1. Stud Health Technol Inform. 2011;163:535-41.
http://www.ncbi.nlm.nih.gov/pubmed/21335852
Salud LH, Peniche AR, Salud JC, de Hoyos AL, Pugh CM.
Northwestern University, Department of Surgery, Feinberg School of Medicine.
We have developed a way to measure performance during a camera-guided rigid
bronchoscopy using manikin-based simulation. In an effort to measure contact
pressures within the airway during a rigid bronchoscopy, we instrumented pressure
sensors in a commercially available bronchoscopy task trainer. Participants were
divided into two groups based on self-reported levels of expertise: novice (none
to minimal experience in rigid bronchoscopy) and experts (moderate to extensive
experience). There was no significant difference between experts and novices in
the time taken to complete the rigid bronchoscopy. However, novices touched a
greater number of areas than experts, showing that novices induce a higher number
of unnecessary soft-tissue contact compared to experts. Moreover, our results
show that experts exert significantly less soft tissue pressure compared to
novices.
PMID: 21335852 [PubMed - in process]
Monday, February 28, 2011
Expanding the use of simulators as assessment tools: the new pop quiz.
Kaye AR, Salud LH, Domont ZB, Blossfield Iannitelli K, Pugh CM.
Northwestern University Feinberg School of Medicine, Department of Surgery.
Stud Health Technol Inform. 2011;163:271-3
PMID: 21335802
Abstract
This study introduces a novel way to implement simulation in medical education. We investigated the feasibility of integrating a newly developed breast examination simulator into a breast exam technique lecture while also collecting detailed data on medical students' breast exam skills. Results indicate that it is feasible to integrate simulation technology into the classroom environment and collect detailed performance data that can be analyzed and used for skills assessment.
PMID: 21335802
Northwestern University Feinberg School of Medicine, Department of Surgery.
Stud Health Technol Inform. 2011;163:271-3
PMID: 21335802
Abstract
This study introduces a novel way to implement simulation in medical education. We investigated the feasibility of integrating a newly developed breast examination simulator into a breast exam technique lecture while also collecting detailed data on medical students' breast exam skills. Results indicate that it is feasible to integrate simulation technology into the classroom environment and collect detailed performance data that can be analyzed and used for skills assessment.
PMID: 21335802
Friday, February 18, 2011
Comparison of Checklist and Anchored Global Rating Instruments for Performance Rating of Simulated Pediatric Emergencies
Adler, Mark D. MD; Vozenilek, John A. MD; Trainor, Jennifer L. MD; Eppich, Walter J. MD, MEd; Wang, Ernest E. MD; Beaumont, Jennifer L. MS; Aitchison, Pamela R. RN; Pribaz, Paul J. MS; Erickson, Timothy MD; Edison, Marcia PhD; McGaghie, William C. PhD
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare:
February 2011 - Volume 6 - Issue 1 - pp 18-24
doi: 10.1097/SIH.0b013e318201aa90
Purpose: To compare the psychometric performance of two rating instruments used to assess trainee performance in three clinical scenarios.
Methods: This study was part of a two-phase, randomized trial with a wait-list control condition assessing the effectiveness of a pediatric emergency medicine curriculum targeting general emergency medicine residents. Residents received 6 hours of instruction either before or after the first assessment. Separate pairs of raters completed either a dichotomous checklist for each of three cases or the Global Performance Assessment Tool (GPAT), an anchored multidimensional scale. A fully crossed person × rater × case generalizability study was conducted. The effect of training year on performance is assessed using multivariate analysis of variance.
Results: The person and person × case components accounted for most of the score variance for both instruments. Using either instrument, scores demonstrated a small but significant increase as training level increased when analyzed using a multivariate analysis of variance. The inter-rater reliability coefficient was >0.9 for both instruments.
Conclusions: We demonstrate that our checklist and anchored global rating instrument performed in a psychometrically similar fashion with high reliability. As long as proper attention is given to instrument design and testing and rater training, checklists and anchored assessment scales can produce reproducible data for a given population of subjects. The validity of the data arising for either instrument type must be assessed rigorously and with a focus, when practicable, on patient care outcomes.
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare:
February 2011 - Volume 6 - Issue 1 - pp 18-24
doi: 10.1097/SIH.0b013e318201aa90
Purpose: To compare the psychometric performance of two rating instruments used to assess trainee performance in three clinical scenarios.
Methods: This study was part of a two-phase, randomized trial with a wait-list control condition assessing the effectiveness of a pediatric emergency medicine curriculum targeting general emergency medicine residents. Residents received 6 hours of instruction either before or after the first assessment. Separate pairs of raters completed either a dichotomous checklist for each of three cases or the Global Performance Assessment Tool (GPAT), an anchored multidimensional scale. A fully crossed person × rater × case generalizability study was conducted. The effect of training year on performance is assessed using multivariate analysis of variance.
Results: The person and person × case components accounted for most of the score variance for both instruments. Using either instrument, scores demonstrated a small but significant increase as training level increased when analyzed using a multivariate analysis of variance. The inter-rater reliability coefficient was >0.9 for both instruments.
Conclusions: We demonstrate that our checklist and anchored global rating instrument performed in a psychometrically similar fashion with high reliability. As long as proper attention is given to instrument design and testing and rater training, checklists and anchored assessment scales can produce reproducible data for a given population of subjects. The validity of the data arising for either instrument type must be assessed rigorously and with a focus, when practicable, on patient care outcomes.
Saturday, February 12, 2011
Use of a continuing medical education course to improve fellows' knowledge and skills in esophageal disorders
PubMed ID: 21309911
Dis Esophagus. 2011 Feb 10. doi: 10.1111/j.1442-2050.2010.01161.x. [Epub ahead of print]
Kim HC, Pandolfino JE, Komanduri S, Hirano I, Cohen ER, Wayne DB.
Departments of Gastroenterology andMedicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Abstract
Advanced esophageal endoscopic procedures such as stricture dilation, hemostasis tools, and stent placement as well as high-resolution manometry (HRM) interpretation are necessary skills for gastroenterology fellows to obtain during their training. Becoming proficient in these skills may be challenging in light of higher complication rates compared with diagnostic procedures and infrequent opportunities to practice these skills. Our aim was to determine if intensive training during a continuing medical education (CME) course boosts the knowledge and skills of gastroenterology fellows in esophageal diagnostic test interpretation and performance of therapeutic procedures. This was a pretest-posttest design without a control group of a simulation-based, educational intervention in esophageal stricture balloon dilation and HRM interpretation. The participants were 24 gastroenterology fellows from 21 accredited US training programs. This was an intensive CME course held in Las Vegas, Nevada from August 7 to August 9, 2009. The research procedure had two phases. First, the subjects were measured at baseline (pretest) for their knowledge and procedural skill. Second, the fellows received 6 hours of education sessions featuring didactic content, instruction in HRM indications and interpretation, and deliberate practice using an esophageal stricture dilation model. After the intervention, all of the fellows were retested (posttest). A 17-item checklist was developed for the esophageal balloon dilation procedure using relevant sources, expert opinion, and rigorous step-by-step procedures. Nineteen representative HRM swallow studies were obtained from Northwestern's motility lab and formed the pretest and posttest in HRM interpretation. Mean scores on the dilation checklist improved 81% from 39.4% (standard deviation [SD]= 33.4%) at pretest to 71.3% (SD = 29.5%) after simulation training (P < sd =" 16.4%)" sd =" 15.8%),">
Saturday, February 5, 2011
New directions in simulation-based surgical education and training: Validation and transfer of surgical skills, use of nonsurgeons as faculty...
New directions in simulation-based surgical education and training: Validation and transfer of surgical skills, use of nonsurgeons as faculty, use of simulation to screen and select surgery residents, and long-term follow-up of learners
Daniel J. Scott MD, FACSa, Carla M. Pugh MD, PhD, FACSb, E. Matthew Ritter MD, FACSc, Lenworth M. Jacobs MD, MPH, FACSd, Carlos A. Pellegrini MD, FACS, FRCSI (Hon)e and Ajit K. Sachdeva MD, FRCSC, FACSf, ,
a University of Texas Southwestern Medical Center, Dallas, TX
b Northwestern University Feinberg School of Medicine, Chicago, IL
c Uniformed Services University, Bethesda, MD
d University of Connecticut School of Medicine, Hartford, CT
e University of Washington, Seattle, WA
f American College of Surgeons, Chicago, IL
Accepted 16 November 2010. Available online 5 February 2011.
The Consortium of American College of Surgeons-Accredited Education Institutes was created to explore new opportunities in simulation-based surgical education and training beyond the scope of individual accredited institutes. During the Third Annual Meeting of the Consortium of American College of Surgeons-Accredited Education Institutes Consortium, 4 work groups addressed the validation and transfer of surgical skills, the use of nonsurgeons as faculty, the use of simulation to screen and select surgery residents, and long-term follow-up of learners. The key elements from the deliberations and conclusions are summarized in this manuscript.
Article Outline
Validation and transfer of surgical skills
Use of nonsurgeons as faculty for simulation-based surgical education
Use of simulation to screen and select surgery residents
Long-term follow-up of learners after participation in simulation-based surgical education and training
Conclusions
References
Daniel J. Scott MD, FACSa, Carla M. Pugh MD, PhD, FACSb, E. Matthew Ritter MD, FACSc, Lenworth M. Jacobs MD, MPH, FACSd, Carlos A. Pellegrini MD, FACS, FRCSI (Hon)e and Ajit K. Sachdeva MD, FRCSC, FACSf, ,
a University of Texas Southwestern Medical Center, Dallas, TX
b Northwestern University Feinberg School of Medicine, Chicago, IL
c Uniformed Services University, Bethesda, MD
d University of Connecticut School of Medicine, Hartford, CT
e University of Washington, Seattle, WA
f American College of Surgeons, Chicago, IL
Accepted 16 November 2010. Available online 5 February 2011.
The Consortium of American College of Surgeons-Accredited Education Institutes was created to explore new opportunities in simulation-based surgical education and training beyond the scope of individual accredited institutes. During the Third Annual Meeting of the Consortium of American College of Surgeons-Accredited Education Institutes Consortium, 4 work groups addressed the validation and transfer of surgical skills, the use of nonsurgeons as faculty, the use of simulation to screen and select surgery residents, and long-term follow-up of learners. The key elements from the deliberations and conclusions are summarized in this manuscript.
Article Outline
Validation and transfer of surgical skills
Use of nonsurgeons as faculty for simulation-based surgical education
Use of simulation to screen and select surgery residents
Long-term follow-up of learners after participation in simulation-based surgical education and training
Conclusions
References
Tuesday, February 1, 2011
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