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The Anatomy of a Failure: Can We Predict Which Residents are Going to Pass/ Fail

The Anatomy of a Failure: Can We Predict Which Residents are Going to Pass/ Fail the ABS Certifying Exam?. Marco Zahedi, BS, Ajay V. Maker, MD, Dana Villines, MA, Vijay K. Maker, MD. University of Illinois at Chicago, Metropolitan Group of Hospitals Residency in General Surgery. Purpose

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The Anatomy of a Failure: Can We Predict Which Residents are Going to Pass/ Fail

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  1. The Anatomy of a Failure: Can We Predict Which Residents are Going to Pass/ Fail the ABS Certifying Exam? Marco Zahedi, BS, Ajay V. Maker, MD, Dana Villines, MA, Vijay K. Maker, MD University of Illinois at Chicago, Metropolitan Group of Hospitals Residency in General Surgery

  2. Purpose To study the patterns of failure in the ABS Certifying examination and To determine if residents at risk of not passing the ABSCE can be identified a priori.

  3. Methods

  4. SAMPLE (2001-2010) Graduated 60 residents

  5. Non Native Speakers

  6. Knowledge • Communication • Spoken English

  7. Descriptive categories with variables of Interest * Separate measuring tool

  8. USMLE 1 …emphasis on principles and mechanisms underlying health, disease, and modes of therapy.

  9. USMLE 2 …apply basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.

  10. ABSITE Percentile scores of the 5 yrs. of residency

  11. UIC/MGH RESIDENCY IN GENERAL SURGERY ″MOCK ORALS″ Objective Evaluation of Clinical Scenarios 4th Tuesday, 7:00 a.m. to 8:00 a.m. Resident Signature: Evaluator Signature:

  12. Citywide Mock Orals

  13. Descriptive categories with variables of Interest * Separate measuring tool

  14. UIC/MGH RESIDENCY IN GENERAL SURGERY CRITIQUE FOR MOCK ORAL EXAM COMMUNICATION SKILLS 4th Tuesday, 7:00 a.m. to 8:00 a.m. Guzman E, Babakhani A, Maker VK. Improving outcomes on the ABS certifying examination: can monthly mock orals do it? J Surg Educ. 2006;65:441-43. Resident Signature: Evaluator Signature:

  15. Non Verbal Communication • Makes up two-thirds of all communication • and should match verbal communication • Less then 10 seconds to make a good impression • First sight observation makes 83% of the impact • Best practiced when persons are face to face SOLER: Non Verbal communication skills Egan G. 1975 Pease B., Pease A. 2004 “The Definitive Book of Body language”

  16. Charles Darwin 1871 The Expressions the Emotions in Man and the Animals

  17. Results

  18. Mean Knowledge Scores

  19. Mean Knowledge Scores

  20. Verbal and Non-verbal Communication Scores

  21. Verbal and Non-verbal Communication Scores

  22. Candidates with higher level of Communication proficiency have higher levels of Organization of their knowledge points James E. Houston and Everett V. Smith Jr. UIC Eval Health Prof 2008 31:404

  23. Maker

  24. Citywide Mock Orals “F” 231 / 248 / 80

  25. Citywide Mock Orals “P” 243 / 245 / 95

  26. Spoken English Scores

  27. CONCLUSIONS • Professional verbal and non-verbal communication was the most important factor in the first time pass rates in the certifying exam. of the American Board of Surgery (ABSCE). • USMLE Step2 scores are more aligned with ABSCE pass rates than Step 1 scores. • 3. US or International Medical School Graduates as well as • native or non-native English speakers did not differ for • ABSCE pass rates.

  28. Limitations

  29. Sample size • Make up of sample • ( AMG 83% IMG 17%) • Communication Tools • Spoken English Tools

  30. The Second Time Around • Measurement error • lacks reliability rater inconsistency • Construct irrelevance Pass: Second Time : 85% (11) Pass: Third Time : 15% (2) Mark R. Raymond and Ulana A. Luciw-Dubas NBME Eval Health Prof 2010 33:386

  31. Questions for APDS • Chief Residents who fail ABSCE are lesser Surgeons ? • Do they become better surgeons when they pass on the second attempt? • Should they be given same operating privileges ? • Should they get reimbursed the same amount of money as you ? • Is second or third time “pass” a public information, if yes…legal implications?

  32. The CIS subcomponent of Step 2 CS has been redesigned to assess a fuller range of competencies.  The new approach divides communication skills into a series of functions. Beginning June 17, 2012, the Communication and Interpersonal Skills (CIS) scale will focus on five functions:1. Fostering the relationship2. Gathering information3. Providing information4. Making decisions: basic5. Supporting emotions: basic Several additional functions are still under development; these include making decisions: advanced; supporting emotions: advanced; and helping patients with behavior change. Availability of USMLE step 2 CK and CS prior to interviews/ match date

  33. SUMMARY OF APPLICATION FOR Ranking

  34. RATING SCALE PART II INTERVIEW PART III

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