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出了一个10中心的研究，研究基于人体模型的模拟在寻求委员会重新认证的执业临床医生的高风险评估中的适用性。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，包括开发具有相关可靠评分工具的标准化场景，在多个测试地点使用这些场景对临床医生的绩效进行分布式交付和评估，以及对200名执业委员会认证麻醉师（BCA）的医疗/技术和行为绩效分布的描述。该结果将为其他专业的医生以及在培训的医生的能力评估提供信息。使用一个由经验丰富的模拟讲师组成的网络和已经提供全天模拟课程的程序，这些课程是BCA希望维持麻醉认证（MOCA）的强制性课程，为解决使用高保真模拟测量临床能力的一些挑战提供了一个独特的机会。具体目标是：1)开发标准化的、可推广的仿真场景以及相关的有效、可靠的性能评估工具，对BCA进行基于仿真的评估；2)证明基于模拟的临床评估可以在多个国家站点可靠地交付，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期间临床表现的分布，来自大量不同的委员会认证医生的横截面；4)开始解决与可靠和有效的基于模拟的执业医生临床能力评估相关的剩余挑战和问题。目标1的产品将是4个标准化的场景，相关的可靠的绩效评级工具，以及进行临床绩效评级的详细方法。在目标2中，我们将在10个asa认可的中心开展为期两年的100多门MOCA(R)课程；评估200个BCA的临床表现。我们假设，医疗/技术和（特别是）行为表现评分将广泛分布，从差到优，反映了参与者的不同横截面。最后，我们将举行一次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。该结果将描述未来临床绩效评估验证研究的要求，并为跨多专业基于模拟的能力评估提供重要指导。

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.