Original ArticleIncorporation of Personality Typing into a Neurologic Surgery Residency Program: Utility in Systems Based Practice, Professionalism, and Self-Reflection
Introduction
In many regards, more is expected of current residents in training than previous generations. Although the overall amount of time spent in the teaching hospital has been curtailed, the amount of bureaucratic work, regulatory pressures, patient acuity, and census is at its peak. Residents are expected to do more in less time, all the while maintaining a higher standard of professionalism than was ever previously demanded of them, as reflected in the Systems-Based Practice and Professionalism sections of the Accreditation Council for Graduate Medical Education competencies. Thus, the current resident is burning both ends of the candle, and navigating the health care setting can be a daunting task from an interpersonal standpoint, with more demands in a more time-compressed fashion, pressure to adhere to duty hour restrictions, and the need to smile and be courteous at all times while doing so. Residents must constantly juggle opposing interests, for example, being a highly focused taskmaster during overnight call while having a bedside presence and patiently discussing a plan of care with a challenging family. Often times, personality traits that are extremely adaptive in some situations can be maladaptive in others.
The Myers–Briggs Type Indicator (MBTI) has been used extensively in the business and administrative world and more recently also studied in medicine with regard to selection of specialty,1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 perspectives on the various specialties,15, 16, 17, 18 and offering insights into how various types learn in different contexts.18, 19, 20, 21, 22, 23 As a quality improvement effort to promote self-reflection and personal and professional improvement among both faculty and residents members in a department of neurosurgery at a tertiary care academic medical center, a group learning exercise was implemented using the MBPT.
Section snippets
Myers–Briggs Type Indicator
Current neurosurgical faculty and residents from a program accredited by the Accreditation Council for Graduate Medical Education in the United States were contacted via e-mail and offered the opportunity to take an online assessment to determine their MBTI. It was stressed that participation was strictly on a volunteer basis. The instrument reports personality typing based on 4 preferences; extraversion (E) and introversion (I), sensing (S) and intuition (N), thinking (T) and feeling (F), and
Results
All residents (11/11) and 85% of faculty (11/13) participated in the exercise.
Personality Typing in Medicine
The MBTI is the most widely adopted instrument used to assess a person's innate preferences and is commonly used in non-health care profession arenas for job interviews, team building exercises, and for increasing self-awareness. The MBTI has been used in medicine most extensively in the study of medical students and their eventual career paths. Observations have included: introversion (I) correlated with careers in academia, feeling (F) preference has been most correlated with entering a
Conclusions
A self-reflection exercise based on personality typing was successfully implemented for faculty and residents of a residency training program in a department of neurosurgery. The _NTJ prototype is heavily overrepresented. The great majority of participants identified value in the exercise in a variety of systems base practice and professionalism domains and would recommend the exercise to other departments around the country.
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Conflict of interest statement: Penumbra Inc., consulting; Cerenovus, consulting; and Minnetronix, consulting.