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A995
October 14, 2007
3:30 PM - 5:00 PM
Room Room 123
Testing Program To Improve Anesthesia Resident Selection
Alexander S. Matveevskii, M.D., Ph.D., Jennifer J. Loyden, M.A., Lisa J. Merlo, Ph.D.
Department of Anesthesiology, University of Florida, Gainesville, Florida
Introduction: Theoretical knowledge, development of manual skills, and development of clinical judgment are essential for anesthesiology residents (1,2). Some anesthesiology residents, after being admitted to an anesthesiology program have problems with multitasking in the operating room (3). A standardized testing program would significantly improve the anesthesiology resident selection process.

Methods: We conducted a pilot study using 21 residents enrolled in an anesthesiology program at an academic medical institution. Ten were identified by members of the clinical competency committee as being high achieving (HA), and 11 as low achieving (LA) in areas of training. Tests were given to each of the 21 residents: Fine Motor Dexterity: Motor skills were assessed using the Finger Tapping test and the Grooved Pegboard test; Executive Functioning: Ability to rotate between two tasks simultaneously was assessed using the Trail-Making test; Processing Speed: Speed of processing was assessed using the Symbol Search and Coding subtests of the Wechsler Adult Intelligence Scales, Third Edition (WAIS-III); Attention: Attention was assessed using the Conner's Continuous Performance Test, Second Edition (CPT-II); Personality: Scores on the Five-Factor Model of Personality (i.e., Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience, and underlying personality facets) was assessed using the International Personality Item Pool Representation of the NEO PI-R (IPIP-NEO). Scores for each test were standardized (e.g., z-scores, T-scores, Standard Scores, or Percentile scores) before analysis. Independent samples t-tests were computed for each study variable to assess for group differences among the HA and LA groups. Given the small sample and the exploratory nature of the study, the significance level was set at p < .10 to minimize the likelihood of Type II error.

Results: Neuropsychological testing indicated no significant group differences related to fine motor coordination, executive functioning, or processing speed. Results indicated that individuals in the LA group were significantly more likely to make commission (i.e., impulsivity) errors (t = 2.07, p < .06), and detectability (i.e., difficulty discriminating between stimuli) errors (t = 2.06, p < .06). No individuals in the HA group scored in the mildly, moderately, or markedly atypical range (i.e., T-score > 60) on these measures. Individuals in the HA group scored significantly higher and above the 50th percentile on: Cooperation (t = 2.42, p = .03), and Self-Efficacy (t = 2.49, p < .03). Most individuals in the HA group scored above the 60th percentile on Achievement-Striving (t = 2.20, p < .05), and Adventurousness (t = 1.94, p < .08). Individuals in the HA group scored significantly lower than their LA counterparts on: Neuroticism (t = 2.37, p < .04), Anxiety (t = 3.12, p < .01), Anger (t = 2.21, p < .05), Vulnerability (t = 3.29, p < .01).

Discussion: We expect to develop a program that will test cooperation, self-efficacy, achievement-striving, neuroticism, anxiety, anger, and vulnerability. This program may be used for selection of anesthesiology residents, and as objective assessment during training.

Refs:

1. Br J Anaesth 2002; 88: 418-429.

2. Anesth Analg 2005; 100: 502-505.

3. J Clin Anesth 1997; 9:629-36.

Anesthesiology 2007; 107: A995