess manual skill), participants determined whether pairs of aircraft were in conflict or not by judging their relative-arrival time at common intersection points. Then in a simulated air traffic control task, participants supervised automation which either partially or fully detected and resolved conflicts on their behalf. Automation supervision required participants to detect when automation may have failed and effectively intervene. When automation failed, participants who had better manual conflict detection skill were faster and more accurate to intervene. However, a substantial proportion of variance in failure intervention was not explained by manual conflict detection skill, potentially reflecting that future research should consider other cognitive skills underlying automation supervision.

Laying the foundations for implementing Magnet principles in hospitals in Europe: A qualitative analysis.

BACKGROUND: Magnet hospitals, a concept developed in the U.S., have been associated with improved nurse recruitment and retention, and better patient outcomes. Magnet principles may be useful to address workforce challenges in European hospitals, but they have not been implemented or evaluated on a large scale in the European hospital context. OBJECTIVE: This study aims to explore the initial phase of implementing Magnet principles in 11 acute care hospitals in six European countries. The specific objectives of the study were to investigate the type of work that characterises the early phase of implementation and how implementation leaders engage with their context. METHODS: A multinational qualitative study was conducted, with data from 23 semi-structured, one-to-one interviews with implementation leaders in 11 acute care hospitals in six European countries. Thematic analyses guided the analysis of data. FINDINGS: Three themes of core work processes during the early phase of implementing Magnet principles in European hospitals were identified. The first theme, 'Creating space for Magnet', describes how work was directed towards creating both political and organisational space for the project. The second theme, 'Framing to fit: understanding and interpreting Magnet principles', describes the translational work to understand what the Magnet model entails and how it relates to the local hospital context. Finally, the third theme, 'Calibrating speed and dose', describes the strategic work of considering internal and external factors to adjust the process of implementation. CONCLUSIONS: The first phase of implementation was characterised by conceptual and relational work; translating the Magnet concepts, considering the fit into existing structures and practices and making space for Magnet in the local context. Understanding the local context played an important role in shaping and guiding the navigation of professional and organisational tensions. Hospitals employed diverse strategies to either emphasise or downplay the role of nurses and nursing to facilitate progress in the implementation.

Longitudinal outcomes of a work inclusion program in mental health departments in the city of Milan.

BACKGROUND: Work functioning impairment is a key diagnostic and prognostic criterion in patients with psychiatric disorders and work inclusion is a major goal of their therapeutic pathway. Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in collaboration with other Departments of Mental Health and Addictions (DSMDs) in the town of Milan (Italy), has been developing the employment inclusion of psychiatric patients. AIMS: The objective of this study is to evaluate its outcomes over 8 years of observation. METHOD: We reported the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients recruited, investigating PIR TR106 outcomes per year focusing on different subgroups. We focused on 'positive', 'negative', and 'other' outcomes. RESULTS: We preliminary calculated job maintenance interventions (5%, 107) and excluded these interventions from the overall. We observed 29 job firing (1.4%) and 15 job resignations (0.7%) as negative results (equal to 2.2% of the total) and 388 job hiring (16.6%), 647 traineeships (31.8%), and 413 work formation (20.3%) as positive outcomes (equal to 68.75%). In other outcomes (29.1%) we found 305 dismissals from PIR TR 106 (15%) and transitory outcomes (14.1%).Job hiring increased from 8.9% in 2012 to 23.8 % in 2019 (p < .001), while the dismissals diminished from 26.7% to 13.3% (p < .001). The effectiveness of traineeships in terms of job hiring increased in the ratio of annual job hiring versus job traineeship (+48.8%). The majority of hired patients (15.1%) were affected by a psychotic disorder. A significant hiring increase was observed in patients with psychotic disorders and personality disorders (p < .005). CONCLUSIONS: PIR-TR106 represents a territorial employment inclusion program with progressively increasing effectiveness and specificity, as suggested by changes in outcomes during the 8-year observation. The adaptive capacity and sustainability of the intervention are worth further investigation.

Psychometric properties of automated video interview competency assessments.

Interviews are one of the most widely used selection methods, but their reliability and validity can vary substantially. Further, using human evaluators to rate an interview can be expensive and time consuming. Interview scoring models have been proposed as a mechanism for reliably, accurately, and efficiently scoring video-based interviews. Yet, there is a lack of clarity and consensus around their psychometric characteristics, primarily driven by a dearth of published empirical research. The goal of this study was to examine the psychometric properties of automated video interview competency assessments (AVI-CAs), which were designed to be highly generalizable (i.e., apply across job roles and organizations). The AVI-CAs developed demonstrated high levels of convergent validity (average r value of .66), moderate discriminant relationships (average r value of .58), good test-retest reliability (average r value of .72), and minimal levels of subgroup differences (Cohen's ds ≥ -.14). Further, criterion-related validity (uncorrected sample-weighted r¯ = .24) was demonstrated by applying these AVI-CAs to five organizational samples. Strengths, weaknesses, and future directions for building interview scoring models are also discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Breast Imaging Fellowship Virtual Interviews: The Program Director's Perspective.

OBJECTIVE: To evaluate breast imaging fellowship program directors' perspectives on the virtual interview process. METHODS: A 20-question survey constructed by members of the Fellowship Match Committee of the Society of Breast Imaging was distributed to all 99 breast imaging program directors registered with the Society. An initial e-mail with a link to the survey was distributed on September 9, 2022, and the survey was closed on October 1, 2022. Results were compiled and a descriptive statistical analysis was performed utilizing Microsoft Excel. RESULTS: There were 63 total responses (63/99, 64% response rate). There was a wide distribution in both the number of applications received and the number of interviews each program offered. Just under a fifth (12/63, 19%) of programs received 1 to 5 applications, whereas a quarter (16/63, 25%) received over 40 applications. In contrast, over a quarter (17/63, 27%) of programs interviewed 1 to 5 applicants, and only a small number (3/63, 5%) interviewed over 40 applicants. When reporting what worked best with the virtual interview process, the responses fell into the following 4 categories: efficiency, flexibility, virtual format, or other. When reporting what did not work well, the most common response (14/37, 38%) was conveying the atmosphere of the program in the virtual setting. CONCLUSION: This study provides an assessment of the virtual interview experience from the perspective of breast imaging fellowship programs, which may be useful in optimizing future interview experiences for programs and applicants.

The Utility of the Standardized Letter of Recommendation for Orthopedic Surgery Residency Applicants: A Systematic Review.

Despite widespread adoption for evaluating residency candidates, few studies have evaluated the orthopedic standardized letter of recommendation (SLOR). A systematic review using PubMed, Embase, and Web of Science was performed in June 2022. Study design and results from SLOR investigations were compiled. Common outcomes studied were summative rank statement scores and SLOR individual domains. Applicants were rated ranked to match or in the top one-third of rank lists in non-normally distributed frequencies. The association of summative rank statement score with match outcome was rarely studied. Applicants' ratings skew positively, the utility is reportedly limited, and influence on match outcome has been inadequately studied. [Orthopedics. 2024;47(1):e1-e5.].

The validity of general cognitive ability predicting job-specific performance is stable across different levels of job experience.

Decades of research in industrial-organizational psychology have established that measures of general cognitive ability (g) consistently and positively predict job-specific performance to a statistically and practically significant degree across jobs. But is the validity of g stable across different levels of job experience? The present study addresses this question using historical large-scale data across 31 diverse military occupations from the Joint-Service Job Performance Measurement/Enlistment Standards Project (N = 10,088). Across all jobs, results of our meta-analysis find near-zero interactions between Armed Forces Qualification Test score (a composite of math and verbal scores) and time in service when predicting job-specific performance. This finding supports the validity of g for predicting job-specific performance even with increasing job experience and provides no evidence for diminishing validity of g. We discuss the theoretical and practical implications of these findings, along with directions for personnel selection research and practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Do gender differences exist in letters of recommendation for reproductive endocrinology and infertility fellowship?

OBJECTIVE(S): To determine if gender differences exist in letters of recommendation (LORs) for reproductive endocrinology and infertility fellowship. DESIGN: Cohort study. SETTING: Academic medical center. PATIENTS: A cohort of applicants to a reproductive endocrinology and infertility fellowship program at a single Midwestern academic institution in a single year. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Quantitative measures included linguistics inquiry and word count analysis, with 4 summary variables and 25 word categories, to quantify tone and themes present by gender. Performing qualitative analysis in parallel to linguistic analysis allowed for the exploration of themes not conveyed in quantitative methods alone. Qualitative measures included the frequency of code themes in LOR by applicant gender. RESULTS: There were 272 letters from 72 applicants, 54 (76%) of which were women and 17 (24%) were men. One applicant was excluded because gender information was not specified; 269 letters were included in the quantitative linguistics and qualitative coding analysis. One hundred 10 letters (41%) were written by women and 159 (59%) by men. LOR written for men had a higher mean word count than those written for women (537 vs. 474, P=.04). Linguistics Inquiry and Word Count analysis exhibited more risk words used to describe men applicants (P=.01). When comparing word categories by letter writer gender, women letter writers more frequently used communal, affect, and home word categories whereas men writers more frequently used affiliation-related words. Qualitative analysis revealed that letters for men applicants described leadership, altruism, rapport with patients, and strong endorsements more frequently, whereas women applicants' letters more often mentioned doubt raisers and disclosures of personal life. In addition, letters for women applicants more often described candidates as drama free, not easy to "fluster," and not complainers. Furthermore, letters for women more frequently disclosed parenthood status. CONCLUSIONS: Gender differences exist among both letter writers and applicants. Qualitative analysis revealed that women applicants were more likely to be described with doubt raisers and personal life disclosures, whereas men were more likely to be described by their altruism and with a strong endorsement. Increasing bias awareness and implementing mitigation strategies would improve gender equity in LOR.

Challenges and career consequences of internationally educated nurses: Empirical research qualitative.

AIM: To explore challenges, and career consequences of internationally educated nurses, and considerations of development policy, education, and support for them from the perspective of nursing administrators. DESIGN: This study applied a qualitative description design. METHODS: A semi-structured interview guideline were used, interviewed eight internationally educated nurses and nine nursing administrators were chosen based on a purposive sampling method. Each interview was recorded and transcribed, after which it was analyzed using the qualitative content analysis method. RESULTS: Three categories were extracted as the challenges and career consequences, and the support they expect to organization of internationally educated nurses: "Language barrier," "Transition to recover their confidence and increase motivation," and "Close support from many quarters". Four categories were extracted as key considerations of support to internationally educated nurses that nursing administrators had recognized: "Clarification of career path", "Support for insufficient language skills", "Support for their career reconstruction", "Comprehensive support". This research found that nursing administrators had recognized necessity of adequate work-related support, it almost met the needs of internationally educated nurses. we need to make a clear policy how to develop internationally educated nurses as valuable human resource based on the evidence of further research relate to support practiced at each facility. PATIENT OR PUBLIC CONTRIBUTION: There was no patient and public involvement since I only conducted interview to nurses in this study.

Big Four LinkedIn Dimensions: Signals of Soft Skills? / [¿Son señales de soft skills las dimensiones del modelo LinkedIn Big Four?]

The use of LinkedIn as a tool in the recruitment and selection process has become routine in human resource management. However, a major drawback of such an approach is the lack of systematic and rigorous inferences on the psychological characteristics of the candidates. Calls have been made by scholars for further research on the psychometric guarantee of LinkedIn as a tool in the selection process. This study adopts signalling theory as a framework for exploring how LinkedIn profile information signals a candidate’s soft skills. Using a sample of 169 ITC professionals, through a cross-sectional design, soft skills were measured by means of a self-report questionnaire and LinkedIn profiles were assessed using rubrics for measuring the LinkedIn Big Four. Our findings demonstrate that LinkedIn Big Four Breadth of Professional Experience and Social Capital are valid signals of leadership, communication, problem solving, entrepreneurial and commercial thinking, planning and organization, and teamwork. We discuss the practical and theoretical implications of our results.(AU)

El uso de LinkedIn como herramienta en el proceso de reclutamiento y selección se ha convertido en algo habitual en la gestión de recursos humanos. Sin embargo, se carece de información rigurosa sobre la calidad de las inferencias que realizan los evaluadores sobre las características psicológicas de los candidatos, por lo que es necesario realizar más investigación sobre las garantías psicométricas de LinkedIn como herramienta de selección de personal. En consecuencia, el presente estudio adopta la teoría de las señales como marco para explorar cómo la información del perfil de LinkedIn es un indicador válido de las soft skills de los candidatos. Utilizando una muestra de 169 profesionales del sector tecnológico en España, mediante un diseño transversal, se midieron estas “habilidades blandas” a través de un cuestionario, mientras que los perfiles de LinkedIn se evaluaron utilizando las rúbricas del modelo LinkedIn Big Four. Los resultados muestran que las dimensiones del LinkedIn Big Four referentes a la experiencia profesional y el capital social, son señales válidas de las siguientes soft skills: liderazgo, comunicación, resolución de problemas, intraemprendimiento, pensamiento comercial, planificación y organización y trabajo en equipo. Finalmente, se discuten las implicaciones prácticas y teóricas de nuestros resultados.(AU)