A new method to evaluate clinical performance and critical incidents in anaesthesia: quantification of daily comments by teachers

Abstract

We have found that the Clinical Anesthesia System of Evaluation (CASE) method provides information regarding clinical performance of residents and critical incidents that is not available from other sources. As a result, it expands the dimensions of the evaluation process and improves validity. In addition, the technique has helped address the concerns of many investigators. (1) It provides specific, real-time evaluations that permit early intervention, improve feedback and guide remediation; (2) it improves sampling techniques by increasing the breadth and volume of evaluators and settings; (3) it enhances the discriminatory power of the evaluation process; and (4) it improves documentation.

Use of interaction cards to evaluate clinical performance

“…Our data showed that few evaluators reported negative remarks about trainees. This result is in keeping with other studies (Hatala & Norman, 1999;Rhoton, 1990). The study also showed that the frequency distribution of the IC summative evaluations was found to be less skewed than the distribution of the global rating scale evaluations.…”

“…This concept also helps to quantify daily comments by evaluators. This method has been evaluated through the use of Interaction Cards (IC) for repeated, observed documentation of the performance of trainees in their clinical encounters with patients in internal medicine (Hatala & Norman, 1999), obstetrics (Brennan & Norman, 1997), anesthesia (Rhoton, 1990), and emergency medicine (Ten Eyck & Maclean, 1994).…”

Exploring reflective 'critical incident' documentation of professionalism lapses in a medical undergraduate setting

“…These studies found that only 1% of negative behaviour related to areas of professionalism, and that there was a link between resident conscientiousness and unprofessional behaviour. Further to this, critical incident reporting was found to permit early intervention in unacceptable behaviour [ 6 ]. Incident reporting forms in recent studies demonstrate the use of areas of fixed concern, derived from professional standards the faculty feel students should exhibit, as a method to assess professionalism [ 7 , 8 ].…”

In‐training assessment in postgraduate training for general practice

“…(Ramsden 1992, pp. 184±185) Table 3 Educational evidence of value in in-training assessment Supervisor's assessments (Rhoton 1990) Correlate reasonably with end-point examinations Progressive testing cf end-point testing (Gaynor & Millham 1976) Progressive testing positively correlated with higher student learning achievement and attitudes Written in-training tests (Leigh et al 1990) Predictive validity with end-point examinations demonstrated. Possible poor acceptability Referral letter analysis (Mc Cain et al 1998 Reasonable discrimination; Westerman et al 1990) Self-assessments (Gordon 1991, Hays 1990a More sensitive to individual weaknesses, but more valid with external benchmarking.…”