Simulation in Graduate Medical Education 2008: A Review for Emergency Medicine

McLaughlin, Steve; Fitch, Michael T.; Goyal, Deepi G.; Hayden, Emily M.; Kauh, Christine Yang; Laack, Torrey A.; Nowicki, Thomas; Okuda, Yasuharu; Palm, Ken; Pozner, Charles N.; Vozenilek, John A.; Wang, Ernest; Gordon, James A.

doi:10.1111/j.1553-2712.2008.00188.x

Cited by 142 publications

(101 citation statements)

References 99 publications

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“…One EM residency program designed a well-received simulation curriculum that found most learners to be competent, but did not translate to an increase in written test scores, 48 which highlights the need to design HFS and other methods of assessment around the educational outcomes the assessment is intended to measure. 37 The ultimate evidence of validity is comparison to actual patient outcomes or subsequent improvements in patient care, but this has been infrequently measured. 49 Internal medicine residents receiving simulation ACLS training performed better than more senior residents with traditional training based on chart reviews of their resuscitations, 50 albeit limited by the fact that assessment of the intervention group was also closer in time to their ACLS training.…”

Section: Overview Of Assessment Methods Identifiedmentioning

confidence: 99%

“…time to action, critical actions performed) and global performance ratings, with different information gleaned from each, all potentially having good discriminatory power 30,35,36 and a combination being most useful. 37 Since patient care requires a broad skill set and knowledge base, multiple scenarios are needed to provide a valid assessment of overall patient care competency and to distinguish between performance at different levels of training. Murray et al 38 demonstrated that 12 scenarios were needed in a study of residents and attending physicians in anesthesia and six in another study comparing student certified registered nurse anesthetists to senior/junior anesthesiologists.…”

Section: Overview Of Assessment Methods Identifiedmentioning

confidence: 99%

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Assessing Patient Care: Summary of the Breakout Group on Assessment of Observable Learner Performance

Takayesu

Kulstad

Wallenstein

et al. 2012

Academic Emergency Medicine

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There is an established expectation that physicians in training demonstrate competence in all aspects of clinical care prior to entering professional practice. Multiple methods have been used to assess competence in patient care, including direct observation, simulation-based assessments, objective structured clinical examinations (OSCEs), global faculty evaluations, 360-degree evaluations, portfolios, self-reflection, clinical performance metrics, and procedure logs. A thorough assessment of competence in patient care requires a mixture of methods, taking into account each method's costs, benefits, and current level of evidence. At the 2012 Academic Emergency Medicine (AEM) consensus conference on educational research, one breakout group reviewed and discussed the evidence supporting various methods of assessing patient care and defined a research agenda for the continued development of specific assessment methods based on current best practices. In this article, the authors review each method's supporting reliability and validity evidence and make specific recommendations for future educational research.ACADEMIC EMERGENCY MEDICINE 2012; 19:1379-1389 by the Society for Academic Emergency Medicine I n 2001, the Accreditation Council for Graduate Medical Education (ACGME) introduced a timeline for the implementation of training and assessment in six core competencies that form the foundation of clinical competence. Introduced in 1996, the Canadian CanMEDS manager competency correlates to the AC-GME patient care competency, broadly defined as "the active engagement in decision-making in the operation of the healthcare system."1 The patient care competency for emergency medicine (EM) has been defined by a previous Academic Emergency Medicine (AEM) consensus conference, 2 now further elaborated on by the milestones in training, 3 as being able to efficiently gather and synthesize medical and diagnostic information, prioritize tasks, and implement management plans on multiple patients, as well as performing essential invasive procedures competently.There is an explicit expectation that physicians in training demonstrate competence in various aspects of clinical care prior to graduation and professional practice. 4 While this accountability falls squarely on the shoulders of residency training programs, it is mirrored by commensurate expectations of maintenance of competency during ongoing professional practice.The goals of the 2012 AEM consensus conference patient care working group were to describe the current state of evidence for assessment of competence in patient care and define a research agenda for the further development of specific assessment methods based on current best practices. METHODSA search was conducted using MEDLINE 1996-present using the key word search terms "assessment," "patient care," "competency," "competence," "assess*," "emergency," and "education" and limited to humans and English language [boolean search: ((assessment and patient care AND (competency or competence)) OR (assess* a...

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Section: Overview Of Assessment Methods Identifiedmentioning

confidence: 99%

Section: Overview Of Assessment Methods Identifiedmentioning

confidence: 99%

Assessing Patient Care: Summary of the Breakout Group on Assessment of Observable Learner Performance

Takayesu

Kulstad

Wallenstein

et al. 2012

Academic Emergency Medicine

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“…Critical actions and target responses are usually objective and relatively easy to capture, measure, and discuss with SBT [8,9] . During the facilitated reflection session following the case, many facilitators will use video playback combined with verbal feedback to allow participants to view and reflect on their behaviors and critical responses from the case [10] .…”

Section: Introductionmentioning

confidence: 99%

Integrating Google Glass into simulation-based training: experiences and future directions

Dameff

Tully

2014

JBGC

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Background: Education experts are starting to explore the potential uses of wearable technology and augmented reality in simulation-based training. In this article, we summarize our experiences with using Google Glass in simulation-based training and discuss potential future directions with this advanced technology. Methods:Emergency medicine residents and medical students participated in a pilot study where each team captain was asked to wear Google Glass during 15 separate simulation-based training sessions. Video obtained from Google Glass was analyzed and utilized during debriefing sessions for the residents and medical students. Results:We were able to successfully integrate Google Glass into simulation-based training and debriefing. During the analysis of each recording, observations were noted about the events that transpired and this data was used to provide instructional feedback to the residents and medical students for self-reflection and appraisal. Post-exercise surveys were conducted after each simulation session and all participants noted that Google Glass did not interfere with their simulation experience. Google Glass enabled the observers to analyze the team captain's primary visual focus during the entire simulation scenario and feedback was provided based on the data recorded. Conclusions:Wearable technologies such as Google Glass can be successfully integrated into simulation-based training exercises without disrupting the learners' experience. Data obtained from this integration can be utilized to improve debriefing sessions and self-reflection. Future research is underway and required to evaluate other potential uses for wearable technology in simulation-based training.

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“…A model for this exists in the field of emergency medicine, where residents have served as simulation facilitators. 14 Holding the sessions during a time slot that was protected from clinical duties allowed interns to participate without sacrificing time spent on patient care or other educational activities. The positive learner perception of the pilot program was comparable to new simulation curricula in other disciplines, such as pediatrics, anesthesiology, obstetrics and gynecology, surgery, and emergency medicine.…”

Section: Discussionmentioning

confidence: 99%

Pilot Program Using Medical Simulation in Clinical Decision-Making Training for Internal Medicine Interns

Miloslavsky¹,

Hayden²,

Currier³

et al. 2012

Journal of Graduate Medical Education

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Background The use of high-fidelity medical simulation in cognitive skills training within internal medicine residency programs remains largely unexplored. Objective To design a pilot study to introduce clinical decision-making training using simulation into a large internal medicine residency program, explore the practicability of using junior and senior residents as facilitators, and examine the feasibility of using the program to improve interns' clinical skills. Methods Interns on outpatient rotations participated in a simulation curriculum on a voluntary basis. The curriculum consisted of 8 cases focusing on acute clinical scenarios encountered on the wards. One-hour sessions were offered twice monthly from August 2010 to February 2011. Internal medicine residents and simulation faculty served as facilitators. Results A total of 36 of 75 total interns volunteered to participate in the program, with 42% attending multiple sessions. Of all participants, 88% rated the sessions as “excellent,” 97% felt that the program improved their ability to function as an intern and generate a plan, and 81% reported improvement in differential diagnosis skills. Conclusions Simulation training was well received by the learners and improved self-reported clinical skills. Using residents as facilitators, supervised by faculty, was well received by the learners and enabled the implementation of the curriculum in a large training program. Simulation can provide opportunities for deliberate practice, and learners perceive this modality to be effective.

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Simulation in Graduate Medical Education 2008: A Review for Emergency Medicine

Cited by 142 publications

References 99 publications

Assessing Patient Care: Summary of the Breakout Group on Assessment of Observable Learner Performance

Assessing Patient Care: Summary of the Breakout Group on Assessment of Observable Learner Performance

Integrating Google Glass into simulation-based training: experiences and future directions

Pilot Program Using Medical Simulation in Clinical Decision-Making Training for Internal Medicine Interns

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