key: cord-1022872-fr2tkg76
authors: Day, Ryan W.; Taylor, Brigitte M.; Bednarski, Brian; Tzeng, Ching-Wei D.; Gershenwald, Jeffrey E.; Lee, Jeffrey E.; Grubbs, Elizabeth G.
title: Virtual Interviews for Surgical Training Program Applicants During COVID-19: Lessons Learned and Recommendations
date: 2020-05-20
journal: Ann Surg
DOI: 10.1097/sla.0000000000004064
sha: 7b3c4ddf485d57b793144486d9130ca9d009d0af
doc_id: 1022872
cord_uid: fr2tkg76

nan

In-person interviews for graduate medical education programs have been suspended due to the SARS-CoV-2 (COVID-19) pandemic. Due to restrictions at our institution, inperson interviews for Complex General Surgical Oncology fellowship were converted to a virtual format. The aim of this manuscript is to share lessons learned and recommendations for conducting virtual interviews for surgical trainee applicants.

In-person interviews for surgical training programs have been suspended due to the SARS-CoV-2 (COVID-19) pandemic 1, 2 

Center, restrictions prohibiting visits to our institution, including trainee applicant interviews, were announced on March 9, 2020. In-person Complex General Surgical Oncology Fellowship interviews were scheduled for March 13-14, 2020 and were immediately converted to a virtual approach for these dates. The aim of this manuscript is to share lessons learned and recommendations for conducting virtual interviews for surgical trainee applicants.

Organizing virtual interviews for surgical trainees requires buy-in from stakeholders in the program. On March 9, a meeting of the Department of Surgical Oncology fellowship program education committee was held to choose between conversion to virtual interviews on the originally scheduled dates or to postpone and conduct in-person interviews at an unknown future date. The group concluded that a virtual approach on the originally confirmed dates was in the best interest of applicants. Essential personnel who coordinate efforts and participate can be broadly categorized as follows: For our group activities we utilized a hybrid approach; the trainee applicants all attended virtually and the PD and current trainees were physically present in a large conference room. If current local rules prevent congregation, group activities can employ a completely virtual approach with all individuals participating remotely. Programs will require platforms for web-based teleconferencing, digital cameras, and digital audio or landline telephones.

We utilized a hybrid approach for individual interviews as well; often having two interviewers physically in one room interacting with the applicant. To facilitate this approach, we used a dedicated desktop computer for each applicant's series of 6 interviews, while the interviewers rotated rooms. In a completely virtual approach most web-based teleconferencing applications have an option to utilize a virtual lobby and interviewers and applicants can be designated into private conversations.

Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

Contingency planning included obtaining contact information for applicants prior to initiating interviews so that telephone, FaceTime (Apple, Cupertino, CA), or other smartphone based teleconferencing could be utilized as a backup. Laptops were on hand to be used as backups in the case of a technical malfunction with a desktop.

When utilizing a conference room for a group activity it is important to maintain proper social distancing in light of COVID19 3 . Per current guidelines, individuals should remain spaced more than 6 feet apart and avoid direct physical contact with one another.

Utilizing a single office for each applicant allowed for straightforward infection control. The desk, computer keyboard, mouse, and telephone were cleaned in-between each interviewer rotation. Interviewers were reminded of observed proper hand washing or use of hand sanitizer when rotating between applicant interviews.

A schedule of interview activities was provided to each applicant with instructions on how to access each activity using the selected teleconferencing platform. Some applicants had difficulty securing a computer, webcam, internet and audio capabilities in a private space on short notice, and required the assistance of their current training programs.

For prior in-person interviews, we provide a detailed packet of program information upon arrival. Two days in advance of the web-based virtual event, a portable document format (PDF) version was distributed. This document allows for meaningful use of interface time during interviews as questions may be developed prior to the event.

Overall, we maintained the general structure of our in-person approach. We truncated virtual activities as we hypothesized that attention spans of training program representatives and applicants are shorter than during in-person interviews. We also feel strongly that Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. Our traditional interview scheduling includes in-person interviews conducted with two waves of six rounds of 12 simultaneous interviews as seen in Figure 1 . Each applicant has a separate interview time with the department chair and fellowship PD. This schedule Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

was recreated in a virtual setting. Interviews were 20 minutes with 5-minute breaks in between interviews.

We had a combination of one-and two-interviewer rooms. When technical issues arise, having two interviewers allows one individual to summon IT help or troubleshoot directly, while the other individual is able to continue the interview, by a temporary alternate mechanism if necessary. Virtual conversations with two interviewers also tended to be less stilted. However, having two interviewers physically together can present challenges maintaining appropriate social distancing while also ensuring that natural conversation and quality audio visual capture and transmission are occurring.

After interview completion, follow-up communication with applicants was initiated, including providing additional information based upon individual interviews. Additionally, we provided each applicant with contact information for a current fellow to serve as a resource for additional questions that may evolve following the interview process. We believe this informal yet direct approach leads to improved communication throughout the interview process and fosters future professional relationships.

Both applicants and participants from the program were anonymously surveyed after the interview process. A Likert scale [0(poor)-10(excellent)] was used for most responses.

The current fellows who participated in the pre-interview group activities gave a mean overall rating of 8.33 range (7-10), trainee applicants gave a mean rating of 8.86 (range 6-10).

For the interviews, interviewers gave a mean overall experience rating of 8.3 (range 7-9) and applicants gave a mean overall rating of 9.2 (range 6-10). All interviewers, current fellows, and trainee applicants questioned regarding length and number of interviews answered "just right" as opposed to "too long" or "too short". No applicant preferred virtual interviews to in-Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

person interviews, but several stated they would not have a preference given a choice of either in the future.

Based on the experience of our virtual interviews, we developed recommendations for programs who are going to implement similar processes in the future. We have divided them chronologically into pre-interview, interview and post-interview. They are summarized in Table 1 .

The rapid evolution of social distancing in the setting of SARS-CoV-2 has required surgical training programs to adopt virtual interview processes. It is important to involve program stakeholders in the design and implementation process. Careful attention to the challenges and opportunities of virtual interviews, including those in the technology, process flow, interviewer and team safety, communication, interpersonal, and social domains, can result in rapid implementation of a successful virtual interview experience. 

Recommendations Pre-Interview · Involve stakeholders including program administration, interviewers, IT, support staff in conversations early regarding logistics · Select web-based teleconference software based on IT experience and the number of interviewers, applicants · Communicate with applicants early about web-based interview timing and requirements · Simulated interviews should be performed to test all AV equipment and software. · Provide written program information to applicants prior to the interviews Interview · Minimize the number of applicant invites to virtual web-based teleconferences · Cell phones should be avoided due to poor audio quality, risk for audio interfernece, and the dependence on unreliable cellular networks · Have IT support immediately available to troubleshoot any technical difficulties · Hold all interviews for an applicant during a discreet time period · Follow local guidelines regarding social distancing and infection control · Include unscripted interactions with current trainees outside of formal interviews Post-Interview · Follow-up with applicants shortly after the conclusion of interviews to provide any requested additional information · Obtain feedback from stakeholders and applicants where possible to help with design of future sessions · Provide program contact information for applicants to obtain additional information bout the program and for future correspondence

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