A New Era in Assessment of Applicants to General Surgery Residency-Simulated Skills Tests for 3 Domains

Introduction: The COVID-19 pandemic forced general surgery residency programs to conduct virtual interviews, limiting traditional evaluation of applicants. We piloted a novel, completely virtual simulated skills assessment for interviewees. We aimed to assess feasibility of virtual skill assessments and determine whether differing domains of skills were successfully assessed. Methods: During their interview, applicants to 1 general surgery residency program in 2020 completed a simulated surgical skills test assessing suturing, knot tying, anatomy, interpretation of chest x-ray and arterial blood gas, emotional intelligence through a challenging standardized patient interaction, and communication through a Lego building task. Applicants were scored on each station and assigned a quartile ranking (1 through 4) based on their relative scores. Results: Surgical skills were assessed in 109 general surgery applicant interviews. A principal components factor analysis was conducted on the 6 items with varimax rotation, Kaiser-Meyer-Olkin = 0.57, all Kaiser-Meyer-Olkin values for individual items > 0.5. Three factors had eigenvalues > 1 and in combination explained 66.38% of the data. The clustered items for the same factor suggest that factor 1 represents medical knowledge and the ability to convey it, factor 2 represents technical skills, and factor 3 represents emotional intelligence. See Table 1 for factor loadings after rotation. Conclusion: As we consider a new era of virtual resident interviews, this research provides evidence that a large group of applicants can undergo a completely virtual skills assessment and that these 6 items likely assess a broad range of domains: medical knowledge, technical skills, and nontechnical skills. [Formula presented]