P3.S362: Getting to know you: Using simulation to help inform hiring decisions

Background: Prior to the COVID-19 pandemic, our neonatal/pediatric transport team’s standard process for interviews included a preliminary screening by human resources, an in-person interview, and a 6-hour job shadowing experience. Our team was required to transition to teleconference interviews due to COVID restrictions impacting in-person contact. Initially, table-top simulations were incorporated into the remote interviews, however were deemed inadequate for prioritizing candidates. To address this, hospital leadership approved a process to bring candidates to the simulation center to participate in high-fidelity simulations as part of the interview process.

Methods: Each candidate who advanced past the teleconference interview was then scheduled for in-person simulations. The sessions consisted of two realistic, case-based, high-fidelity simulations in which the candidate was paired with a current transport team member. Embedded simulation participants fulfilled the roles of parent and referring hospital staff. Simulation scenarios were intentionally selected with consideration of each candidate’s background and to serve as a challenge. For example, neonatal simulations were utilized for nursing candidates with prior emergency room or pediatric intensive care unit backgrounds. A potentially difficult conversation was utilized for the respiratory therapist candidates. A prebrief was held to familiarize the candidate with the mannikin, review the Basic Assumption™, and acknowledge it was a high-stakes situation used to inform hiring decisions. Interpersonal communication, decision-making, and demeanor were observed by the transport leadership team. A debrief was conducted after each simulation that included formative feedback.

Results: Interview simulations provided insight into candidates’ clinical decision-making ability. Strong candidates demonstrated key characteristics needed in transport medicine, including excellent communication skills and adaptability to dynamic situations. Some candidates with a mediocre teleconference interview demonstrated clinical prowess in the simulated clinical environment. Since incorporating simulations into the interview process all new team members have successfully completed orientation.

Conclusion: High-fidelity simulations as part of interviews for transport team candidates have contributed to a more informed hiring process. This addition has created the opportunity for candidates to move forward in the interview process who otherwise would have been rejected after a poor teleconference interview. It has promoted the hiring of strong candidates by allowing observation of real-time clinical decision-making. This has been superior to our prior process of evaluating a candidate on years of experience and good interviewing skills alone. A future step is to develop a rubric to increase objectivity and decrease the risk of bias.