Publications

Scholarly Journals--Published

• Hauer KE, Giang D, Kapp ME, Sterling R. Standardization in the MSPE, key tensions for learners, schools, and residency programs. Acad Med 2020, The Medical Student Performance Evaluation (MSPE), which summarizes a medical student's academic and professional undergraduate medical education performance and provides salient information during the residency selection process, faces persistent criticisms regarding heterogeneity and obscurity. Specifically, MSPEs do not always provide the same type or amount of information about students, especially from diverse schools, and important information is not always easy to find or interpret. To address these concerns, a key guiding principle from the Recommendations for Revising the MSPE Task Force of the Association of American Medical Colleges (AAMC) was to achieve "a level of standardization and transparency that facilitates the residency selection process." Benefits of standardizing the MSPE format include clarification of performance benchmarks or metrics, consistency across schools to enhance readability, and improved quality. In medical education, standardization may be an important mechanism to ensure accountability of the system for all learners, including those with varied backgrounds and socioeconomic resources. In this article, members of the aforementioned AAMC MSPE task force explore 5 tensions inherent in the pursuit of standardizing the MSPE: (1) presenting each student's individual characteristics and strengths in a way that is relevant, while also working with a standard format and providing standard content; (2) showcasing school-specific curricular strengths while also demonstrating standard evidence of readiness for internship; (3) defining and achieving the right amount of standardization so that the MSPE provides useful information, adds value to the residency selection process, and is efficient to read and understand; (4) balancing reporting with advocacy; and (5) maintaining standardization over time, especially given the tendency for the MSPE format and content to drift. Ongoing efforts to promote collaboration and trust across the undergraduate to graduate medical education continuum offer promise to reconcile these tensions and promote successful educational outcomes. (01/2021) (link)
• Stansfield RB, Giang D, Markova T. Development of the Resident Wellness Scale for measuring resident wellness. J Patient Cent Res Rev. 2019;6:17-27 Abstract Purpose: Graduate medical education programs have a responsibility to monitor resident wellness. Residents are at risk of burnout, depression, and suicide. Burnout and depression are associated with poor patient care. Many existing tools measure burnout, depression, and general human well-being, but resident wellness is a distinct construct. We aimed to develop an instrument to measure resident wellness directly. Methods: An expert panel from two purposefully different graduate medical education institutions generated a behavior- and experience-based model of resident wellness. The panel and resident leaders from both institutions generated 92 items, which were tested alongside anchor scales measuring burnout, depression, personality, optimism, life satisfaction, and social desirability in a convenience sample of 62 residents. Ten items were selected using a combination of factor analysis, a genetic algorithm, and purposeful selection. The 10-item scale was distributed to 5 institutions at which 376 residents completed it anonymously. Exploratory factor analysis was used to examine the factor structure of the scale. Results: The model of resident wellness aligned with an accepted framework of well-being in the literature. The 10-item Resident Wellness Scale broadly covered the model and correlated meaningfully with anchor scales. The factor structure of the scale suggested sensitivity to meaningful work, life security, institutional support, and social support. Conclusions: This novel Resident Wellness Scale is designed to track residents' wellness longitudinally. It is sensitive to aspects of resident wellness that have been shown to reduce burnout and depression and appears to be a psychometrically strong measure of resident wellness. (01/2019) (link)

Online Publications

• Recommendations for Revising the Medical Student Performance Evaluation (MSPE), Association of American Medical Colleges In 1989, the Association of American Medical Colleges (AAMC) charged a Committee on Deans’ Letters, composed of experienced representatives from medical schools and graduate medical education (GME) programs, to “develop guidelines on the evaluative information desired by program directors” and to “explore the feasibility of providing a model format for deans’ letters.” In 2002, a second Dean’s Letter Advisory Committee released recommendations designed to reaffirm the purpose of the Medical Student Performance Evaluation (MSPE), ensure consistency, and establish ongoing quality improvement. Feedback over the years has been robust and spirited, with both consensus and disagreement on the direction of the MSPE. In 2014, an MSPE Task Force was charged with revisiting the document. Pulling from earlier feedback and an initial review of relevant literature and survey data, the Task Force identified six principles to guide what the revised MSPE would provide: 1. supplemental value to the information already provided in the ERAS application, transcripts, and letters of recommendation 2. a level of standardization and transparency that facilitates the residency selection process 3. comparative information on applicants 4. information about applicants’ standing on the competencies required to be successful in residency 5. increased opportunity for program directors to examine applicants holistically in the pre-interview stage 6. qualitative and quantitative assessments of applicants in an easy to read format Using these principles as a guide, the Task Force undertook a more comprehensive review of survey findings and research on standardized and competency-based assessments and gathered additional feedback from program directors, student affairs deans, and other stakeholders. The recommendations made in this document represent that research and information gathering and reflect a continued commitment both to the guiding principles and to improving the residency application and selection process for learners, medical schools, and residency programs.  (05/2017) (link)