Simulation-based evaluation of anaesthesia residents: optimising resource use in a competency-based assessment framework

2019 ◽  
Vol 6 (6) ◽  
pp. 339-343
Author(s):  
Melinda Fleming ◽  
Michael McMullen ◽  
Theresa Beesley ◽  
Rylan Egan ◽  
Sean Field
Keyword(s):  
Resource Use ◽  
Clinical Training ◽  
Optimal Number ◽  
Theory And Practice ◽  
High Stakes ◽  
Simulation Based ◽  
Optimal Resource ◽  
Competency Based ◽  
The Impact ◽  
Competency Based Assessment

IntroductionSimulation training in anaesthesiology bridges the gap between theory and practice by allowing trainees to engage in high-stakes clinical training without jeopardising patient safety. However, implementing simulation-based assessments within an academic programme is highly resource intensive, and the optimal number of scenarios and faculty required for accurate competency-based assessment remains to be determined. Using a generalisability study methodology, we examine the structure of simulation-based assessment in regard to the minimal number of scenarios and faculty assessors required for optimal competency-based assessments.MethodsSeventeen anaesthesiology residents each performed four simulations which were assessed by two expert raters. Generalisability analysis (G-analysis) was used to estimate the extent of variance attributable to (1) the scenarios, (2) the assessors and (3) the participants. The D-coefficient and the G-coefficient were used to determine accuracy targets and to predict the impact of adjusting the number of scenarios or faculty assessors.ResultsWe showed that multivariate G-analysis can be used to estimate the number of simulations and raters required to optimise assessment. In this study, the optimal balance was obtained when four scenarios were assessed by two simulation experts.ConclusionSimulation-based assessment is becoming an increasingly important tool for assessing the competency of medical residents in conjunction with other assessment methods. G-analysis can be used to assist in planning for optimal resource use and cost-efficacy.

scholarly journals Robotic surgery basic skills training: Evaluation of a pilot multidisciplinary simulation-based curriculum

2013 ◽  
Vol 7 (11-12) ◽  
pp. 430 ◽  
Author(s):  
Kirsten Foell ◽  
Antonio Finelli ◽  
Kazuhiro Yasufuku ◽  
Marcus Q. Bernardini ◽  
Thomas K Waddell ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Da Vinci ◽  
Basic Skills ◽  
Skills Training ◽  
Educational Process ◽  
Simulation Based ◽  
Robotic Skills ◽  
Competency Based ◽  
Multidisciplinary Simulation ◽  
The Impact

Purpose: Simulation-based training improves clinical skills, while minimizing the impact of the educational process on patient care. We present results of a pilot multidisciplinary, simulation-based robotic surgery basic skills training curriculum (BSTC) for robotic novices.Methods: A 4-week, simulation-based, robotic surgery BSTC was offered to the Departments of Surgery and Obstetrics & Gynecology (ObGyn) at the University of Toronto. The course consisted of various instructional strategies: didactic lecture, self-directed online training modules, introductory hands-on training with the da Vinci robot (dVR) (Intuitive Surgical Inc., Sunnyvale, CA), and dedicated training on the da Vinci Skills Simulator (Intuitive Surgical Inc., Sunnyvale, CA) (dVSS). A third of trainees participated in competency-based dVSS training, all others engaged in traditional time-based training. Pre- and post-course skill testing was conducted on the dVR using 2 standardized skill tasks: ring transfer (RT) and needle passing (NP). Retention of skills was assessed at 5 months post-BSTC.Results: A total of 37 participants completed training. The mean task completion time and number of errors improved significantly post-course on both RT (180.6 vs. 107.4 sec, p < 0.01 and 3.5 vs. 1.3 sec, p < 0.01, respectively) and NP (197.1 vs. 154.1 sec, p < 0.01 and 4.5 vs. 1.8 sec, p = 0.04, respectively) tasks. No significant difference in performance was seen between specialties. Competency-based training was associated with significantly better post-course performance. The dVSS demonstrated excellent face validity.Conclusions: The implementation of a pilot multidisciplinary, simulation-based robotic surgery BSTC revealed significantly improved basic robotic skills among novice trainees, regardless of specialty or level of training. Competency-based training was associated with significantly better acquisition of basic robotic skills.

scholarly journals Medical Simulation as a Competency-Based Assessment within Physician Assistant Education

2021 ◽  
Author(s):  
Michele Toussaint
Keyword(s):  
Patient Care ◽  
Communication Skills ◽  
Internal Consistency ◽  
Clinical Training ◽  
Rating Scales ◽  
Rating Scale ◽  
Physician Assistant ◽  
Global Rating ◽  
Simulation Based ◽  
Competency Based

Simulation-based practices are widely utilized in medical education and are known to be a safe and effective way to train and assess learners, improve provider confidence and competency, and improve patient safety. Competency-based initiatives are being more broadly utilized to assess learner proficiency in health professions education. Recent publication of competencies expected of new graduate physician assistants, and updated accreditation requirements which include assessment of learner competencies in non-knowledge based domains, have led to the creation of this simulation-based summative assessment of learner competency in communication and patient care skills for Physician Assistant students. The purpose of this quantitative study was to identify if this simulation assessment had appropriate construct validity and rater consistency, and to identify if correlation existed between learner performance on the simulation exam and in required Supervised Clinical Training Experiences for measures of communication skills and patient care skills. While raters for the simulation assessment had minimal variability, measures of internal consistency did not achieve suitable thresholds for patient care skills. Communication skills assessment was able to achieve the minimum suitable threshold for internal consistency with minor revisions. No correlation was noted between exam performance for communication skills or patient care skills and clinical practice ratings. Several key areas exist which may explain these results including the rating scale for the simulation exam which utilized checklists and not global rating scales, faculty raters with broad and diverse clinical backgrounds, observation-related factors on the part of the student, and the high-complexity and multidimensional nature of provider-patient interactions.

Experiential learning for trainee therapists through a shame attack exercise

2020 ◽  
Vol 13 ◽  
Author(s):  
James Collard ◽  
Michael Clarke
Keyword(s):  
Experiential Learning ◽  
Personal Development ◽  
Conceptual Knowledge ◽  
Behavioural Therapy ◽  
Theory And Practice ◽  
List Type ◽  
Cognitive Behavioural ◽  
Competency Based ◽  
Trainee Therapists ◽  
Competency Based Assessment

Abstract Research on self-practice/self-reflection (SP/SR) programmes in training cognitive behavioural therapy (CBT) have shown promising outcomes over the past decade. To date, the SP/SR framework research has generally focused on entire programmes and has rarely assessed the utility of specific exercises as teaching tools. This study aimed to determine the utility of an exposure intervention known as a shame attack in helping to facilitate CBT training in a clinical psychology programe when delivered in a SP/SR framework. It also sought to examine the potential for the exercise to be used as a form of competency-based assessment. Forty-one student trainees engaged in self-directed shame attack exercises and provided written reflections on their experiences. The reflections were then studied via thematic analysis. The results indicate that the exercise provides an avenue for competency-based assessment of trainee therapists’ conceptual knowledge, formulation skills and intervention planning. It also promoted learning outcomes relating to a ‘deeper’ and more nuanced appreciation of CBT theory and practice. The shame attack exercise provided for personal development and the opportunity to experience typical client challenges with engaging in exposure interventions, which have the potential for enhancing empathy and cognitive behavioural skills. Key learning aims (1) To understand the usefulness of a shame attack exercise for training within a SP/SR framework. (2) To examine the potential for using SP/SR as a form of competency-based training. (3) To demonstrate the benefits of experiential learning through SP/SR in training CBT.

scholarly journals Study on Construction Resource Optimization and Uncertain Risk of Urban Sewage Pipe Network

2021 ◽  
Author(s):  
Xin Li ◽  
Jian Huang ◽  
Chunwei Li ◽  
Ning Luo ◽  
Wen Lei ◽  
...  
Keyword(s):  
Meteorological Data ◽  
Optimal Schedule ◽  
Simulation Method ◽  
Optimal Number ◽  
Pipe Network ◽  
Sewage Pipe ◽  
Urban Sewage ◽  
Optimal Resource ◽  
The Cost ◽  
The Impact

With considering sewage pipe network upgrading projects in the “villages” in cities, the optimization of construction resources and the assessment of delay risks could be achieved. Based on the schedule-cost hypothetical theory, the mathematical model with constraint indicators was established to obtain the expression of optimal resource input, and conclude the method to analyze the schedule uncertainties. The analysis showed that cyclical footage of pipe could be regarded as a relatively fixed value, and the cost can be regarded as a function that depending on the number of working teams. The optimal number of teams and the optimal schedule occurred when the minimum total cost achieved. In the case of insufficient meteorological data, the Monte Carlo simulation method and uncertainty analysis method can be applied to assess the impact of rainfall on the total construction period, correspondingly the probability of such risk could be derived. The calculation showed that the risk of overdue completion varied significantly according to the construction starting time. It was necessary to take rainfall risk into consideration and make corresponding strategies and measures.

scholarly journals P057: Performance of a national simulation-based resuscitation OSCE for emergency medicine trainees

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S97-S98 ◽  
Author(s):  
C. Hagel ◽  
A.K. Hall ◽  
D. Klinger ◽  
G. McNeil ◽  
D. Dagnone
Keyword(s):  
Emergency Medicine ◽  
Large Scale ◽  
Assessment Tool ◽  
Postgraduate Medical Education ◽  
Perceived Realism ◽  
Simulation Based ◽  
Competency Based ◽  
Generalizability Study ◽  
Graduate Trainees ◽  
Competency Based Assessment

Introduction: The use of high-fidelity simulation is emerging as an effective method for competency-based assessment in postgraduate medical education. We have previously reported the development of the Queen’s Simulation Assessment Tool (QSAT), for use in simulation-based Objective Structured Clinical Examinations (OSCEs) for Emergency Medicine (EM) trainees. We aimed to demonstrate the feasibility and present an argument for the validity of a simulation-based OSCE utilizing the QSAT with EM residents from multiple Canadian training sites. Methods: EM post-graduate trainees (PGY 2-5) from 9 Canadian EM training programs participated in an 8-station simulation-based resuscitation OSCE at Queen’s University in Kingston, ON. Each station was scored by a single trained rater from a group of 9 expert Canadian EM physicians. Raters utilized a station-specific QSAT and provided an Entrustment Score. A post-examination questionnaire was administered to the trainees to quantify perceived realism, comfort and educational impact. Statistical analyses included analysis of variance to measure the discriminatory capabilities and a generalizability study to examine the sources of variability in the scores. Results: EM postgraduate trainees (N=36) participated in the study. Discriminatory validity was strong, with senior trainees (PGY4-5) outperforming junior trainees (PGY2-3) in 6 of 8 scenarios and in aggregated QSAT and Entrustment Scores across all 8 stations (p<0.01). Generalizability studies found the largest sources of random variability was due to the trainee by station interaction and the error term, with a G coefficient of 0.84. Resident trainees reported reasonable comfort being assessed in the simulation environment (3.6/5), indicated significant perceived realism (4.1/5), and found the OSCE valuable to their learning (4.8/5). Conclusion: Overall, this study demonstrates that a large-scale simulation-based EM resuscitation OSCE is feasible, and an argument has been presented for the validity of such an examination. The incorporation of simulation or a simulation-based OSCE in the national certification process in EM may help to satisfy the increased demand for competency-based assessment required by the Royal College of Physicians & Surgeons of Canada’s Competency by Design transition.

Role of Simulation in Perioperative Echocardiography Training

2016 ◽  
Vol 21 (1) ◽  
pp. 81-94 ◽  
Author(s):  
Soheyla Nazarnia ◽  
Kathirvel Subramaniam
Keyword(s):  
Medical Education ◽  
Patient Outcomes ◽  
Clinical Training ◽  
Perioperative Period ◽  
Noncardiac Surgery ◽  
Future Research ◽  
Hemodynamic Compromise ◽  
Simulation Based ◽  
The Impact

Echocardiography plays a major role in the diagnosis and management of hemodynamic compromise during the perioperative period. Both transthoracic and transesophageal echocardiography have been shown to improve outcomes after cardiac and noncardiac surgery. Teaching basic echocardiographic skills to perioperative physicians remains a challenging task. Thus far, simulation-based medical education has been proven useful in teaching specific procedural skills and management of infrequent catastrophic events. Simulation-based echocardiography education has the potential to facilitate clinical training in echocardiography. Several small studies have shown the benefits of echocardiographic simulation on developing psychomotor and cognitive echocardiography skills. Future research should focus on the impact of simulation on actual clinical echocardiographic performance in the operating room and ultimately, patient outcomes.

Forecasting US movies box office performances in Turkey using machine learning algorithms

2020 ◽  
Vol 39 (5) ◽  
pp. 6579-6590
Author(s):  
Sandy Çağlıyor ◽  
Başar Öztayşi ◽  
Selime Sezgin
Keyword(s):  
Machine Learning ◽  
Global Economy ◽  
Learning Algorithms ◽  
Forecast Model ◽  
Machine Learning Algorithms ◽  
Gradient Boosting ◽  
High Stakes ◽  
Box Office ◽  
Industry Forecast ◽  
The Impact

The motion picture industry is one of the largest industries worldwide and has significant importance in the global economy. Considering the high stakes and high risks in the industry, forecast models and decision support systems are gaining importance. Several attempts have been made to estimate the theatrical performance of a movie before or at the early stages of its release. Nevertheless, these models are mostly used for predicting domestic performances and the industry still struggles to predict box office performances in overseas markets. In this study, the aim is to design a forecast model using different machine learning algorithms to estimate the theatrical success of US movies in Turkey. From various sources, a dataset of 1559 movies is constructed. Firstly, independent variables are grouped as pre-release, distributor type, and international distribution based on their characteristic. The number of attendances is discretized into three classes. Four popular machine learning algorithms, artificial neural networks, decision tree regression and gradient boosting tree and random forest are employed, and the impact of each group is observed by compared by the performance models. Then the number of target classes is increased into five and eight and results are compared with the previously developed models in the literature.

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