1. Date of download: 9/18/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Manual Dexterity Aptitude Testing: A Soap Carving Study JAMA Otolaryngol Head Neck Surg. 2014;140(3):243-249. doi:10.1001/jamaoto.2013.6456 Soap Carving InstructionsEach applicant to the Kaiser Permanente Medical Center Oakland Head and Neck Surgery residency program was given a set of instructions, a #11 blade, a #15 blade, and a bar of Ivory soap (Procter & Gamble). Applicants were given an hour to complete the soap carving. 3-D indicates 3-dimensional. Figure Legend:

2. Date of download: 9/18/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Manual Dexterity Aptitude Testing: A Soap Carving Study JAMA Otolaryngol Head Neck Surg. 2014;140(3):243-249. doi:10.1001/jamaoto.2013.6456 Good and Bad Soap CarvingsExamples of best and worst soap carvings were selected in a blinded fashion from the set of all applicant soap carvings for that year. Each year there were roughly 40 applicants and hence 40 soap carvings to select from. Soap carvings from 1990 through 2006 were examined. Figure Legend:

3. Date of download: 9/18/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Manual Dexterity Aptitude Testing: A Soap Carving Study JAMA Otolaryngol Head Neck Surg. 2014;140(3):243-249. doi:10.1001/jamaoto.2013.6456 Surgical Skills SurveyThe 3 best and the 3 worst soap carvings among all the residency applicants each year since 1990 were determined. Surveys were submitted to the residencies from which these applicants graduated, specifically to the chief of their department and the residency director. OR indicates operating room. Figure Legend:

4. Date of download: 9/18/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Manual Dexterity Aptitude Testing: A Soap Carving Study JAMA Otolaryngol Head Neck Surg. 2014;140(3):243-249. doi:10.1001/jamaoto.2013.6456 Specialty BreakdownThere was no correlation between applicants with a good or bad soap carving and whether they matched into a medical/surgical specialty. There was no correlation between an applicant’s soap carving quality and the probability of matching into otolaryngology–head and neck surgery. GI indicates gastroenterology; and Heme/Onc, hematology/oncology. Figure Legend:

5. Date of download: 9/18/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Manual Dexterity Aptitude Testing: A Soap Carving Study JAMA Otolaryngol Head Neck Surg. 2014;140(3):243-249. doi:10.1001/jamaoto.2013.6456 Soap Carving Quality and Class RankThe graph shows that the proportion of applicants who were in the top of their class was similar between those with good soap carvings and those with bad soap carvings. Figure Legend:

6. Date of download: 9/18/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Manual Dexterity Aptitude Testing: A Soap Carving Study JAMA Otolaryngol Head Neck Surg. 2014;140(3):243-249. doi:10.1001/jamaoto.2013.6456 Mean Score of Resident AbilityAlthough individuals with bad soap carvings had lower mean scores than individuals with good soap carvings, the results were not significant. Mean scores for cognitive knowledge, visuospatial ability, manual dexterity, and decision making were 4.09, 4.00, 3.88, and 4.16, respectively, for individuals with good soap carvings and 3.84, 3.73, 3.57, and 3.61, respectively, for individuals with bad soap carvings. Figure Legend: