Abstract
The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an important opportunity to examine applicants’ reactions to acute stress. In the context of multi-station selection centres for recruitment to anaesthesia training programmes, we investigated the factors influencing candidates’ pre-station challenge/threat evaluations and the extent to which their evaluations predicted subsequent station performance. Candidates evaluated the perceived stress of upcoming stations using a measure of challenge/threat evaluation—the cognitive appraisal ratio (CAR)—and consented to release their demographic details and station scores. Using regression analyses we determined which candidate and station factors predicted variation in the CAR and whether, after accounting for these factors, the CAR predicted candidate performance in the station. The CAR was affected by the nature of the station and candidate gender, but not age, ethnicity, country of training or clinical experience. Candidates perceived stations involving work related tasks as more threatening. After controlling for candidates’ demographic and professional profiles, the CAR significantly predicted station performance: ‘challenge’ evaluations were associated with better performance, though the effect was weak. Our selection centre model can help recruit prospective anaesthetists who are able to rise to the challenge of performing in stressful situations but results do not support the direct use of challenge/threat data for recruitment decisions.
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Acknowledgments
We would like to acknowledge the assistance of the staff of the South West Peninsula Deanery, Plymouth, UK, staff from the Horizon Centre, Torbay Hospital, Torquay, UK, and healthcare professionals from hospitals in the region who were involved in running the selection centres. We also thank Sam Vine, University of Exeter, for valuable comments on earlier drafts of this paper and for information regarding his research on stress evaluations in airline pilots, and Vicki LeBlanc, University of Toronto, for perceptive feedback on a near-final version of the paper. The Royal College of Anaesthetists kindly gave permission to reproduce the detailed descriptors used to score candidates’ portfolios of academic and professional achievement (“Appendix”).
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Appendix: Criteria for assessment of candidates’ portfolios
Appendix: Criteria for assessment of candidates’ portfolios
Tables 6 and 7 give the detailed criteria that were used to assess candidates’ portfolios of academic and professional achievement. These criteria were used both by candidates, to self-assess their own portfolios at the point of application, and by assessors (who verified evidence presented by candidates at the portfolio station of the selection centre). The tables are reproduced here by kind permission of the Royal College of Anaesthetists.
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Roberts, M.J., Gale, T.C.E., McGrath, J.S. et al. Rising to the challenge: acute stress appraisals and selection centre performance in applicants to postgraduate specialty training in anaesthesia. Adv in Health Sci Educ 21, 323–339 (2016). https://doi.org/10.1007/s10459-015-9629-6
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DOI: https://doi.org/10.1007/s10459-015-9629-6