Trainees' perspectives on the assessment and self‐assessment of surgical skills

Evans, Alan W.; McKenna, Colleen; Oliver, Martin

doi:10.1080/0260293042000264253

Cited by 34 publications

(34 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…First, cost analysis was not calculated using direct cost measurement but on patient self-reporting of resource utilization on the HAPSQ. Although recall bias is often associated with self-report measures, studies have shown that resource utilization declines over time whereby patients have a tendency to under-report values resulting in a net underestimation of cost and utilization values [48,49]. The study also attempted to account for potential error by using conservative estimates of costs, and when possible, using detailed costing data from reliable databases such as billing records, medical benefits’ and pharmaceutical price lists [24,25], government costing reports [26].…”

Section: Discussionmentioning

confidence: 99%

Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

Lau

Lafave

Mohtadi

et al. 2012

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundMusculoskeletal disorders (MSDs) affect a large proportion of the Canadian population and present a huge problem that continues to strain primary healthcare resources. Currently, the Canadian healthcare system depicts a clinical care pathway for MSDs that is inefficient and ineffective. Therefore, a new inter-disciplinary team-based model of care for managing acute knee injuries was developed in Calgary, Alberta, Canada: the Calgary Acute Knee Injury Clinic (C-AKIC). The goal of this paper is to evaluate and report on the appropriateness, efficiency, and effectiveness of the C-AKIC through healthcare utilization and costs associated with acute knee injuries.MethodsThis quasi-experimental study measured and evaluated cost and utilization associated with specific healthcare services for patients presenting with acute knee injuries. The goal was to compare patients receiving care from two clinical care pathways: the existing pathway (i.e. comparison group) and a new model, the C-AKIC (i.e. experimental group). This was accomplished through the use of a Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ).ResultsData from 138 questionnaires were analyzed in the experimental group and 136 in the comparison group. A post-hoc analysis determined that both groups were statistically similar in socio-demographic characteristics. With respect to utilization, patients receiving care through the C-AKIC used significantly less resources. Overall, patients receiving care through the C-AKIC incurred 37% of the cost of patients with knee injuries in the comparison group and significantly incurred less costs when compared to the comparison group. The total aggregate average cost for the C-AKIC group was $2,549.59 compared to $6,954.33 for the comparison group (p <.001).ConclusionsThe Calgary Acute Knee Injury Clinic was able to manage and treat knee injured patients for less cost than the existing state of healthcare delivery. The combined results from this study show that the C-AKIC is an appropriate, effective, and efficient model of clinical care for patients presenting with acute knee injuries.

show abstract

Section: Discussionmentioning

confidence: 99%

Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

Lau

Lafave

Mohtadi

et al. 2012

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…items (%)Post-procedure – no. items (%)Barsuk et al (2009c)2711 (41)6 (22)1 (4)1 (4)4 (15)13 (48)5 (19)Barsuk et al (2009a)2710 (37)6 (22)1 (4)1 (4)4 (15)13 (48)6 (22)Berenholtz et al (2004)86 (75)8 (100)0 (0)1 (13)0 (0)1 (13)1 (13)Blaivas and Adhikari (2009)30 (0)0 (0)0 (0)0 (0)3 (100)3 (100)0 (0)Britt et al (2009)146 (43)2 (14)0 (0)1 (7)7 (50)9 (64)1 (7)Carvalho (2007)10 (0)0 (0)0 (0)0 (0)1 (100)1 (100)0 (0)Coopersmith et al (2002)96 (67)7 (78)0 (0)0 (0)1 (11)0 (0)3 (33)Costello et al (2008)1815 (83)13 (72)1 (6)9 (50)5 (28)0 (0)2 (11)Dong et al (2010)1511 (73)6 (40)2 (13)1 (7)3 (20)3 (20)1 (7)Evans et al (2005)6131 (51)9 (15)1 (2)3 (5)18 (30)24 (39)8 (13)Huang et al (2009)2212 (55)5 (23)1 (5)1 (5)2 (9)11 (50)1 (5)Kilbourne et al (2009)61 (17)0 (0)0 (0)0 (0)2 (33)5 (83)0 (0)Lee et al (2009)199 (47)6 (32)1 (5)…”

Section: Resultsunclassified

Measuring competence in central venous catheterization: a systematic-review

et al. 2014

View full text Add to dashboard Cite

ObjectivesCentral venous catheterization is a complex procedural skill. This study evaluates existing published tools on this procedure and systematically summarizes key competencies for the assessment of this technical skill.MethodsUsing a previously published meta-analysis search strategy, we conducted a systematic review of published assessment tools using the electronic databases PubMed, MEDLINE, Education Resource Information Center (ERIC), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica, and Cochrane Central Register of Controlled Trials. Two independent investigators abstracted information on tool content and characteristics.ResultsTwenty-five studies were identified assessing a total of 147 items. Tools used for assessment at the bedside (clinical tools) had a higher % of items representing “preparation” and “infection control” than tools used for assessment using simulation (67 ± 26% vs. 32 ± 26%; p = 0.003 for “preparation” and 60 ± 41% vs. 11 ± 17%; p = 0.002 for “infection control”, respectively). Simulation tools had a higher % of items on “procedural competence” than clinical tools (60 ± 36% vs. 17 ± 15%; p = 0.002). Items in the domains of “Team working” and “Communication and working with the patient” were frequently under-represented.ConclusionThis study presents a comprehensive review of existing checklist items for the assessment of central venous catheterization. Although many key competencies are currently assessed by existing published tools, some domains may be under-represented by select tools.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-33) contains supplementary material, which is available to authorized users.

show abstract

“…Little explanation as to how learners perform self-evaluation is offered, although some studies allude to considerations such as context and impression management (Evans et al 2005;Rees and Shepherd 2005). There is a surprising dearth of qualitative studies in a field which relates to an inherently relative concept such as self-perception.…”

Section: Introductionmentioning

confidence: 98%

Influences on self-evaluation during a clinical skills programme for nurses

Yeo

Steven

Pearson

et al. 2009

Adv in Health Sci Educ

View full text Add to dashboard Cite

Education has moved from teacher to student-centred practices. Increasing emphasis is placed on 'life-long' learning in the context of a rapidly changing knowledge base. Self-evaluation is seen as one strategy to facilitate student-centred continuous professional development. The literature, however, suggests that learners' ability to self-assess is mixed, and little is known regarding how students perform self-assessment. This study focussed on senior nurses undertaking a scenario-based clinical skills course. Learners were asked to self-evaluate several times during the course. This research explored the influences on using the self-evaluation exercise. The study drew upon grounded theory methodology and was influenced by constructionist and postmodernist theories. Three methods of data collection were used: semi-structured interviews, observation of supervision sessions and recording of the numerical self-evaluation ratings. Multiple interviews with students (n = 14) and the educational supervisor (n = 1) were conducted. Thematic analysis and data collection were conducted iteratively. The study found that feeling confident and stating that confidence were not necessarily the same. Feeling confident was complex, influenced by changing perceptions of clinical skills and credibility. Changing frames of reference were used to judge feelings of confidence. Stating confidence appeared to be socially negotiated, influenced by social acceptability considerations such as modesty and the need to show progress over time. The discourses of empowerment and surveillance were influential and self-evaluation is discussed using Foucault's theory of governmentality, illustrating how learners can be both empowered and controlled through self-evaluation. Further consideration of the socially constructed nature of self-evaluations would benefit both educational practice and future research.

show abstract

Trainees' perspectives on the assessment and self‐assessment of surgical skills

Cited by 34 publications

References 17 publications

Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

Measuring competence in central venous catheterization: a systematic-review

Influences on self-evaluation during a clinical skills programme for nurses

Contact Info

Product

Resources

About