Introduction: The National Residency Matching Program (NRMP) allows post-interview contactbetween residency applicants and residency programs. Thank-you communications representone of the most common forms, but data on their value to applicants and program directors (PD)are limited. The objective of this study was to assess the effect of thank-you communications onapplicant- and residency-program rank lists.

Methods: Two anonymous, voluntary surveys were sent after the 2018 NRMP Match, one toapplicants who were offered an interview at a single academic site in the 2017-2018 Match cycle,and one to EM PDs nationwide. The surveys were designed in conjunction with a nationallyrecognizedsurvey center and piloted and revised based on feedback from residents and faculty.

Results: Of 196 residency applicants, 97 (49.5%) responded to the survey. Of these, 73/95 (76.8%)reported sending thank-you communications. Twenty-two of 73 (30%) stated that they sent thank-youcommunications to improve their spot on a program’s rank list; and 16 of 73 (21.9%) reported that theychanged their rank list based upon the responses they received to their thank-you communications. Of 163 PDs, 99 (60.7%) responded to the survey. Of those PDs surveyed, 22.6% reported that anapplicant could be moved up their program’s rank list and 10.8% reported that an applicant could movedown a program’s rank list based on their thank-you communications (or lack thereof).

Conclusion: The majority of applicants to EM are sending thank-you communications. Asignificant minority of applicants and PDs changed their rank list due to post-interview thank-youcommunications.

Introduction: The “stable marriage” algorithm underlying the National Residency Match Program (NRMP) has been shown to create optimal outcomes when students submit true preference lists. Previous research has shown students may allow external information to affect their rank lists. The objective of this study was to determine whether medical students consistently make rank lists that reflect their true preferences.

Methods: A voluntary online survey was sent to third-year students at a single midwestern medical school. Students were given hypothetical scenarios that either should or should not affect their true residency preferences and rated the importance of six factors to their final rank list. The survey was edited by a group of education scholars and revised based on feedback from a pilot with current postgraduate year 1 residents.

Results: Of 175 students surveyed, 140 (80%) responded; 63% (88/140) reported that their “perceived competitiveness” would influence their rank list at least a “moderate amount. Of 135 students, 31 (23%) moved a program lower on their list if they learned they were ranked “low” by that program, while 6% (8/135) of respondents moved a program higher if they learned they were ranked “at the top of the list.” Participants responded similarly (κ = 0.71) when presented with scenarios asking what they would do vs what a classmate should do.

Conclusion: Students’ hypothetical rank lists did not consistently match their true residency preferences. These results may stem from a misunderstanding of the Match algorithm. Medical schools should consider augmenting explicit education related to the NRMP Match algorithm to ensure optimal outcomes for students.

Introduction: The Association of American Medical Colleges has introduced the Standardized Video Interview (SVI) to assess the communication and professionalism skills of residency applicants to allow a more holistic view of applicants beyond academic performance. Initial data suggests scores are not correlated with academic performance and provide a new measure of applicant attributes. It is not currently known how the SVI compares to existing metrics for assessing communication and professionalism during the interview process.

Methods: Applicants to the University of Wisconsin Emergency Medicine Residency program were invited and interviewed without use of the SVI scores or videos. All faculty interviewers were blinded to applicants’ SVI information and asked to rate each applicant on their communication and professionalism on a scale from 1-25 (faculty gestalt score), analogous to the 6-30 scoring used by the SVI. We transformed SVI scores to our 1-25 system (transformed SVI score) for ease of comparison and compared them to faculty gestalt scores as well as applicants’ overall score for all components of their interview day (interview score).

Results: We collected data for 125 residency candidates. Each applicant received a faculty gestalt score from up to four faculty interviewers. There was no significant correlation of SVI scores with faculty gestalt scores (Spearman’s rank correlation coefficient [rs] (123)=0.09, p=0.30) and no correlation with the overall interview score (rs(123)=0.01, p=0.93). Faculty gestalt scores were correlated positively with interview scores (rs(123)=0.65, p<0.01).

Conclusion: SVI scores show no significant correlation with faculty gestalt scores of communication and professionalism. This could relate to bias introduced by knowledge of an applicant’s academic performance, different types of questions being asked by faculty interviewers, or lack of uniform criteria by which faculty assess these competencies. Further research is needed to determine whether SVI scores or faculty gestalt correlate with performance during residency.

Introduction: Emergency physicians encounter scenarios daily that many would consider “disgusting,” including exposure to blood, pus, and stool. Physicians in procedural specialties such as surgery and emergency medicine (EM) have lower disgust sensitivity overall, but the role this plays in clinical practice is unclear. The objective of this study was to determine whether emergency physicians with higher disgust sensitivity see fewer “disgusting” cases during training.

Methods: All EM residents at a midsize urban EM program were eligible to complete the Disgust Scale Revised (DS-R). We preidentified cases as “disgust elicitors” based on diagnoses likely to induce disgust due to physician exposure to bodily fluids, anogenital anatomy, or gross deformity. The “disgust elicitor” case percent was determined by “disgust elicitor” cases seen as the primary resident divided by the number of cases seen thus far in residency. We calculated Pearson’s r, t-tests and descriptive statistics on resident and population DS-R scores and “disgust elicitor” casesper month.

Results: Mean DS-R for EM residents (n = 40) was 1.20 (standard deviation [SD] 1.24), significantly less than the population mean of 1.67 (SD 0.61, p<0.05). There was no correlation (r = -0.04) between “disgust elicitor” case (n = 2191) percent and DS-R scores. There was no significant difference between DS-R scores for junior residents (31.1, 95% confidence interval [CI], 26.8-35.4) and for senior residents (29.0, 95% CI, 23.4-34.6).

Conclusion: Higher disgust sensitivity does not appear to be correlated with a lower percentage of “disgust elicitor” cases seen during EM residency.

ABSTRACT: Audience: The continuous residency improvement committee (CRIC) innovation is designed for residency program leadership and residency program coordinators.

Introduction: The Accreditation Council for Graduate Medical Education (ACGME) requires residency- training programs to perform ongoing self-study in order to maintain accreditation status and to engage in continuous program improvement.1 Standard evaluation constructs for self-study often fail to capture input from non-traditional stakeholders and do not always result in actionable recommendations for program improvement. We developed the CRIC process to address the need for a user-friendly evaluation construct that yields actionable recommendations for programmatic improvement from a variety of stakeholders and aligns with the ACGME-prescribed continuous self-study process.

Objectives: The purpose of this innovation was to develop a novel approach to continuous program evaluation and improvement using a multisource feedback design to improve resident satisfaction with the program’s responsiveness to feedback while addressing the ACGME mandate for self-study.

Methods: A committee of rotating reviewers systematically evaluates resident educational rotations over a 12-month period. Reviews focused on obtaining input from both traditional and non-traditional stakeholders in a multisource model in order to document and address deficiencies identified within the rotations.

Topics: ACGME self-study, 360-evaluation, program evaluation, program evaluation committee.