Assessments of Otolaryngology Resident Operative Experiences Using Mobile Technology: A Pilot Study

2019 ◽  
Vol 161 (6) ◽  
pp. 939-945 ◽  
Author(s):  
Jenny X. Chen ◽  
Elliott Kozin ◽  
Jordan Bohnen ◽  
Brian George ◽  
Daniel G. Deschler ◽  
...  

Objectives Surgical education has shifted from the Halstedian model of “see one, do one, teach one” to a competency-based model of training. Otolaryngology residency programs can benefit from a fast and simple system to assess residents’ surgical skills. In this quality initiative, we hypothesize that a novel smartphone application called System for Improving and Measuring Procedural Learning (SIMPL) could be applied in an otolaryngology residency to facilitate the assessment of resident operative experiences. Methods The Plan Do Study Act method of quality improvement was used. After researching tools of surgical assessment and trialing SIMPL in a resident-attending pair, we piloted SIMPL across an otolaryngology residency program. Faculty and residents were trained to use SIMPL to rate resident operative performance and autonomy with a previously validated Zwisch Scale. Results Residents (n = 23) and faculty (n = 17) were trained to use SIMPL using a standardized curriculum. A total of 833 assessments were completed from December 1, 2017, to June 30, 2018. Attendings completed a median 20 assessments, and residents completed a median 14 self-assessments. All evaluations were resident initiated, and attendings had a 78% median response rate. Evaluations took residents a median 22 seconds to complete; 126 unique procedures were logged, representing all 14 key indicator cases for otolaryngology. Discussion This is the first residency-wide application of a mobile platform to track the operative experiences of otolaryngology residents. Implications for Practice We adapted and implemented a novel assessment tool in a large otolaryngology program. Future multicenter studies will benchmark resident operative experiences nationwide.

2021 ◽  
pp. 019459982110503
Author(s):  
Jenny X. Chen ◽  
Francis Deng ◽  
Andrey Filimonov ◽  
Elizabeth A. Shuman ◽  
Emily Marchiano ◽  
...  

Objective There is concern that current otolaryngology residents may not receive adequate surgical training. We aimed to characterize residents’ surgical experiences at 5 academic centers performing the 14 key indicator procedures (KIPs) outlined by the Accreditation Council for Graduate Medical Education. Study Design Prospective study. Setting Five otolaryngology training programs. Methods Data were gathered from December 2019 to December 2020 with a smartphone application from the Society for Improving Medical Professional Learning. After each operation, residents and faculty rated trainee autonomy on a 4-level Zwisch scale and performance on a 5-level modified Dreyfus scale. Results Residents and attendings (n = 92 and 78, respectively) logged 2984 evaluations. Attending ratings of resident autonomy and performance increased with training level ( P < .001). Resident self-assessments of autonomy and performance were lower than paired attending assessments ( P < .001). Among attending evaluations of KIPs performed by senior residents (postgraduate year 4 or 5), 55% of cases were performed with meaningful autonomy (passive help or supervision only). Similarly, attendings rated 55% of these cases as a practice-ready or exceptional performance. Senior residents had meaningful autonomy for ≥50% of cases for most KIPs, with the exception of flaps and grafts (40%), pediatric/adult airway (39%), and stapedectomy/ossiculoplasty (33%). Similarly, senior residents received practice-ready or exceptional performance ratings for ≥50% of cases across all KIPs other than pediatric/adult airway (42%) and stapedectomy/ossiculoplasty (33%). Conclusion In this multicenter study, resident surgical autonomy and performance varied across otolaryngology KIPs. The development of nationwide benchmarks will help programs and residents set educational goals. Level of evidence 2.


CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S63-S63
Author(s):  
T. Chaplin ◽  
L. McMurray ◽  
A.K. Hall

Introduction / Innovation Concept: Junior residents are often the first physicians who attend to the acutely unwell floor patient, especially at night and on weekends. The ‘Nightmares Course’ at Queen’s University was designed to address an Entrustable Professional Activity (EPA) relevant to several residency programs at the ‘Foundations of Discipline’ level of training: “to manage the acutely unwell floor patient for the first 5-10 minutes until help arrives”. In keeping with competency based medical education principles, this course offers longitudinal and repetitive practice and assessment. We have also designed a summative objective structured clinical exam (OSCE) in order to identify trainees who require additional remedial practice of this EPA. Methods: We developed simulated cases that reflect common but “scary” calls to the floor. We then, using a modified Delphi process with experts in resuscitation, defined relevant milestones applicable to the Foundations of Discipline level of training in order to inform our formative assessment. We also modified the Queen’s Simulated Assessment Tool (QSAT) to adopt CBME terminology and this will be used to provide a summative assessment during a four-scenario OSCE in the spring. Residents with QSAT scores below the competency threshold will be enrolled in a remediation course. Curriculum, Tool, or Material: Weekly sessions were led by staff physicians and were offered to first-year residents from internal medicine, core surgery, obstetrics and gynecology, and anesthesiology over the academic year. Each resident participated in one session every 4-week block. Sessions were organized into themes such as “shortness of breath” or “decreased level of consciousness” and involved three high-fidelity simulated cases with a structured debrief following each case. Formative feedback was given following each case. Conclusion: The Nightmares Course is a novel simulation-based, multidisciplinary curriculum in resuscitation medicine. It includes longitudinal practice and repetitive assessment, as well as summative testing and remediation of an EPA common to several residency programs.


2014 ◽  
Vol 19 (2) ◽  
pp. 335-342 ◽  
Author(s):  
Michael D. Warren ◽  
Suzanna D. Dooley ◽  
Meredith J. Pyle ◽  
Angela M. Miller

2021 ◽  
pp. 1-18
Author(s):  
Vilma Johnsson ◽  
Martin Tolsgaard ◽  
Jon Hyett ◽  
Ulrich Gembruch ◽  
Rory Windrim ◽  
...  

<b><i>Introduction:</i></b> The aim of this study was to obtain expert consensus on the content of a curriculum for learning chorionic villus sampling (CVS) and amniocentesis (AC) and the items of an assessment tool to evaluate CVS and AC competence. <b><i>Methods:</i></b> We used a 3-round iterative Delphi process. A steering committee supervised all processes. Seven international collaborators were identified to expand the breadth of the study internationally. The collaborators invited fetal medicine experts to participate as panelists. In the first round, the panelists suggested content for a CVS/AC curriculum and an assessment tool. The steering committee organized and condensed the suggested items and presented them to the panelists in round 2. In the second round, the panelists rated and commented on the suggested items. The results were processed by the steering committee and presented to the panelists in the third round, where final consensus was obtained. Consensus was defined as support by more than 80% of the panelists for an item. <b><i>Results:</i></b> Eighty-six experts agreed to participate in the study. The panelists represented 16 countries across 4 continents. The final list of curricular content included 12 theoretical and practical items. The final assessment tool included 11 items, systematically divided into 5 categories: pre-procedure, procedure, post-procedure, nontechnical skills, and overall performance. These items were provided with behavioral scale anchors to rate performance, and an entrustment scale was used for the final overall assessment. <b><i>Conclusion:</i></b> We established consensus among international fetal medicine experts on content to be included in a CVS/AC curriculum and on an assessment tool to evaluate CVS/AC skills. These results are important to help transition current training and assessment methods from a time- and volume-based approach to a competency-based approach which is a key step in improving patient safety and outcomes for the 2 most common invasive procedures in fetal medicine.


2021 ◽  
Vol 18 (1-2) ◽  
Author(s):  
Justina Purwarini

In clinical nursing, students apply knowledge gained from classroom experience to real life situations. This educational model is experiential in nature, where patient learning experiences are selected based on the successful learning process. Hence, the competencies anticipated at a certain level are achieved in accordance with the objectives of knowledge. Purpose: This study was, therefore, aimed at developing a valid clinical assessment tool to guide the education system, and evaluate nursing students’ performance during practice in Indonesia. Methods: This research employed an exploratory sequential mixed method research design. Result: The transcripts generated from Focus Group Discussions and in-depth interviews showed three major areas of competence to be achieved while undergoing clinical practice. These ought to be combined with learning outcomes on the Competency-Based Curriculum in Indonesia, and subsequently reprocessed, to establish the final results, comprising 37 items. The study shows IN-CAT as acceptable (Scale-CVI= 0.9), indicating the agreement is adequate (Cohen’s kappa= 0.795), and satisfactory (The Cronbach’s alpha= 0.949). Conclusion: The results initially specify the scale as a reliable and valid measurement tool, with the potential for use in the assessment and evaluation of clinical competence amongst nursing students. Based on the feedback from teachers and students, The assessment tool demonstrates clarified learning objectives, improved focus, and enhanced the evaluation objectivity.


Author(s):  
Denise Villanyi ◽  
Romain Martin ◽  
Philipp Sonnleitner ◽  
Christina Siry ◽  
Antoine Fischbach

Although student self-assessment is positively related to achievement, skepticism about the accuracy of students’ self-assessments remains. A few studies have shown that even elementary school students are able to provide accurate self-assessments when certain conditions are met. We developed an innovative tablet-computer-based tool for capturing self-assessments of mathematics and reading comprehension. This tool integrates the conditions required for accurate self-assessment: (1) a non-competitive setting, (2) items formulated on the task level, and (3) limited reading and no verbalization required. The innovation consists of using illustrations and a language-reduced rating scale. The correlations between students’ self-assessment scores and their standardized test scores were moderate to large. Independent of their proficiency level, students’ confidence in completing a task decreased as task difficulty increased, but these findings were more consistent in mathematics than in reading comprehension. We conclude that third- and fourth-graders have the ability to provide accurate self-assessments of their competencies, particularly in mathematics, when provided with an adequate self-assessment tool.


2020 ◽  
pp. 084653711989366
Author(s):  
Joseph Yang ◽  
Danny Jomaa ◽  
Omar Islam ◽  
Benedetto Mussari ◽  
Corinne Laverty ◽  
...  

Purpose: Implementing competency-based medical education in diagnostic radiology residencies will change the paradigm of learning and assessment for residents. The objective of this study is to evaluate medical student perceptions of competency-based medical education in diagnostic radiology programs and how this may affect their decision to pursue a career in diagnostic radiology. Methods: First-, second-, and third-year medical students at a Canadian university were invited to complete a 14-question survey containing a mix of multiple choice, yes/no, Likert scale, and open-ended questions. This aimed to collect information on students’ understanding and perceptions of competency-based medical education and how the transition to competency-based medical education would factor into their decision to enter a career in diagnostic radiology. Results: The survey was distributed to 300 medical students and received 63 responses (21%). Thirty-seven percent of students had an interest in pursuing diagnostic radiology that ranged from interested to committed and 46% reported an understanding of competency-based medical education and its learning approach. The implementation of competency-based medical education in diagnostic radiology programs was reported to be a positive factor by 70% of students and almost all reported that breaking down residency into measurable milestones and required case exposure was beneficial. Conclusions: This study demonstrates that medical students perceive competency-based medical education to be a beneficial change to diagnostic radiology residency programs. The changes accompanying the transition to competency-based medical education were favored by students and factored into their residency decision-making.


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