Identification of foundational non-clinical attributes necessary for successful transition to residency: a modified Delphi study with experienced medical educators

Stephen J. Wolf, Tai M. Lockspeiser, Jennifer Gong, Gretchen Guiton

We aimed to identify foundational non-clinical attributes expected of medical school graduates to be successful in residency. We conducted a three-round modified Delphi study with snowball sampling of experienced medical educators. In Round 1, respondents rated 28 attributes identified from a literature search. Additional attributes were proposed through invited comments. In Round 2, respondents expressed their agreement with advanced attribute definitions and examples. Consensus on final definitions and examples was obtained in Round 3. Sixty-four percent (105/163) of invited educators participated in Round 1. There was broad representation of educational focus (undergraduate, graduate, and continuing medical education) and field of practice (primary care, sub-specialty, medical, and surgical). Thirteen attributes were advanced to Round 2. Ninety-seven of 105 (92%) respondents participated in Round 2, with greater than 92% agreement for all attributes. Three pairs were consolidated. In Round 3, 88% (85/97) of educators expressed greater than 92% agreement about definitions and representative examples. The final 10 foundational attributes are: communication skills, critical thinking, emotional intelligence, ethical behavior, intellectual curiosity, organizational skills, resilience, self-improvement, teamwork, and vocational commitment. Through a consensus-building process of medical educators, we identified and defined 10 foundational non-clinical attributes for a medical student's successful transition to residency.