Creating simulation-based performance assessment tools for practicing physicians

描述（由申请人提供）：为执业医师创建基于模拟的绩效评估工具一个由领先的模拟研究人员和教育工作者组成的团队提出了一项10中心研究，研究基于人体模型的模拟对寻求董事会重新认证的执业临床医生的高风险评估的适用性。这项独特的研究将解决执业临床医生的绩效评估的重要问题，其中包括开发标准化方案与相关的可靠评分工具，分布式交付和评估临床医生的绩效，使用这些方案在多个测试站点，以及描述200名执业委员会认证的麻醉师（BCA）的医疗/技术和行为表现的分布。结果将告知其他专业的医生以及培训医生的能力评估。使用经验丰富的模拟教师和程序网络已经提供了一整天的模拟课程，这是BCA渴望麻醉认证（莫卡）的强制性，提供了一个独特的机会，以解决使用高保真模拟测量临床能力的一些挑战。具体目标是：1）开发标准化的、可推广的模拟场景，以及相关的有效、可靠的性能评估工具，以进行基于模拟的BCA评估; 2）证明基于模拟的临床评估可以在多个国家地点可靠地进行，以评估寻求重新认证的委员会认证医生; 3）定量和定性地描述模拟过程中来自大量不同截面的委员会认证医生的临床表现的分布;和4）开始解决与执业医师临床能力的可靠和有效的基于模拟的评估相关的剩余挑战和问题。目标1的产品将是4个标准化场景、相关的可靠性能评级工具以及进行临床性能评级的详细方法。在目标2中，我们将在10个ASA认可的中心进行为期两年的100多个莫卡（R）课程;将评估200个BCA的临床性能。我们假设，将有一个广泛的分布的医疗/技术和（特别是）行为表现评级从差到优，反映了不同的横截面的参与者。最后，我们将举行全国利益相关者共识会议，讨论与可靠和有效的基于模拟的临床能力评估相关的剩余挑战和问题。研究结果将为临床绩效评估的未来验证研究提供必要的指导，并为跨多个专业的基于模拟的能力评估提供重要的指导。 公共卫生相关性：保证医生检测和管理不常见但可能致命的事件的能力是一个特别受社会关注的领域，可能适合基于模拟的性能评估。这项多中心研究将开发严格的方法和措施，使用基于人体模型的高保真模拟来评估执业医生的急性护理能力。

DESCRIPTION (provided by applicant): Creating simulation-based performance assessment tools for practicing physicians A team of leading simulation researchers and educators propose a 10-center study of the applicability of mannequin-based simulation to high-stakes assessment of practicing clinicians who are seeking board recertification. This unique study will address important issues for performance evaluation of practicing clinicians, which include the development of standardized scenarios with associated reliable scoring instruments, distributed delivery and assessment of clinicians' performance using those scenarios across multiple testing sites, and a description of the distribution of medical/technical and behavioral performance of 200 practicing board- certified anesthesiologists (BCA). The results will inform competency assessment of physicians in other specialties as well as physicians-in-training. Using a network of experienced simulation instructors and programs already offering all-day simulation courses that are mandatory for BCA desiring Maintenance of Certification in Anesthesia (MOCA) provides a singular opportunity to address some of the challenges of measuring clinical competency using high-fidelity simulation. The Specific Aims are to: 1) Develop standardized, generalizable simulation scenarios with associated valid, reliable performance assessment tools to conduct simulation-based assessment of BCA; 2) Demonstrate that simulation-based clinical assessment can be reliably delivered across multiple national sites for the purpose of evaluating board-certified physicians seeking recertification; 3) Describe quantitatively and qualitatively the distribution of clinical performance during simulation from a large and diverse cross-section of board-certified physicians; and 4) Begin to address the remaining challenges and questions related to reliable and valid simulation-based assessment of practicing physicians' clinical competency. The products of Aim 1 will be 4 standardized scenarios, associated reliable performance rating instruments, and detailed methods for conducting clinical performance ratings. In Aim 2, we will conduct more than 100 MOCA(R) courses over a two-year period in 10 ASA-Endorsed centers; the clinical performance of 200 BCA will be assessed. We hypothesize that there will be a broad distribution of medical/technical and (especially) behavioral performance ratings from poor to excellent, reflecting a diverse cross-section of participants. Finally, we will hold a national stakeholders consensus conference to discuss the remaining challenges and questions related to reliable and valid simulation-based assessment of clinical competency. The results will delineate the requirements of future validation studies of clinical performance assessment and provide important guidance for simulation-based competency assessment across multiple specialties. PUBLIC HEALTH RELEVANCE: Assurance of physicians' ability to detect and manage uncommon but potentially lethal events is an area of particular societal concern and may be amenable to simulation-based performance assessment. This multicenter study will develop rigorous methods and measures for assessing the acute care competency of practicing physicians using mannequin-based high-fidelity simulation.