ImportanceSelection processes for surgical training should aim to identify candidates who will become competent independent practitioners and should aspire to high standards of reliability and validity.ObjectiveTo determine the association between measured candidate factors at the time of an Irish selection and assessment outcomes in surgical training, examined via rate of progression to Higher Specialist Training (HST), attrition rates, and performance as assessed through a multimodal framework of workplace-based and simulation-based assessments.Design, Setting, and ParticipantsThis retrospective observational cohort study included data from all successful applicants to the Royal College of Surgeons in Ireland (RCSI) national Core Surgical Training (CST) program. Participants included all trainees recruited to dedicated postgraduate surgical training from 2016 to 2020. These data were analyzed from July 11, 2016, through July 10, 2022.ExposuresSelection decisions were based on a composite score that was derived from technical aptitude assessments, undergraduate academic performance, and a 4-station multiple mini-interview.Main outcomes and measuresAssessment data, attrition rates, and rates of progression to HST were recorded for each trainee. CST performance was assessed using workplace-based and simulation-based technical and nontechnical skill assessments. Potential associations between selection and assessment measures were explored using Pearson correlation, logistic regression, and multiple linear-regression analyses.ResultsData were available for 303 trainees. Composite scores were positively associated with progression to HST (odds ratio [OR], 1.09; 95% CI, 1.05-1.13). There was a weak positive correlation, ranging from 0.23 to 0.34, between scores and performance across all CST assessments. Multivariable linear regression analysis showed technical aptitude scores at application were associated with future operative performance assessment scores, both in the workplace (β = 0.31; 95% CI, 0.14-0.48) and simulated environments (β = 0.57; 95% CI, 0.33-0.81). There was evidence that the interpersonal skills interview station was associated with future performance in simulated communication skill assessments (β = 0.55; 95% CI, 0.22-0.87).Conclusions and RelevanceIn this study, performance at the time of Irish national selection, measured across technical and nontechnical domains in a multimodal fashion, was associated with future performance in the workplace and in simulated environments. Future studies will be required to explore the consequential validity of selection, including potential unintended effects of selection and ranking on candidate performance.

中文翻译：

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爱尔兰选拔中的表现和外科训练中的未来表现

重要性外科培训的选择过程应旨在确定将成为有能力的独立从业者的候选人，并应追求高标准的可靠性和有效性。目的确定爱尔兰选拔时测量的候选人因素与外科培训评估结果之间的关联，检查设计、设置和参与者 这项回顾性观察性队列研究包括所有成功申请者的数据爱尔兰皇家外科学院 (RCSI) 国家核心外科培训 (CST) 计划。参与者包括 2016 年至 2020 年招募的专门研究生外科培训的所有学员。这些数据是在 2016 年 7 月 11 日至 2022 年 7 月 10 日期间进行分析的。选择决定基于技术能力评估、本科生学业表现得出的综合分数，以及 4 个站的多个小型访谈。主要结果和措施记录了每位学员的评估数据、自然减员率和 HST 进展率。使用基于工作场所和基于模拟的技术和非技术技能评估来评估 CST 绩效。使用 Pearson 相关、逻辑回归和多元线性回归分析探索选择和评估措施之间的潜在关联。结果数据适用于 303 名受训者。综合评分与 HST 进展呈正相关（优势比 [OR]，1.09；95% CI，1.05-1.13）。所有 CST 评估的分数和表现之间存在微弱的正相关性，范围为 0.23 到 0.34。多变量线性回归分析显示，应用时的技术能力得分与未来的操作绩效评估得分相关，无论是在工作场所（β = 0.31；95% CI，0.14-0.48）还是模拟环境（β = 0.57；95% CI，0.33-0.33） 0.81）。有证据表明，人际交往能力面试站与模拟沟通技能评估中的未来表现相关（β = 0.55；95% CI，0.22-0.87）。结论和相关性在这项研究中，爱尔兰国家选拔时的表现通过衡量技术和非技术领域以多模式方式与工作场所和模拟环境中的未来表现相关联。未来的研究需要探索选择的相应有效性，包括选择和排名对候选人表现的潜在意外影响。