Simulation Story board Overview

Workshop

simulation title: Completing an Electronic Residency Application

Field and/or

discipline

This simulation is intended for third year medical students who are in the process of applying

for a medical residency. This application, like all job applications, can make or break their

success in getting the residency of their choice.

Topic of simulation The purpose of this simulation is to guide the third-year medical student through the online

residency application process. She will select the appropriate choices when presented with

ethical questions that may present in the application process.

Environment and

characters

The main character is a third-year medical student who is completing her residency

application. The environment will be the medical school library while sitting at her

computer.

Short summary of

the simulation

The student is unprepared and encounters several pitfalls and ethical challenges and must

make choices about how to proceed through the medical student application process. She will

need to request letters of recommendations from her advisors as well as contact the office of

student affairs for guidance.

Target audience The target audience is third year medical students at the medical school.

The big Idea of the

simulation

Residency and other applications can be complex and the choices that the applicant makes

can have a significant impact on whether they are selected for a position or job.

Unfortunately, most applicants will never know why they did not get a particular position.

Applicants rarely seek assistance with these applications because the application appears

straight-forward and the potential to make mistakes is not obvious.

SMART Objectives 1. Identify appropriate options when an applicant does not have all their required

information.

2. Identify the proper way to ask for letters of recommendation and considerations the

applicant should weigh.

3. Identify the ramifications of lying by omission on an application.

4. Explain what is meant by unconscious bias and why a professional photo matters.

5. Define plagiarizing and the risk of plagiarizing internet content on a personal

statement.

6. Identify the definition of copyright

7. Choose the appropriate option in a number of research authorship questions.

Scene #1

Setting Student logging into ERAS system and recognizing that she does not have the appropriate

required

information

Visual Student is sitting in the library. She has delayed completing her ERAS application until 2

weeks before the upload date.

Interaction Student will make a choice between: 1. Contacting the student affairs office and requesting

direction on how to obtain her AAMC number 2. Contacting the AAMC and requesting a

new AAMC number 3. Ignoring the field and hoping she does not need it

Audio Narration Marie is sitting in the Miami Valley Hospital library at her computer. She is stressed and

more than a little irritated. Why? She needs to fill out her application for residency and she is

unprepared. She has spent hours researching, volunteering, and seeking leadership positions

to make her application as competitive as possible, but she has neglected any preparation for

completing the application itself. She has not met with any advisors or reviewed any

available content to prepare for the application. She realizes that she does not have their

required AAMC number to start the application.

Slide Text Marie prepares to complete her residency application and realizes that she is unprepared and

does not have her required AAMC number.

Branching 1. Student affairs will provide the student with the required AAMC number, but the student

feels this may be detrimental because they will realize that the student waited until the last

minute to begin the application process. 2. The AAMC will provide a new AAMC number,

but having two numbers associated with the student name will result in some confusion in

the application process and all documents may not be assigned appropriately. 3. Lack of the

AAMC number will result in an inability to complete the application. Drag and drop the

choices into the correct results bin.

Resolution Student contacts student affairs and is emailed their appropriate AAMC number. The other

two options will lead to an image that says

Scene # 2

Setting Student is now in the Electronic Residency Application System (ERAS) and begins to fill out

the identifying information. The student reaches the box requesting add the NRMP number.

Interaction Student makes a choice between: 1. Contacting student affairs. 2. Going to the NRMP

website and contacting them to get a NRMP number 3. Skipping this section completely.

Audio Narration Marie now has her AAMC number and is logged into the ERAS application. She begins to

fill in the identifying information. She reaches a field that requests a NRMP number. Marie

wonders how she is supposed to get this number. She is starting to wish she had taken the

time to go to the required ERAS presentation given by her student affairs office.

Slide Text Marie has started the ERAS application and reaches a box that requests an NRMP number.

Branching 1. When Marie contacts the office of student affairs she is told that the required presentation

on ERAS as well as the Career Essentials Pilot page provides this information. A link will be

provided to this page. 2. The student is told that this information is not available until noon

on September 15th. 3. The number is not available until September 15th at noon. She should

get the number by registering at the NRMP and add the number to her ERAS application

after she obtains it. The student is not able to rank order residency choices without this

number and there is a late fee if she does not register for it be November 30th. A link will be

provided to the NRMP website.

Resolution Student appropriately contacts student affairs and then chooses to review the ERAS

application section on Career Essentials before going any further on the application process.

Choosing option 2 or 3 results in:

Scene #3

Setting The student notices that there is no correction feature or auto check on the ERAS application.

Interaction 1. The student knows that proper punctuation and grammar are important so she types all her

answers in Microsoft Word and uses the review feature and then copies and pastes it into her

application. 2. The student feels that they will recognize any errors and that it will take too

long to copy and paste so they choose to complete the application in the ERAS application.

Audio Narration Marie continues to work on her application. She notices that there is no punctuation and

grammar correction feature in the myERAS system. She pauses to decide whether to

continue typing in myERAS or to copy and paste after using Microsoft Word.

Slide Text Marie’s application is progressing well. She notices that there is no punctuation and grammar

correction feature in myERAS.

Branching 1. The student has an error-free application. 2. Residency program directors can interpret

errors as either a rushed application or failure to pay attention to details.

Resolution Student appropriately chooses to do the application in Microsoft Word and has a friend check

it to make sure they don’t see any errors. Choosing option 2 results in:

Scene #4

Setting Marie gets to the end of the personal information section of the application and notices there

is a spot to enter any misdemeanors. She has had a speeding ticket in the last year which is a

misdemeanor in the state of Ohio, but she doesn’t think this is what they meant by

misdemeanor and the law is not consistent across states.

Interaction 1.Student can choose to enter the misdemeanor conviction. 2. Student can choose to not add

the misdemeanor. 3. Student can contact an advisor to get further information.

Audio Narration Marie reaches the end of the personal information section. The next question asks if she has

ever had a misdemeanor. Marie does not know much about the law, but does remember that

she had to go to court regarding her speeding ticket last year. She is sure that was listed as a

misdemeanor.

Slide Text Marie has a misdemeanor speeding ticket, but is a routine speeding ticket really considered a

misdemeanor?

Branching 1. Student chooses to enter her misdemeanor conviction. She wants to be completely honest

and is concerned that not adding it and having it show up in a background check would be

very detrimental to her application. This will take her to a section on background checks as

well as a section on Ohio law on minor misdemeanors. 2. Student chooses not to add the

misdemeanor. Only three states include speeding as a misdemeanor and she feels adding it

will put her at a disadvantage when program directors filter applications. This section will

take her to Ohio Law as well as the AAMC statement on fabrication. 3. Student contacts her

advisor and asks them what to do. This will take her to an animation of a phone ringing

endlessly.

Outcome

Student chooses to add the misdemeanor. The response from the AAMC after asked this

question because speeding tickets are only a misdemeanor in three states. There are many

differences state by state in prosecution trends, the types of offenses considered to be

misdemeanors or felonies, sentencing guidelines, and so on. Some states also have laws that

prohibit employers from considering certain types of background information, and although

ERAS collects the information, many residency programs do not view misdemeanor history

for applicants. For clarity, the questions about criminal history are intended to capture

factually what would appear on a criminal history check; there are no exclusions for certain

types of offenses. In addition, remember that residency program directors have filtering

options on their program director’s work stations. If you have a misdemeanor speeding ticket

and do not get an interview in a place where you feel you are a good candidate, you may

need to call the program to ask about whether they filter based on misdemeanors. If they do

let them know details about your speeding ticket. Option 2 or 3 results in:

Scene #5

Setting Student has reached the section on publications.

Interactions Marie must choose between 1. Adding the publications to the publication section of her

application. 2. Not listing the publications in the publication section, but listing them as

submitted in the research section.

Audio Narration Marie has three research projects that she has written up for publication. She has submitted

all three of them and her preceptor feels that they will all be accepted for publication, but so

far none of them have. She has applied to a residency that values research and publications.

Her application would be much stronger if she lists these publications.

Slide Text Marie has three submitted papers for publication. Her preceptor feels they will be accepted

before she interviews for residency positions.

Branching 1. Student chooses to add the three publications to her application. She decided that if her

preceptor feels it will be accepted, that they probably will be and then when she goes to

interview in three to four months her application will be accurate and as competitive as

possible. This choice will take the student to a section on fabrication in her application

process. We will review some of the literature available on fabrication on residency

applications and what residency program directors are doing to crack down on it. 2. Student

decides to not list the publication and describes the research in her research section instead.

She knows that this might make her application less competitive, but she can bring copies of

the publications to the interview when they have been accepted.

Outcome

Add research data

on fabricated

publications.

The student chooses to wait on the publications and bring them to the interview. She feels

that the risk of not being completely honest on her application is a greater risk than not

having the three publications on it.

Choice 1 results in:

Scene #6

Setting Student needs to upload a photo for their residency

application. She is unsure why she needs her photo

redone when she has a professional one from her

convocation.

Interaction Marie can choose: 1. To have a professional headshot done 2. Marie decides to use her

convocation photo, after all she needs to watch her finances. 3. Marie decides to not upload

any photo at all.

Audio Narration Student needs to upload a photo for her application. She already has one from convocation,

but it is informal. She doesn’t want to order a new photo, but wonders if it will affect her

application negatively if she does not.

Slide Text Marie needs a photo for her residency application.

Branching 1. Student goes to get a new photo in a professional outfit and following the guidelines on the

Career Essentials page. 2. Student decides that her convocation photo is acceptable and she

does not want to spend any additional money. Student will be taking to a section on

unconscious bias. 3. Student decides to avoid the issue and not upload a photo. Student will

be told that this will make her application incomplete and won’t be read by many program

directors.

Outcomes

Add information

unconscious bias.

Student gets a new photo. She recalls a friend who did attend the ERAS application session

telling her a story about a current 4th year student who did not get her photo redone even

though she was in a casual summer dress and was wearing jewelry and a slogan on her shirt

that was not considered professional. She did not get any interview calls. She then had her

photo redone and within weeks had 7 interview offers. Option 2 and 3 results in:

Scene #7

Setting Student needs three letters of recommendation. She has not asked anyone yet, but knows

which three faculty she plans to ask.

Interaction 1. Marie emails her preceptors and requests that they write her letters of recommendation 2.

Marie emails her preceptors and requests her letters of recommendation, but includes her

C.V. and personal statement. 3. Marie calls the faculty person’s office and schedules an

appointment to meet with the faculty member to request the letter.

Audio Narration Marie needs three letters of recommendation for her residency application. Student looked on

Career Essentials and it said that letters of recommendation should be requested in person,

but she is short on time. She needs to decide how to request one from her faculty preceptors.

Slide Text Marie needs three letters of recommendation, but her application is due in two weeks.

Branching 1. Student knows that she is running short on time and decides to email the faculty and ask

them to write her letters. She feels that they were her preceptors and clerkship evaluators so

they should already have the information they need. 2. Student emails the preceptor and

requests the letters of recommendation, but also sends a copy of her CV and her personal

statement. 3. Student calls the faculty person’s office and schedules an appointment to meet

with the faculty member to request the letter. She knows that this will cut into the faculty

member’s time to write the letter, but she knows it is better to ask in person instead of

emailing a request. (Rank in order of best choices) Each of these choices will take the student

to a section where a faculty member will tell the student what the consequences of the delay

has on the faculty member’s schedule.

Outcome Student decides to email her request along with her CV and personal statement. She knows

the more appropriate method is to ask in person, but she is afraid that will cut into the letter

writer’s time too much. Weighing the risks and benefits and knowing the preceptors know

her well and she doesn’t have much time to ask an alternate person.

Scene #8

Setting Student is writing her personal statement. She feels that her writing skills are adequate, but

not exceptional. She has decided to read a number of the online personal statements to get an

idea of what to include.

Scene #8 part 2

Interaction

While looking online student has noticed two options. One there is a number of available

online personal statements and there are a number of companies that she can pay to write her

personal statement for her.

Branching 1 Student notices that there are a number of personal statements for residency available

online. She looks at the various choices and sits down to write her own personal statement. 1.

She closes all of the online options and decides that now that she has an idea of expectations

she will begin writing her own. She completes it and spell checks it and then uploads it to her

application. 2. She closes all of the online options and begins to write her own personal

statement. She knows that she has about a week so she sends it to several faculty that know

her well and ask them to evaluate the writing. 3. Student finds three personal statements that

she likes. She decides to take some of the content from each of the three statements so that

she hasn’t really plagiarized any of them. This choice will take the student to a section on

plagiarism.

Outcome

1 Student decides to write her own personal statement and asks several faculty members to

critique it. She knows that there are several types of plagiarism detection software available

and she is concerned that they may pick up the similarity between her personal statement and

the three online ones. Choices 2 and 3 result in:

Audio Narration Marie now needs to write her personal statement. There are several personal statements

available online as well as many professional writers who one can hire to write your personal

statement. Marie knows that she waited too long to begin working on this personal statement

and that the personal statement is ranked in the top five of things important to residency

program directors.

Slide Text Marie needs to write her personal statement. She reads online medical personal statements to

get ideas.

Branching 2 Student looks at the online options available and notices that there are several different

options. One option is to send a company information about herself and her specialty choice

and they will write the personal statement for her. 2. She can pay a writer to take her personal

statement and rewrite it into a stylistically better format. 3. She can work with the writing

department at her University. They will provide suggestions and edits on her personal

statement. Each of these wrong choices will return her back to the beginning of the scene.

Outcome 2 Student decides to go to her University writing center. They can help her make the best

product possible, but it will be her writing and this would make it easier for her to explain it

at her interview. Choices 1 and 2 result in:

Scene #9

Setting Student has completed her application.

Interaction Student has completed her application. Should she upload it now without the publication? 1.

She should upload on September 15th. 2. She should wait for the publication to be decided on

Audio Narration Marie has completed her application. It is September 14th. She has been strongly advised by

her advisor to upload her application on September 15th. She has one publication that will get

a decision in the next 2-3 days. Should she wait?

Slide Text Marie is ready to upload her application.

Branching 1. She should upload on September 15th. 2. She should wait for the publication to be decided

on. Student will be taken to a section where residency match statistics will be displayed so

she can see how steep the competition is.

Options In order to be included in the initial batch of applications being sent out, she should send her

application out on September 15th. Her MSPE will not be sent out until October 1st. She can

contact student affairs and ask that the publication be added to her noteworthy characteristics

instead.

Summative Assessment

Need to score at

least an 80% to

complete the

module.

Students need to score a minimum of 80% on the quiz to successfully complete the module.

Remedial Process Begin the workshop over again

Question 1

Visual

Question If you do not have your AAMC number, where should you get it.

Answers 1. Contact Student Affairs for the number

2. Contact the AAMC for a new number

3. Leave the space blank it will be filled in eventually

Response Feedback Contact Student Affairs. Getting a second AAMC could result in confusion when your

documents are assigned. You cannot start the application without your AAMC number.

Advancement

options

Next button If incorrect the student will be returned to scene #1

Question 2

Visual

Question If you do not have your NRMP number, you should:

Answers 1. Contact student affairs for the NRMP number.

2. Go to the NRMP website and contacting them to get a NRMP number

3. Skipping this section initially and add it before November 30th.

Response Feedback 3. The section should initially be skipped. The NRMP number is available between

September 15th at noon and November 30th and should be added after you get the number.

After November 30th, there is a late fee.

Advancement

options

Next Button If unsuccessful student will be returned to scene

#2

Question 3

Visual

Question The myERAS application service provides spell and grammar check?

Answers 1. True

2. False

Response Feedback The answer is false. Answer the questions in Microsoft or another platform that provides this

service and then copy and paste it to your application.

Advancement

options

Next button If unsuccessful, student will be returned to scene

#3

Question 4

Visual

Question Speeding tickets are misdemeanors in all states?

Answers 1. True

2. False

Response Feedback False, they are only misdemeanors in three states.

Advancement

options

Next button If unsuccessful, student will be returned to scene

#4.

Question 5

Visual

Question According to the AAMC, students should use their discretion when deciding whether to

report minor misdemeanors. Residency Program Directors have a filter on their software and

having a misdemeanor can be disadvantageous to your application.

Answers 1. True

2. False

Response Feedback False, you should report all misdemeanors. Residency programs will do a background check

and if it shows up after the fact they have the option of rescinding your contract.

Advancement

options

Next button If unsuccessful, student will be returned to scene

#4.

Question 6

Visual

Question Your convocation photo could be acceptable for your residency application if it looks like

you currently look and you are professionally dressed?

Answers 1. True

2. False

Response Feedback True, if it is up-to-date and professional, it is acceptable.

Advancement

options

Next button If unsuccessful, student will be returned to scene

#6

Question 7

Visual

Question Where can a student go for complete information on all aspects of the residency application

process?

Answers 1. The NRMP website

2. Their mentor

3. Student doctor.net

4. Career Essentials

Response Feedback Career Essentials

Advancement

options

Next button If unsuccessful, student will be returned to scene

#1

Question 8

Visual

Question How many letters of recommendation are required for most residency applications?

Answers 1. 1

2. 2

3. 3

4. 4

Response Feedback Generally, 3, but a maximum of 4 can be used.

Advancement

options

Next button If unsuccessful, student will be returned to scene

#7.

Question 9

Visual

Question On what date do all medical students applying for a residency in the next academic year need

to submit their applications?

Answers 1. September 6th

2. September 15th

3. September 30th

4. October 1st

Response Feedback September 15th

Advancement

options

Next button If unsuccessful, student will be returned to scene

#10.

Question 10

Visual

Question It is acceptable to list your submitted papers as publications if you think they will be

published before you are likely to start interviewing?

Answers 1. True

2. False

Response Feedback False, it is not accurate and can be interpreted as deceptive.

Advancement

options

Next button If unsuccessful, student will be returned to scene

#5.

References for

pictures

1.Question Mark: http://www.netzsch-

nachwuchs.de/wpcontent/uploads/2014/08/fragezeichen.jpg

2. Next button:

https://t4.ftcdn.net/jpg/00/29/40/15/240_F_29401553_K8bC1C5K2yNyWYHzP0c4pVdMBv

LWmhHx.jpg

3. Girl in red shirt: Pixabay no attribution required

https://static.pexels.com/photos/53535/beautiful-business-computer-female-53535.jpeg

4. Photo of medical residents: https://aamc-

orange.global.ssl.fastly.net/production/media/filer_public/49/dd/49ddd318-39df-444c-89a4-

657707078e1f/people_med-students-reading-results_landscape.jpg

5. Frustrated doctor http://www.lilesparker.com/wp-content/uploads/2010/03/Frustrated-

Doctor.jpg

6. Cop with radar: http://photos1.blogger.com/blogger/6772/1888/400/cop%20radar.jpg

7. Woman in purple shirt: https://pixabay.com/p-1064658/?no_redirect

8. Computer: www.upstate.edu

9. Angry blonde woman: http://i.vimeocdn.com/video/572189683_1280x720.jpg

10. Professional dress image: https://pixabay.com/p-767811/?no_redirect