Simulation-based assessment in anesthesia: an international multicentre validation study
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REPORTS OF ORIGINAL INVESTIGATIONS
Simulation-based assessment in anesthesia: an international multicentre validation study L’e´valuation base´e sur la simulation en anesthe´sie: une e´tude multicentrique internationale de validation . Ralph J. McKinnon, MBChB . Elaine Ng, MD . Tobias C. Everett, MBChB Pradeep Kulkarni, MD . Bruno C. R. Borges, MD . Michael Letal, MD . Melinda Fleming, MD . M. Dylan Bould, MBChB . for the MEPA Collaborators Received: 12 September 2018 / Revised: 14 June 2019 / Accepted: 14 June 2019 Ó Canadian Anesthesiologists’ Society 2019
Abstract Purpose Simulated clinical events provide a means to evaluate a practitioner’s performance in a standardized manner for all candidates that are tested. We sought to provide evidence for the validity of simulation-based assessment tools in simulated pediatric anesthesia emergencies. Methods Nine centres in two countries recruited subjects to participate in simulated operating room events. Participants ranged in anesthesia experience from junior residents to staff anesthesiologists. Performances were video recorded for review and scored by specially trained, blinded, expert raters. The rating tools consisted of
The MEPA Collaborators are listed in ‘‘Acknowledgements’’.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-019-01488-4) contains supplementary material, which is available to authorized users. T. C. Everett, MBChB (&) E. Ng, MD Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada e-mail: [email protected] R. J. McKinnon, MBChB Department of Anesthesia, Royal Manchester Children’s Hospital, Manchester, United Kingdom P. Kulkarni, MD Department of Anesthesia, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada
scenario-specific checklists and a global rating scale that allowed the rater to make a judgement about the subject’s performance, and by extension, preparedness for independent practice. The reliability of the tools was classified as ‘‘substantial’’ (intraclass correlation coefficients ranged from 0.84 to 0.96 for the checklists and from 0.85 to 0.94 for the global rating scale). Results Three-hundred and ninety-one simulation encounters were analysed. Senior trainees and staff significantly out-performed junior trainees (P = 0.04 and P \ 0.001 respectively). The effect size of grade (junior vs senior trainee vs staff) on performance was classified as ‘‘medium’’ (partial g2 = 0.06). Performance deficits were observed across all grades of anesthesiologist, particularly in two of the scenarios. Conclusions This study supports the validity of our simulation-based anesthesiologist assessment tools in several domains of validity. We also describe some residual challenges regarding the validity of our tools, M. Letal, MD Department of Anesthesia, Alberta Children’s Hospital, University of Calgary, Calgary, AB, Canada M. Fleming, MD Department of Anesthesia, Queens
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