Absite Smackdown! · Episode 29: Does Writing Research Papers Correlate With Clinical Performance?


Jessica: Hi everyone. Welcome back. This is Jessica, the host of Absite Smackdown! the podcast show. And I'm here with Dr. David Kashmer, the author of The Absite Smackdown! review course and book.

David: Hi Jessica. It's good to be back with you today on the podcast.

Jessica: Well, thanks for coming in again, David, I am enjoying that this is becoming a weekly thing where we get together and discuss the book and discuss, you know, how residents can do better on their ABSITE tests.

David: Yeah. You know, I think you guys have been really great about setting things up so that we're talking not just about the content for the test, which is a lot of what we typically focus on, you know, when we teach residents, but also other things that help predict or improve scores. So I think this is a really great service and that's part of why I really enjoy coming on the program with you to talk all about it.

Jessica: Well, I know lately more than just content, we've been discussing a lot about version 2.0, and it releasing because it is new and it's the baby right now. So there's a lot of focus on that, especially considering the fact that we have so many contributing authors that came in to help us with this version. And most of them being residents themselves.

David: Yeah. Absite Smackdown 2.0, has been really fun to release and you're right. Getting there has been just a trip. We talked about it at the retirement party that we did as a previous episode where we retired Absite Smackdown! version 1.0. And, so we won't go through it all again here. You know, I won't bring it up to you all again, but I definitely agree having that many co-authors on this version of the book has been very rewarding, but also a real trip. And it's been great fun.

Jessica: It has been fun. I don't think that people realize how important it is for residents to be authors or do this kind of work & how helpful it can be. I know that when I was doing research and reading articles on what their contributions could mean or help for them, I came across, an article. It was back from 2016, but it was on the BMC medical education page. And it was talking about how there's an association between resident physician publications, and then their clinical performance. And it was a really interesting article. I sent it to you.

David: I did get it. And I'm happy to talk about it with you today on the show. I do want to share upfront:  I think it's so important that resident colleagues be involved in contributing to their field in research or in writing. I just think it's part of, kind of the giving back and it's part of us educating residents, staff appropriately to make them productive colleagues, not just clinically, not just taking care of patients, which is really important, but also furthering their field and contributing to their field as a whole. And so part of the education, I think, as we teach residents, is to teach them how to write things, how to balance that with their busy practice, how to stay involved and how to self-educate, because as you write things down, you really tend to crystallize your thoughts and remember from working with it, what the facts are or what the new thing is, and just further your education. So I really appreciated it when you sent the article, it's called Associations Between Resident Physicians' Publications And Clinical Performance During Residency Training. And it's from Seaberg et al. It was in BMC medical education. I think that you said we're going to put the link in the description of the podcast.  So yeah, thanks a lot for sending it over. And I think it's worth discussing, for sure.

Jessica: Well, basically the study, it was at Mayo clinic, which we all know is, you know, well known and they did it for 308 residents that were going to be graduating from the 2006 to 2012 year. So, that was pretty much the start of how they did it. And then they had 642 papers published by these residents that were reviewed.

David: You know, the first thing about the article, like we said is, like you said, is it's one study in one center and this center is a very academically productive center. It may not represent, you know, all the centers and residencies across the country. And I'll tell you, it was interesting to me about this paper. it goes on to say that, you know, outcomes included the American board of internal medicine certification scores, clinical exam scores, faculty evals, et cetera. And they found out that, on adjusted analysis, the multi score clinical performance evaluations were significantly associated with the number of research articles. And I'm going to tell you, Jessica basically that says to me that faculty evals and performance evals and multi-source clinical performance evals, it's kinda tough to tease out exactly what that meant, but they correlated with a sort of academic productivity or resident research.

And I'm going to tell you, you know, we discussed this earlier on the podcast, for Absite scores, that faculty evaluations are not predictive really, in at least a couple of papers on Absite score. So it's interesting to me for this, as it seems like faculty eval and some other clinical sources, you know, were associated with resident research productivity, but, you know, having worked in residencies with residencies before having been a resident myself, you always wonder, well, when a resident's doing research with a faculty member, or being productive that way, they tend to be looked at favorably on faculty evaluations, et cetera. So the question to my mind is, you know, really our faculty evaluations are faculty just happy when the residents are doing research for a whole bunch of different reasons, in surgery land, like I said, it doesn't seem like Absite correlates with faculty evaluations, at least according to some papers and my experience with it. So, long way of saying, that this in this study that you sent from the Mayo clinic, it seems like their academic productivity, on adjusted analysis, really correlated with their clinical performance. But number one, I'm not sure that holds everywhere. And number two, I'm not sure the yardsticks by which clinical performance was measured really that those are super objective or correlate with what we see in Surgery. So those are my thoughts on it.

Jessica: Well, I mean, especially because like you said, each program is different. For example, this study in this program, 64% of the participants were male. So, you know, that's, that's kind of a huge number and it can be more diverse and other programs.  So that being from that particular program with those demographics and those kinds of papers might not necessarily reflect the way other programs, what test,

David: Again, this is one series at one center. And it's just really interesting to me again, that, you know, that their productivity from a research standpoint is then read backward on the clinical performance. I think that, in my experience in Surgery, sometimes faculty conflate the fact that a resident may be very productive or on their research paper with how well the resident is doing. And you know, another thing Jessica is it could be if this is the case and if this does hold across centers, maybe it's just that these residents who can also crank out research papers are just really good at time management. They're really good at juggling the multiple stressors of residency. And, you know, as a result, they're able to also do better on their exam. So you can sort of imagine, it's true that they make more research papers. It's true that they perform better clinically.  And yet they're not directly related. They're just related by the fact that people are better at time management. Or again, it could be that this doesn't hold across centers at all. So really an interesting paper, I think to discuss, from the clinic and what it implies about education. I really wonder if it holds for Surgery and I'll be on the lookout to see if this holds also across a residency types.

Jessica: Do you not also feel like in the program that you direct that you look for a certain type of resident, like from personality to, you know, the way they do things that fit. So therefore wouldn't Mayo, and what they look for, the kind of residents they pull in...it would have a certain personality type versus maybe some of the other programs.

David: Well, absolutely. we'll talk about resident selection criteria and you know, it's interesting and timely that you brought this up because we're going to be starting these webinars soon and having these online webinars in the midst of COVID. Of course the Absite Smackdown course is completely online for review, but then beyond that, we're going to do some different online webinars.

And one of them is about a similar topic. How are residents selected?  How do we do it?  What's behind the curtain for how we select for Surgery?  These things called audit filters and where the tests fall in and how do I go from being a prelim surgery resident to a categorical surgery resident?  We're going to discuss all of that. And you're right, what one center selects for maybe different than what another selects for and, and why. And, when it comes to the Mayo clinic, clearly a healthy, robust research program is sort of part of the atmosphere.

It's pretty likely to my mind that they select for people who have a history of being able to do that already or something similar or at the very least a strong interest in getting that done, including pick it up today. So appreciate you bringing this paper up today and we get to talk about it on the podcast. and again, you know, I thank you guys because some really interesting things are coming up, not just with the release of version 2.0, which has been doing great on Amazon and the website site AbsiteSmackdown.com, but also the upcoming webinars and training.  That we're going to be doing kind of live.

So, this article segues into how managing our time is really important. And, I think that this service, the podcast, the social media feeds that you guys put out with daily.absite.fact (on Insta), and then the book and course itself, which lets you study and listen from anywhere...those are the kinds of time management aids that we're really looking to get out there for the Absite and for busy surgical residents. So again, really timely article and happy to discuss it with you.

Jessica: Well, thank you so much for coming in today! I hope that our next podcast can be after you do that webinar. So we can kind of do a little wrap up for everybody and let them know how it went and everything we discussed, because I definitely want to ask questions about your personal opinion on surgeons. Just the ones that become trauma, the ones that become cardiac, the ones that become neurosurgeons, if they have different little ticks that make them well suited for that. I am curious. So hopefully we can get into that too, but again, just thank you so much for coming today. We look forward to having you back and again!  #AbsiteSmackdown!

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