Raj Woolever, MD Deborah Taylor, PhD Central Maine Medical Center Family Medicine Residency 2010 FMEC Northeast Region Meeting October 3o, 2010

Timeline  Our Objectives and Yours  OD Principles of “Cultural Fit”  Clinical Readiness  Small Group Exercise  Gathering Wisdom of SGE  Wrap up and Evaluation

Objectives  Identify 3-4 key competencies or traits of applicants to your residency that will “fit” well with your organizational culture  Develop questions or learn how to elicit stories that speak to those competencies or traits  Implement regular use of a clinical readiness tool in your recruiting process

O.D. re: cultural fit  Not about good vs bad applicants and programs  Key is success!  Defined as a match between what the applicant offers and what the program needs/requires  Org Culture shaped by history, mission, values, attitudes, and group behaviors

Two major categories of skills  Technical/Clinical  Come from educational/training background  Performance  Interpersonal  Self Discipline  Leadership

Assess clinical readiness  Do medical students arrive well-prepared?  What kind of clinical experiences are medical students having?

Assess clinical readiness  Standardized test performance is NOT indicative of clinical readiness McManus, IC, et al. Clinical experience, performance in final examinations, and learning style in medical students: prospective study. BMJ 316:

Assess clinical readiness  Standardized test performance is NOT indicative of clinical readiness  Clinical experience without training increases confidence, but not competence Marteau, TM, et al. Resuscitation: experience without feedback increases confidence but not skill. BMJ 300:

Assess clinical readiness  Use a standard clinical scenario  Range of acceptable answers  Review process and interaction w/ systems  Valuable information about:  Medical knowledge  Patient care  Systems-based practice

Consider learner types  Learning style is predictive of clinical readiness and becoming a “reflective practitioner”  Surface  Deep  Strategic McManus, IC, et al. Clinical experience, performance in final examinations, and learning style in medical students: prospective study. BMJ 316:

Behavioral Interviewing

Future behavior

How does behavioral interviewing differ from conventional interviewing?  Conventional  Attitudes  Knowledge  Future Behavior  Behavioral  Actions  Problems Solved  Past Behavior  Reporter Questions  Who  What  When  Where  Why  How

“FIT” areas we identified  Tolerance for and Flexibility Around Change (PBL)  Intellectual Curiosity (PBL)  Self Reflection (PBL)  Team Player (ICPS, Prof)  Self Directed Learner (PBL)

Group Exercise  Start by reflecting on what traits or characteristics you are trying to recruit for in applicants?  Reverse logic – what kinds of residents have not fared well in your system?  Go with your gut about “fit” →  List of possible traits include:

Ex. of Traits/Characteristics  Adaptability/Flexibility  Oral Communication  Written Communication  Need for Control  Critical Thinking  Attention to Detail  Energy  Insight/Reflection  Independence  Initiative  Integrity  Judgment  Leadership/Influence  Listening  Participative  Presentation Skills  Resilience  Safety Awareness  Self-confidence  Sensitivity

Break into Groups of 2-3  Share your traits/characteristics  Work together to develop behavioral interviewing questions (stories) that would give you information about these traits in your applicants?  Write them down  Create a “database” of “story questions” for certain traits – we will share

Using “the competencies” to guide recruiting  Medical Knowledge (transcript, board scores)  Patient Care (personal statement, clerkship comments in DL)  Interpersonal and Communication Skills (interview with faculty/residents and interview dinner)  Professionalism (appearance, language used)  Practice-based Learning & Improvement (interview questions, clerkship comments in DL, LORs)  Systems Based Practice (CV)

Summary  Past behavior predicts future behavior  Determining “FIT” requires a organizational culture assessment  Clinical readiness is an impt focus  Head home for a fac dev session on this topic

Questions?  Thanks for participating