Pediatrics

Identifying residency candidates with the best attitudes for your

program’s culture

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•Melodie Allison, TAGME •Lauren Baber, MD •Sam Rosenblatt, MD •Joey Spinner, MD •Mark Ward, MD •Michelle Barajaz, MD •Teri Turner, MD, MPH, MEd

Presenters

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•Teri Turner is a paid educational consultant for Abbott pharmaceuticals. The work she performs for Abbott pharmaceuticals has no bearing on the content of this presentation and thus she has no conflict of interests to resolve. All other presenters have no conflict of interests to disclose.

Disclosures

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•Identify 3-5 critical attitudes (X factors) for success as a resident within your program

•Develop interview questions that require candidates to describe specific incidents that called for the critical attitude

•Practice conducting and scoring a structured interview for critical attitudes

•Develop an implementation and monitoring plan for hiring for the X factor

Objectives

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It’s Interview Season: Let the Judging Begin

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•How many of your residency programs train your interviewers?

•How many of your residency programs have a standardized set of question themes or interview questions for all applicants?

•Of those programs with a standardized set of questions, how many assign questions to interviewers?

How Does Your Program Prepare Interviewers?

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•How many programs have assessed the culture of your residency program (i.e. know the characteristics of trainees who do well in your program)?

•How many programs do behavioral based interviewing?

How Does Your Program Prepare Interviewers?

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Why Is This Important: The Resident’s Perspective

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Why Is This Important: The Residency Program Perspective

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The Subjectivity of Interview Season

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“Under the conditions of this study, the MSPE bottom line descriptor had greater impact than the narrative description on the ranking of applicant desirability. This was despite the fact that applicants were not from the same school, making direct comparison of their class rank inappropriate as a primary determinant of relative medical school performance.”

Effect of the MSPE “Bottom Line” on Reviewer Assessment of Applicant

Desirability

Mark A Ward, MD, Teri L Turner, MD, MPH, MEd, Debra L Palazzi, MD, Hilel Frankenthal, M.D., and Martin I Lorin, MD

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Lack of correlation between Residents Performance Variables and Letter of

Recommendation Scores

Teri L Turner, MD, MPH, MEd, Mark A, Ward, MD, Anne Gill, PhD

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Predictors of Success

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Hiring for Attitude by Mark Murphy

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The attitudes that work for your organization are unique

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Great Knowledge and Skills ≠ Great Fit for your Program

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•The unique attitudinal characteristics that make your program different from all others. They are a list of the key attitudes that define your best residents, but they also describe the characteristics of the residents who aren’t making it.

Brown Shorts

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Top 5 reasons individuals perform poorly?

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Goldilocks Principle

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•What are the characteristics/traits of the residents that excel in your program?

•What are the characteristics/traits of the residents that perform poorly in your program?

Activity: Differential Characteristics

Be as descriptive as possible. Think about specific residents and describe what they do.

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Think of a resident in your program who truly represents the culture of the organization. This

would be the poster child for having the right attitude. Could you tell me about a time he or she

did something that exemplifies having the right attitude? It could be big or small, but something

that made an impression on you.

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•Motivated •Team player •Knowledgeable •Strong work ethic •Efficient •Attention to detail •Reliable

Brown Shorts for a Surgery Program

•Sense of entitlement •Not willing to improve •Apathy •Poor communication •Inefficient •Disorganized •Defensive

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Standard Interview Questions Don’t Assess Behavior

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Canned Answers for Strengths and Weaknesses

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What’s the Point in Giving a Test if Everyone Gets the Same Grade?

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Past behavior is a better predictor than what someone might do

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•Leading question: Could you tell me about a time when you had to balance competing priorities and did so successfully?

•Better question: Could you tell me about a time when you had to balance competing priorities.

Better Behavioral Questions

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Behavioral questions are only helpful when they prompt a response that reveals the truth

about both weaknesses and strengths.

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Identify “differential situations” - the moments when the differences between high and low performers

are most starkly in contrast.

“Climb the Tree” Scenarios

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1. Pick one of your “brown short” characteristics (the one you listed for your table)

2. Describe high and low performers related to this characteristic

3. Identify differential situations to elicit this brown short characteristic and write 2-3 interview questions

4. Begin the question by asking “Could you tell me about a time you ….. And then insert the question.

Activity: Scoring Rubric

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Self-absorbed, passively follows others, limited participation in team activities or discussions, little initiative to interact with team members, little acknowledgement of the contribution of others, self-centered approach to work, tries to “outshine” other team members, throws other team members “under the bus”, doesn’t help pick up the slack, focuses solely on getting their work done, disagrees with others, wants everything his or her own way, does not ask for assistance even when overloaded

Working collaboratively, cooperative, flexible, trustworthy, share the workload, allow others to show what they know, willing to help, admits when they need help and accepts that help, accepts feedback from team members, listens and seeks understanding of other team members opinions and issues, supportive, tries to make other people on the team look good, willing to do extra work to help the team, recognizes when others are swamped, handles differences of opinion constructively

1 2 3 4 5 6 7 8 9 10

Team work

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•Know the candidate

•Allow them to feel some control

•Use the Interview Sandwich

Interviewing Basics

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Do Not Ask Undifferentiated Questions

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Do Not Ask Hypothetical Questions

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Do Don’t Ask

Use questions open to interpretation The 3 most common questions Leave the question hanging Leading questions Allow for silence Hypothetical questions Probe for deeper understanding Undifferentiating questions Seek contrary evidence Illegal questions

For questions about the program

Do’s and Don’ts of Questioning

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High Performers usually use these words in their answers

Low Performers usually use these words in their answers

Pronouns I, me, we (talk about themselves and what they did)

You, your, he , she they, it, itself (talk a lot more in second or third person language)

Verb tense Past tense (when you ask a high performer about a past experience, they will actually tell you about that past experience)

Present tense, future tense (a low performer will describe what they are doing or what they will do – they can’t tell about past experiences because they don’t have them)

Voice Active voice Passive voice (if being used to appear smarter than they really are)

Emotions Positive emotions (happy, thrilled, excited)

Negative emotions (angry, afraid, pessimistic)

Qualifiers Adverbs (thoroughly, quickly) negation (no, neither), waffling (could be maybe, perhaps), absolutes ( always, never)

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Problem Bringers •Describe a problem but don’t reference how it was ultimately solved

•Tend to dump a problem or blame rather than taking responsibility

Problem Solvers •Go on to describe how the person overcame the failure to eventually solve the problem

•Can’t bring themselves to think of a situation as a total failure - they keep trying or at least try to salvage some useful lesson

Problem Bringers vs. Problem Solvers

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Interviewing for Teamwork Skills

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•Pair up with an individual not at your table ‐Someone at Table 1 will pair with person at Table 2

‐Table 3 will pair with Table 4 (etc)

•You will have 5 minutes to interview your colleague

•Switch rolls

Activity: Mock Interviews

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Reflection

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Action Plan: What Will I Do

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