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=====Interview Scores Correlate with Fellow Microsurgical Skill and Performance=====

====Abstract=====
===Background=== 
The interview process for surgical trainees aims to select those individuals who will perform best during training and have the greatest potential as future surgeons. The objective of this study was to evaluate the relationship between criteria assessed at interview, technical skills, and performance, for the first time, to optimize
the selection process for a Microsurgery fellowship.

===Methods=== 
Twenty microsurgery fellows in three consecutive annual cohorts at a single
academic center were prospectively evaluated. At interview, subjects were scored for
multiple standardized domains. At the start and at end of the fellowship, microsurgical
technical skill was assessed both in the laboratory and operating room (OR) using a validated
assessment tool. At the end of the fellowship, there was a final evaluation of performance.

===Results=== 
At the start, microsurgical skill significantly correlated with almost all
domains evaluated at interview, most closely with prior plastic surgery training
experience. At the end of the fellowship, skill level improved in all trainees, with the
greatest improvement made by the lowest ranked and skilled trainees. The highest
ranked trainees, however, made the greatest improvement in speed.

===Conclusions=== 
The results of this study, for the first time, validate the current interview
process to correctly select the highest performing and most skilled candidates and
support the effectiveness of a 1-year microsurgical fellowship in improving microsurgical skill in all trainees, irrespective of their initial ability. The importance of valuing
the relative quality of prior training and experience at selection is also highlighted.

====Figures====
{{:jnl:schaverien2018-01.jpg?400|Figure 1. Line graph demonstrating the correlation between microsurgical assessment overall performance scores using the SAMS tool in the OR at the start
and end of the fellowship. At the start of the fellowship, on all measures, the highest ranked trainees were scored the highest on microsurgical performance. By the end of the fellowship the same trainees also demonstrated slightly better scores, but these were similar to those achieved by the trainees ranked lowest at interview. Linear regression lines are shown. OR, operating room; SAMS, Structured Assessment of Microsurgery Skill.}}

{{:jnl:schaverien2018-02.jpg?400|Figure 2. Line graph comparing time taken to perform an arterial anastomosis in the rat femoral artery in the laboratory at the start and end of the fellowship.
When time taken was evaluated, paradoxically at the start of the fellowship the highest ranked trainees took longer to perform a microvascular anastomosis than the lower ranked trainees, with significant outliers affecting the scores. By the end of the fellowship the trainees ranked highest at interview were fastest, making the greatest the improvement in time, and there was a reduction in variance about the mean. Linear regression lines are shown.}}

====Commentary====
  - Very interesting study. I have not come across many articles like this one in ortho/plastic/hand domain. Provides evidence that you can predict performance
  - However, since same group of people picking and assessing, there may be some bias (they are looking at some perspective of "good"). An independent assessment would be better
  - All improve by their metrics, but the "weaker" ones improved more.

====Source=====
Schaverien, M., Butler, C., Suami, H., Garvey, P., Liu, J., & Selber, J. (2018). Interview Scores Correlate with Fellow Microsurgical Skill and Performance. Journal of Reconstructive Microsurgery, 34(03), 211–217. https://doi.org/10.1055/s-0037-1607392
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