A Retrospective Analysis Comparing the New Standardized Letter of Recommendation in Dermatology with the Classic Narrative Letter of Recommendation.

Abstract

<b>Background:</b> In an effort to avoid numerous problems associated with narrative letters of recommendation, a dermatology standardized letter of recommendation was utilized in the 2014-2015 resident application cycle. <b>Objective:</b> A comparison of the standardized letter of recommendation and narrative letters of recommendation from a single institution and application cycle to determine if the standardized letter of recommendation met its original goals of efficiency, applicant stratification, and validity. <b>Methods:</b> Eight dermatologists assessed all standardized letters of recommendation/narrative letters of recommendation pairs received during the 2014-2015 application cycle. Five readers repeated the analysis two months later. Each letter of recommendation was evaluated based on a seven question survey. Letter analysis and survey completion for each letter was timed. <b>Results:</b> Compared to the narrative letters of recommendation, the standardized letter of recommendation is easier to interpret (<i>p</i><0.0001), has less exaggeration of applicants' positive traits (<i>p</i><0.001), and has higher inter-rater and intrarater reliability for determining applicant traits including personality, reliability, work-ethic, and global score. Standardized letters of recommendation are also faster to interpret (<i>p</i><0.0001) and provide more information about the writer's background or writer-applicant relationship than narrative letters of recommendation (<i>p</i><0.001). <b>Limitations:</b> This study was completed at a single institution. <b>Conclusions:</b> The standardized letter of recommendation appears to be meeting its initial goals of 1) efficiency, 2) applicant stratification, and 3) validity. (<i>J Clin Aesthet Dermatol.</i> 2016;9(9):36-2.).