Faculty Opinions recommendation of Performance of residents and anesthesiologists in a simulation-based skill assessment.

Background Anesthesiologists and anesthesia residents are expected to acquire and maintain skills to manage a wide range of acute intraoperative anesthetic events. The purpose of this study was to determine whether an inventory of simulated intraoperative scenarios provided a reliable and valid measure of anesthesia residents' and anesthesiologists' skill. Methods Twelve simulated acute intraoperative scenarios were designed to assess the performance of 64 residents and 35 anesthesiologists. The participants were divided into four groups based on their training and experience. There were 31 new CA-1, 12 advanced CA-1, and 22 CA-2/CA-3 residents as well as a group of 35 experienced anesthesiologists who participated in the assessment. Each participant managed a set of simulated events. The advanced CA-1 residents, CA-2/CA-3 residents, and 35 anesthesiologists managed 8 of 12 intraoperative simulation exercises. The 31 CA-1 residents each managed 3 intraoperative scenarios. Results The new CA-1 residents received lower scores on the simulated intraoperative events than the other groups of participants. The advanced CA-1 residents, CA-2/CA-3 residents, and anesthesiologists performed similarly on the overall assessment. There was a wide range of scores obtained by individuals in each group. A number of the exercises were difficult for the majority of participants to recognize and treat, but most events effectively discriminated among participants who achieved higher and lower overall scores. Conclusion This simulation-based assessment provided a valid method to distinguish the skills of more experienced anesthesia residents and anesthesiologists from residents in early training. The overall score provided a reliable measure of a participant's ability to recognize and manage simulated acute intraoperative events. Additional studies are needed to determine whether these simulation-based assessments are valid measures of clinical performance.

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Faculty Opinions recommendation of Management of anesthesia equipment failure: a simulation-based resident skill assessment.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1163944.624583 ◽

2009 ◽

Author(s):

Cate McIntosh

Keyword(s):

Skill Assessment ◽

Equipment Failure ◽

Simulation Based ◽

Anesthesia Equipment

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Simulation-Based Education with Mastery Learning Improves Paracentesis Skills

Journal of Graduate Medical Education ◽

10.4300/jgme-d-11-00161.1 ◽

2012 ◽

Vol 4 (1) ◽

pp. 23-27 ◽

Cited By ~ 74

Author(s):

Jeffrey H. Barsuk ◽

Elaine R. Cohen ◽

John A. Vozenilek ◽

Lanty M. O'Connor ◽

William C. McGaghie ◽

...

Keyword(s):

Internal Medicine ◽

Mastery Learning ◽

Skill Assessment ◽

First Year ◽

Procedural Skills ◽

Internal Medicine Residents ◽

Simulation Based ◽

Before And After ◽

Item Checklist ◽

Passing Score

Abstract Background Paracentesis is a commonly performed bedside procedure that has the potential for serious complications. Therefore, simulation-based education for paracentesis is valuable for clinicians. Objective To assess internal medicine residents' procedural skills before and after simulation-based mastery learning on a paracentesis simulator. Methods A team with expertise in simulation and procedural skills developed and created a high fidelity, ultrasound-compatible paracentesis simulator. Fifty-eight first-year internal medicine residents completed a mastery learning-based intervention using the paracentesis simulator. Residents underwent baseline skill assessment (pretest) using a 25-item checklist. Residents completed a posttest after a 3-hour education session featuring a demonstration of the procedure, deliberate practice, ultrasound training, and feedback. All residents were expected to meet or exceed a minimum passing score (MPS) at posttest, the key feature of mastery learning. We compared pretest and posttest checklist scores to evaluate the effect of the educational intervention. Residents rated the training sessions. Results Residents' paracentesis skills improved from an average pretest score of 33.0% (SD = 15.2%) to 92.7% (SD = 5.4%) at posttest (P < .001). After the training intervention, all residents met or exceeded the MPS. The training sessions and realism of the simulation were rated highly by learners. Conclusion This study demonstrates the ability of a paracentesis simulator to significantly improve procedural competence.

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