Journal of Surgical Education最新文献

{"title":"Concordance in Intraoperative Surgeons’ Opinion in the Diagnosis and Management of Acute Appendicitis: The Role of Training","authors":"","doi":"10.1016/j.jsurg.2024.05.004","DOIUrl":"10.1016/j.jsurg.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>Acute appendicitis is a wide spectrum disease, from simple inflammation to evident intestinal perforation. The correct interpretation of the degree of inflammation is crucial to guarantee appropriate treatment and adherence to protocols and guidelines. In order to investigate this concordance, the authors compared the definition of appendicitis and the predicted treatment among all surgeons affiliated to a single Pediatric Surgery School (consisting of 8 different centers).</p></div><div><h3>Design</h3><p>Twenty-two short recordings of intra-operative manipulation of appendices were shown to 56 surgeons, blindly to clinical information. Four items were collected and analyzed: classification of appendicitis, type and length of predicted antibiotic therapy, day of re-alimentation. Data were analyzed to identify the concordance kappa coefficient, stratified according to expertise of the responding surgeon.</p></div><div><h3>Results</h3><p>The 1232 evaluations obtained in all valued items low overall concordance. Subgroup analysis identified a good agreement between younger surgeons only in the choice of antibiotic (k 0.47). However, if the centers were divided between University and non-University Hospitals, a strong agreement was found in the former both for classification (k 0.45 vs 0.32) and type of antibiotic (k 0.42 vs 0.24).</p></div><div><h3>Conclusions</h3><p>The overall concordance between surgeons in different centers in the diagnostic classification and predicted treatment of appendicitis is quite low. University Hospital have a highest concordance in both items at all levels of expertise; it might be postulated that teaching to younger surgeon increase the comparison between experts and finally the concordance and adherence to protocols within the center.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the COVID-19 Pandemic on Geographic Placement of Applicants to General Surgery Residency Programs","authors":"","doi":"10.1016/j.jsurg.2024.05.019","DOIUrl":"10.1016/j.jsurg.2024.05.019","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>COVID-19 greatly influenced medical education and the residency match. As new guidelines were established to promote safety, travel was restricted, visiting rotations discontinued, and residency interviews turned virtual. The purpose of this study is to assess the geographic trends in distribution of successfully matched General Surgery applicants prior to and after the implementation of pandemic guidelines, and what we can learn from them as we move forward.</p></div><div><h3>DESIGN</h3><p>This was a retrospective review of 129 Accreditation Council for Graduate Medical Education (ACGME) accredited, academic General Surgery Residency Programs across 46 states and the District of Columbia. Categorically matched residents’ medical schools (i.e., home institutions), medical school states, and medical school regions as defined per the Association of American Medical Colleges (AAMC), were compared to the same geographic datapoints as their residency program. Preliminary residents were excluded. Residents in the 2018, 2019, and 2020 cycles were sub-categorized into the “pre-COVID” group and residents in the 2021 and 2022 applications cycles were sub-categorized into the “post-COVID” group. The percentages of residents who matched at their home institution, in-state, and in-region were examined.</p></div><div><h3>SETTING</h3><p>Multiple ACGME-accredited, university-affiliated General Surgery Residency Programs across the United States of America.</p></div><div><h3>PARTICIPANTS</h3><p>A total of 4033 categorical General Surgery residents were included.</p></div><div><h3>RESULTS</h3><p>Of 4033 categorical residents who matched between 2018 and 2022, 56.1% (n = 2,263) were in the pre-COVID group and 43.9% (n = 1770) were in the post-COVID group. In the pre-COVID group 14.4% (n = 325) of residents remained in-home (IH), 24.4% (n = 553) in-state (IS), and 37.0% (n = 837) in- region (IR), compared to 18.8% IH (n = 333), 27.8% IS (n = 492), and 39.9% IR (n = 706) in the post-COVID group, respectively. Significant increases for IH and IS resident matching at 4.5% and 3.4%, respectively, were noted in the post-COVID period (p &lt; 0.05).</p></div><div><h3>CONCLUSION</h3><p>The COVID-19 pandemic, and the ensuing changes adopted to promote safety, significantly impacted medical student opportunities and the General Surgery residency application process. General Surgery match data over the last 5 years reveals a statistically significant increase in the percentage of applicants matching at in-home and in-state institutions after the pandemic.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeing is Believing – A Qualitative Study Exploring What Motivates Medical Students to Pursue a Career In General Surgery","authors":"","doi":"10.1016/j.jsurg.2024.05.016","DOIUrl":"10.1016/j.jsurg.2024.05.016","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>The personal statement (PS) is a rich text in which medical students introduce themselves to the programs to which they are applying. There is no prompt or agreed upon structure for the personal statement. Therefore it represents a window in to medical students’ beliefs and perceptions. The goal of this study was to identify what events or experiences motivate medial students to pursue a career in general surgery. Previous work in this area has been largely survey and interview-based. This study is unique in that it looks at what medical students say when not prompted.</p></div><div><h3>Design</h3><p>This is a single-institution, retrospective, qualitative review of applicants’ PSs. The PSs were coded based on an <em>a priori</em> coding scheme. The coding scheme was based on published literature of why medical students might apply for a general surgery training position.</p></div><div><h3>Setting</h3><p>Academic, safety-net hospital.</p></div><div><h3>Participants</h3><p>The study evaluated a subset of the PSs of applications submitted through the Electronic Residency Application Service (ERAS) for a categorical general surgery position in our program during the 2022 match. Specifically, 308 of all received applications were included in this study. This is the subgroup of applications that was pulled out for a close review based on holistic screening of received applications.</p></div><div><h3>Results</h3><p>The single most frequently mentioned motivating factor for applying to general surgery training was the experience a student had on the surgery clerkship. The early years of medical school and sub-internships were less frequently identified as motivating experiences. After the overall clerkship experience, the next most frequent motivating factors were that their personality fit well with the culture of surgery and that they realized the important role surgeons played in patient care. 59 applicants wrote about a pre-existing interest in surgery prior to entering medical school. Most frequently this interest developed after witnessing family or friends or applicant themselves have surgery or shadowing a surgeon.</p></div><div><h3>Conclusions</h3><p>In this study, students most frequently noted the clerkship experience as having sparked their interest in a career in surgery. Having had exposure to surgeons, through personal experience or shadowing, often led to students to develop an interest in pursuing a career in surgery prior to entering medical school. The findings suggest that to increase the attractiveness of surgery to potential applicants, positive exposure to surgeons and surgery as a field of practice are critical.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Support Communication Between Nurses and Residents During Shift Work: A Mixed-Methods Study Into Local Practices and Perceptions","authors":"","doi":"10.1016/j.jsurg.2024.05.017","DOIUrl":"10.1016/j.jsurg.2024.05.017","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>The aim of this study was to explore local practices and perceptions of effective nurse-resident communication during shifts. Subsequently, effective communication was sought to be reinforced by implementing an initiative for improvement.</p></div><div><h3>DESIGN</h3><p>A mixed-methods study was performed, combining a questionnaire with focus groups. Following qualitative analysis, 3 initiatives for improvement of nurse-resident communication were scrutinized, after which 1 initiative was implemented. Overall contentment with the implementation and effectiveness of communication was reassessed through a questionnaire at 3 months postimplementation.</p></div><div><h3>SETTING</h3><p>This study took place between 2022 and 2023 at the Department of Surgery of the Leiden University Medical Center, a tertiary center in the Netherlands.</p></div><div><h3>PARTICIPANTS</h3><p>All surgical nurses (n = 150) and residents (n = 20) were invited to participate, by responding to the questionnaire and take part in the focus groups. A total of 38 nurses (response rate 25.3%) and 12 residents (60%) completed the questionnaire, and 31 nurses and 13 residents participated in the focus groups.</p></div><div><h3>RESULTS</h3><p>The themes “clarity,” “mutual respect,” “accessibility” and “approach” were critical for effective communication, in which there were interdisciplinary differences in the interpretation and needs regarding “clarity.” In response, structured moments for interdisciplinary consultation during shifts were implemented, which were foremostly useful according to nurses (73.9%), compared to residents (40.0%). A majority of the nurses agreed that communication during shifts improved through fixed moments (60.9%).</p></div><div><h3>CONCLUSION</h3><p>Differences in the perception of critical elements for efficient nurse-resident communication during shifts can be found, which could possibly be explained by differences in training and culture. Mutual awareness for each other's tasks, responsibilities and background seems vital for the ability to deliver good patient care during shifts. To improve interprofessional practice and overcome concerns of quality of care, attention for local practices is imperative. Practical arrangements, such as fixed moments for peer communication, can strengthen partnership during shift work.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424002459/pdfft?md5=07b97e31c7975aeaf1789b3135ae121e&pid=1-s2.0-S1931720424002459-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Table of Contents & Bacode","authors":"","doi":"10.1016/S1931-7204(24)00263-0","DOIUrl":"https://doi.org/10.1016/S1931-7204(24)00263-0","url":null,"abstract":"","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424002630/pdfft?md5=965c34383162407396d38031e466e5ba&pid=1-s2.0-S1931720424002630-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operating Room Teams Display Acceptable Levels of Patient Safety Behaviors During Surgical Cases","authors":"","doi":"10.1016/j.jsurg.2024.05.005","DOIUrl":"10.1016/j.jsurg.2024.05.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Cornerstones of patient safety include reliable safety behaviors proposed by Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) practices. A better quantification of these behaviors is needed to establish a baseline for future improvement efforts.</p></div><div><h3>Methods</h3><p>At one large academic medical center, OR Teams were prospectively assigned to be observed during surgical cases, and patient safety behaviors were quantified using the Teamwork Evaluation of Non-Technical Skills (TENTS) instrument. Mean scores of each TENTS behavior were calculated with 95% confidence intervals and compared using a paired t-test with a false discovery rate (FDR) control. Using the TENTS instrument, one hundred one surgical cases were observed by purposefully trained medical student volunteers. The average with 95% confidence interval (CI) of observed safety behaviors quantified using the TENTS instrument (including 20 types of safety behaviors scored 0 = expected but not observed, 1 = observed but poorly performed or counterproductive, 2 = observed and acceptable, and 3 = observed and excellent).</p></div><div><h3>Results</h3><p>All safety behaviors averaged slightly above 2, and the lower bound of 95% CI was above 2 for all behaviors except one. Statistically significant differences (p &lt; 0.05) were detected between a few safety behaviors, with the lowest-rated safety behavior being “employs conflict resolution” (2.07, 95% CI: 1.96-2.18) and the highest-rated behavior being “willingness to support others across roles” (2.36, 95% CI: 2.27-2.45). There were no significant differences (p &gt; 0.05) based on the number of persons present during the case, case duration, or by surgical department.</p></div><div><h3>Conclusions</h3><p>Given the persistent patient safety incidents in ORs nationwide, it might be necessary to advance these behaviors from acceptable to exceptional to advance patient safety.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimension Sawbone Models and Shadow-Play: A Low-Cost Approach to Improve Orthopedic Plain Radiograph Reading in Medical Students","authors":"","doi":"10.1016/j.jsurg.2024.05.014","DOIUrl":"10.1016/j.jsurg.2024.05.014","url":null,"abstract":"<div><h3>Background</h3><p>The usage of 3D sawbone models and shadow-play is a novel teaching method in orthopedic education. The aim of this study was to evaluate the effectiveness of 3D sawbone models and shadow-play in improving medical student orthopedic knowledge and interpretation of plain radiographs.</p></div><div><h3>Methods</h3><p>Ninety-three medical students with no prior clinical orthopaedic experience were recruited into 2 groups: Group 1 underwent conventional education methods and Group 2 underwent a sawbone and shadow-play education. A pre and post-test designed to determine orthopedic knowledge and interpretation of plain radiographs was performed. Five participants were randomly selected for a semi-structured qualitative interview postintervention.</p></div><div><h3>Results</h3><p>There was an increase in mean test scores in both groups. The difference in the means of pre- and post-test average outcomes between the control group was 3.00 (SD = 2.08), as compared to 4.74 (SD = 2.69) for the sawbone group. Group 2 (sawbone) exhibited a significantly better improvement. (p &lt; 0.001). Interviews revealed several themes: improved engagement, enhanced visualization, holistic learning, and challenges.</p></div><div><h3>Conclusions</h3><p>The utilization of 3D sawbone models and shadow-play as teaching tools in orthopedics demonstrates significant efficacy and is more effective than conventional teaching methods in novice medical students. Students perceived the incorporation of sawbone models and shadow-play as highly engaging, providing them with enhanced visualization capabilities, consequently fostering a deeper comprehension of anatomical structures and X-ray interpretations.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Real Time Feedback on Novice's Laparoscopic Learning Curve","authors":"","doi":"10.1016/j.jsurg.2024.05.006","DOIUrl":"10.1016/j.jsurg.2024.05.006","url":null,"abstract":"<div><h3>Objective</h3><p>Analyze the learning curve of medical students when they are trained with a laparoscopic box trainer and are presented with different modes of real-time feedback on their performance in the laparoscopic suturing procedure.</p></div><div><h3>Design</h3><p>A prospective randomized controlled trial (RTC) was performed. Three groups were proposed: control, visual, and haptic. The block randomization technique was used to assign the participants to one of the three groups. Each group trained the intracorporeal square flat knot task in a standardized FLS box simulator. A total of 11 sessions were programmed for this study: a pre-training session, eight training sessions, a post-training session, and a follow-up session. Measurement of the generated reaction force during the task were taken weekly for the first 10 sessions (pre-training, training, and post-training); then, the follow-up measurement was taken a month after.</p></div><div><h3>Setting</h3><p>This study was carried out in a single center at the <em>Unidad de Simulación de Posgrado</em> (USIP) of the postgraduate medicine program of the <em>Universidad Nacional Autónoma de México</em> (UNAM) between May and August 2023.</p></div><div><h3>Participants</h3><p>The eligible participants were medical students without experience in minimally invasive surgery. All social service intern medics doing their social service in the USIP were invited to participate. A total of 20 participants entered the study from which 18 of them finished all the programmed sessions.</p></div><div><h3>Results</h3><p>A total of ten metrics were extracted from the reaction force signal measured at each session. All metrics are directly proportional to the reaction force and low magnitudes imply high tissue-handling proficiency. All groups improved their tissue handling skills, being the visual group the one who achieved better performance, followed by the haptic group and lastly the control group.</p></div><div><h3>Conclusion</h3><p>The use of real time feedback, especially visual feedback can help novices to shorten the learning process of tissue handling and achieve a better proficiency in advanced tasks in shorter training periods.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonphysician Evaluators and Recording-Based Tools in Surgical Skill Assessment: A Feasibility Study","authors":"","doi":"10.1016/j.jsurg.2024.05.013","DOIUrl":"10.1016/j.jsurg.2024.05.013","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the feasibility of nonmedically trained evaluators and image- and video-based tools in the assessment of surgical skills in a key orthopedic procedure.</p></div><div><h3>Design</h3><p>Orthopedic surgeons at varying skill levels were evaluated by their ability to repair a cadaveric bi-malleolar ankle fracture. Nonphysician viewers and expert orthopedic surgeons independently scored video recordings and fluoroscopy images of the procedure through Global Rating Scales (GRS) and procedure-specific checklist tools. Statistical analysis was used to determine if the evaluators and assessment tools were able to differentiate skill level.</p></div><div><h3>Setting</h3><p>An academic tertiary care hospital.</p></div><div><h3>Participants</h3><p>The surgical procedure was completed by 3 orthopedic residents, 3 orthopedic trauma fellows, and 4 orthopedic trauma attending surgeons. The procedure was independently evaluated by 2 orthopedic surgeons and 2 nonphysicians.</p></div><div><h3>Results</h3><p>Operating participants were stratified by ≤ or &gt;10 bimalleolar ankle fracture cases performed alone (inexperienced, n = 5 vs experienced, n = 5). Expert surgeon viewers could effectively stratify skill group through the GRS for video and fluoroscopy analysis (p &lt; 0.05), and the video procedure-specific checklist (p &lt; 0.05), but not the fluoroscopy procedure-specific checklist. Nonphysician viewers generally recognized skill groupings, although with less separation than surgeon viewers. These evaluators performed the best when aided by video and fluoroscopy procedure-specific checklists. Meanwhile, breakdowns of each tool into critical zones for improvement and evaluator-independent metrics such as case experience, self-reported confidence, and surgical time also indicated some skill differentiation.</p></div><div><h3>Conclusions</h3><p>The feasibility of using video recordings and fluoroscopic imaging based surgical skills assessment tools in orthopedic trauma was demonstrated. The tools highlighted in this study are applicable to both cadaver laboratory settings and live surgeries. The degree of training that is required by the evaluators and the utility of measuring surgical times of specific tasks should be the subject of future studies.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Going Above and Beyond With SJTs: Impact of Applicant Characteristics on Open Response SJT Participation","authors":"","doi":"10.1016/j.jsurg.2024.05.002","DOIUrl":"10.1016/j.jsurg.2024.05.002","url":null,"abstract":"<div><h3>Background</h3><p>Situational judgment tests (SJT) have gained popularity as a standardized assessment of nontechnical competencies for applicants to medical school and residency. SJT formats range from rating the effectiveness of potential response options to solely open response. We investigated differences in test-taking patterns between responders and nonresponders to optional open response SJT questions during the application process.</p></div><div><h3>Methods</h3><p>This was a prospective multi-institutional study of general surgery applicants to seven residency programs. Applicants completed a 32-item SJT designed to measure ten core competencies: adaptability, attention to detail, communication, dependability, feedback receptivity, integrity, professionalism, resilience, self-directed learning, and team orientation. Each SJT item included an optional, nonscored, open response space for applicants to provide a behavioral response if they desired. Trends in applicant gender, race, ethnicity, medical school ranking, and USMLE scores were examined between the responder versus nonresponder group.</p></div><div><h3>Results</h3><p>In total, 1491 general surgery applicants were invited to complete the surgery-specific SJT. Of these, 1454 (97.5%) candidates completed the assessment and 1177 (78.9%) provided additional responses to at least one of the 32 SJT scenario sets. There were no differences in overall SJT performance, USMLE scores (Step 1: 235, SD 14, Step 2: 250, SD 11), race and/or ethnicity between the responder and nonresponder groups. Responders were more likely to be from a top 25 medical school (p &lt; 0.05) compared to the nonresponder group. Among applicants who completed any open response questions, women completed a significantly higher number of questions compared to men (7.21 vs 6.07, p = 0.003). The number of open responses provided correlated with higher scores on SJT items measuring dependability (r = 0.07, p = 0.007).</p></div><div><h3>Conclusions</h3><p>SJT design and format has the potential to impact test-taker response patterns. SJT developers and adopters should ensure test format and design have no unintended consequences prior to implementation.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}