Does the experience of the writer affect the evaluative components on the standardized letter of recommendation in emergency medicine?

TitleDoes the experience of the writer affect the evaluative components on the standardized letter of recommendation in emergency medicine?
Publication TypeJournal Article
Year of Publication2014
AuthorsBeskind DL, Hiller KM, Stolz U, Bradshaw H, Berkman M, Stoneking LR, Fiorello A, Min A, Viscusi C, Grall KJH
JournalJ Emerg Med
Volume46
Issue4
Pagination544-50
Date Published2014 Apr
ISSN Number0736-4679
KeywordsClinical Clerkship, Correspondence as Topic, Education, Medical, Graduate, Educational Measurement, Emergency Medicine, Humans, Internship and Residency, Personnel Selection, Professional Competence, Retrospective Studies, Time Factors, Writing
Abstract

BACKGROUND: The Standardized Letter of Recommendation (SLOR) was developed in an attempt to standardize the evaluation of applicants to an emergency medicine (EM) residency.

OBJECTIVE: Our aim was to determine whether the Global Assessment Score (GAS) and Likelihood of Matching Assessment (LOMA) of the SLOR for applicants applying to an EM residency are affected by the experience of the letter writer. We describe the distribution of GAS and LOMA grades and compare the GAS and LOMA scores to length of time an applicant knew the letter writer and number of EM rotations.

METHODS: We conducted a retrospective review of all SLORs written for all applicants applying to three EM residency programs for the 2012 match. Median number of letters written the previous year were compared across the four GAS and LOMA scores using an equality of medians test and test for trend to see if higher scores on the GAS and LOMA were associated with less experienced letter writers. Distributions of the scores were determined and length of time a letter writer knew an applicant and number of EM rotations were compared with GAS and LOMA scores.

RESULTS: There were 917 applicants representing 27.6% of the total applicant pool for the 2012 United States EM residency match and 1253 SLORs for GAS and 1246 for LOMA were analyzed. The highest scores on the GAS and LOMA were associated with the lowest median number of letters written the previous year (equality of medians test across groups, p < 0.001; test for trend, p < 0.001). Less than 3% received the lowest score for GAS and LOMA. Among letter writers that knew an applicant for more than 1 year, 45.3% gave a GAS score of "Outstanding" and 53.4% gave a LOMA of "Very Competitive" compared with 31.7% and 39.6%, respectively, if the letter writer knew them 1 year or less (p = 0.002; p = 0.005). Number of EM rotations was not associated with GAS and LOMA scores.

CONCLUSIONS: SLORs written by less experienced letter writers were more likely to have a GAS of "Outstanding" (p < 0.001) and a LOMA of "Very Competitive" (p < 0.001) than more experienced letter writers. The overall distribution of GAS and LOMA was heavily weighted to the highest scores. The length of time a letter writer knew an applicant was significantly associated with GAS and LOMA scores.

DOI10.1016/j.jemermed.2013.08.025
Alternate JournalJ Emerg Med
PubMed ID24113483
Faculty Reference: 
Matthew Berkman, MD
Daniel Beskind, MD, MPH, FACEP
Hans Bradshaw, MD
Albert B. Fiorello, MD, RDMS, FACEP
Katherine Hiller, MD, MPH, FACEP
Alice Min Simpkins, MD, FACEP
Lisa Stoneking, MD, FACEP
Chad Viscusi, MD