A Semistructured Interview for Surgical Residency Targeting Nontechnical Skills

Abstract

Objective: We review the development, implementation, and initial outcomes of a semistructured interview process to assess the nontechnical skills of surgical residency applicants.

Design: In 2018, we restructured our residency selection interview process. Through semistructured faculty interviews, we sought to evaluate candidates along seven nontechnical skills (grit, ownership, rigor, teamwork, presence, impact, and organizational alignment). We plotted each candidate's scores on a radar plot for graphical representation and calculated the plot area of each candidate. We retrospectively evaluated 3 years of data, comparing the nontechnical skill scores of matriculants into the training program to those of nonmatriculants.

Setting: Tenwek Hospital is a 361-bed tertiary teaching and referral hospital in rural western Kenya with a 5-year general surgery residency program.

Participants: Thirty-one applicants were interviewed over 3 years. Thirteen matriculated into the program.

Results: Scores for grit, (4.8 vs 3.9; p = 0.0004), impact (4.2 vs 3.5; p = 0.014), ownership (4.2 vs 3.6; p = 0.01), and organizational alignment (4.3 vs 3.8; p = 0.008) were significantly higher in matriculants.

Conclusions: This semistructured interview process provides a robust and beneficial mechanism for assessing applicants' nontechnical skills, which may allow for the matriculation of more well-rounded candidates into surgical residency and, ultimately, surgical practice.

Keywords: multiple mini-interview; nontechnical skills in surgery (NOTSS); residency interviews; structured interview; surgical education; surgical interviews.