The Validity of Performance Assessments Using Simulation |
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Authors: | Devitt, J. Hugh M.D., M.Sc., F.R.C.P.C. Kurrek, Matt M. M.D. Cohen, Marsha M. M.D., M.H.Sc., F.R.C.P.C. Cleave-Hogg, Doreen B.A., M.A., Ph.D.
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Affiliation: | Devitt, J. Hugh M.D., M.Sc., F.R.C.P.C.*; Kurrek, Matt M. M.D.†; Cohen, Marsha M. M.D., M.H.Sc., F.R.C.P.C.‡; Cleave-Hogg, Doreen B.A., M.A., Ph.D.§ |
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Abstract: | Background: The authors wished to determine whether a simulator-based evaluation technique assessing clinical performance could demonstrate construct validity and determine the subjects' perception of realism of the evaluation process. Methods: Research ethics board approval and informed consent were obtained. Subjects were 33 university-based anesthesiologists, 46 community-based anesthesiologists, 23 final-year anesthesiology residents, and 37 final-year medical students. The simulation involved patient evaluation, induction, and maintenance of anesthesia. Each problem was scored as follows: no response to the problem, score = 0; compensating intervention, score = 1; and corrective treatment, score = 2. Examples of problems included atelectasis, coronary ischemia, and hypothermia. After the simulation, participants rated the realism of their experience on a 10-point visual analog scale (VAS). Results: After testing for internal consistency, a seven-item scenario remained. The mean proportion scoring correct answers (out of 7) for each group was as follows: university-based anesthesiologists = 0.53, community-based anesthesiologists = 0.38, residents = 0.54, and medical students = 0.15. The overall group differences were significant (P < 0.0001). The overall realism VAS score was 7.8. There was no relation between the simulator score and the realism VAS (R = -0.07, P = 0.41). |
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