The relationship of cognitive, personality, and academic measures to anesthesiology resident clinical performance

Cognitive skills (including vigilance), personality factors, and standardiz ed academic test performance may be associated with clinical competence in anesthesiology to varying degrees. Sixty-seven anesthesiology residents in training at one center between 1993 and 1995 were administered the modified Vigil (For Thought, Ltd., Nashua, NH), the Paced Auditory Serial Addition Test, the California Personality Inventory, the State-Trait Anxiety Invento ry, and five standardized academic performance tests. The clinical performa nce of anesthesiology residents was rated on a quarterly basis by a clinica l competence committee. A growth curve model indicated that there was signi ficant variability in clinical competence at the start of residency and a s tatistically significant improvement over time, and that the relative ranki ng of the residents remained stable ol er the course of training. Of 46 pot ential variables, 7 were associated (P < 0.10) with poor clinical performan ce; these were subjected to a multivariate test (Mantel-Haenszel). Cognitiv e variables predicting poor clinical performance were difficulty performing a rapid mental arithmetic test requiring divided attention and commission errors during complex visual target detection. Personality variables predic ting poor clinical performance were introversion and flexibility. A predict ive academic variable was poor anesthesia knowledge as measured by using tw o different tests during the first month of training. There were varying le vels of independence among these variables. Implications: Early academic te st performance and certain cognitive and personality tests were associated with the clinical performance of anesthesiology residents. The predictive v alue of these findings should be confirmed in a prospective, multicenter st udy.