Creating simulation-based performance assessment tools for practicing physicians

描述(由申请人提供)：为执业医生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议进行一项10中心研究，探讨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绩效评估的重要问题，其中包括开发具有相关可靠评分工具的标准化情景、分布式交付和使用这些情景跨多个测试地点评估临床医生的绩效，以及描述200名执业委员会认证麻醉师(BCA)的医疗/技术和行为绩效的分布情况。这一结果将为其他专科医生以及正在接受培训的医生提供能力评估信息。使用经验丰富的模拟讲师网络和已经提供全天模拟课程的计划，对于希望维持麻醉认证(MOCA)的BCA来说，提供了一个独特的机会来解决使用高保真模拟衡量临床能力的一些挑战。其具体目标是：1)开发标准化、通用化的模拟场景和相关的有效、可靠的绩效评估工具，以进行基于模拟的BCA评估；2)展示基于模拟的临床评估可以跨多个国家地点可靠地提供，目的是评估寻求重新认证的董事会认证医生；3)定量和定性地描述大量不同的董事会认证医生在模拟过程中的临床表现分布；以及4)开始解决与基于模拟的可靠和有效的执业医生临床能力评估相关的剩余挑战和问题。AIM 1的产品将是4个标准化的场景、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100多个为期两年的MOCA(注册商标)课程；将评估200个BCA的临床表现。我们假设，将会有从差到优的医疗/技术和(特别是)行为表现评级的广泛分布，反映了参与者的不同横截面。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。研究结果将勾勒出未来临床绩效评估验证性研究的要求，并为基于模拟的跨专业能力评估提供重要指导。 公共卫生相关性：确保医生发现和管理不常见但可能致命的事件的能力是一个特别社会关注的领域，可能适合于基于模拟的绩效评估。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.