Aimee Gardner¹
Paula Costa²
1 Baylor College of Medicine 
2 SurgWise 

Introduction 

Postgraduate medical education programs are actively searching for efficient, effective, and equitable solutions for selecting applicants into their programs. Situational judgment tests (SJTs) have been proposed as one approach to make headway on this complex issue. We perform a multi-institutional study examining how SJTs designed to measure an array of desirable competencies can predict multiple dimensions of performance through the first two years in residency training. 

Applicants to general surgery residency programs in the United States completed unique program-specific SJTs as part of their application packets over three selection cycles. Performance along the dimensions of patient care, medical knowledge, systems-based practice, practice-based learning & Improvement, interpersonal & communication skills, and professionalism were collected for those selected into each program for the first two years in training. Descriptive statistics and correlations were computed, and then analysis of variance (ANOVA) tests were run to examine differences between four groups of SJT performance. 

Performance data were collected for PGY1 and PGY2 residents from seven surgery residency programs. SJT performance was positively related to patient care, medical knowledge, practice-based learning and improvement, professionalism, interpersonal and communication skills, and the overall milestone scores. In general, higher performance on the SJT resulted in higher performance later in training, with the exception of interpersonal and communication skills. Residents who did not complete an SJT assessment performed significantly worse overall compared to all other trainees. 

SJTs demonstrate promise for assessing important noncognitive attributes in residency applicants and align with international efforts to review candidates more holistically and minimize potential biases. These findings demonstrate the value of the SJT methodology in postgraduate medical education selection and predicting future in-training performance 

References (maximum three) 

1. Cullen MJ, Zhang C, Sackett PR, Thakker K, Young JQ. Can a Situational Judgment Test 235 Identify Trainees at Risk of Professionalism Issues? A Multi-Institutional, Prospective Cohort 236 Study. Acad Med. 2022 Oct 1;97(10):1494-1503. 

2. Willis RE, Kempenich JW, Patnaik R, Dent DL. Identifying Potential Attrition during the 241 Residency Applicant Screening Process Using a Situational Judgment Test. J Surg Educ. 2022 242 Nov-Dec;79(6):e103-e108. 

3. Gardner AK, Dunkin BJ. Evaluation of Validity Evidence for Personality, Emotional Intelligence, 245 and Situational Judgment Tests to Identify Successful Residents. JAMA Surg. 2018 May 246 1;153(5):409-416.