• David J Murray, Walter A Boyle, Mary Beth Beyatte, Justin G Knittel, Paul W Kerby, Julie Woodhouse, and John R Boulet.
• Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, United States of America; Howard and Joyce Wood Simulation Center, Washington University School of Medicine, St Louis, MO, United States of America. Electronic address: murrayd@wustl.edu.
• J Crit Care. 2018 Oct 1; 47: 133-138.

PurposeHealth care professionals are expected to acquire decision-making skills during their training, but few methods are available to assess progress in acquiring these essential skills. The purpose of this study was to determine whether a simulation methodology could be used to assess whether decision-making skills improve during critical care training.Materials And MethodsSixteen simulated scenarios were designed to assess a critical care provider's ability to make decisions in the care of a critical ill patient. Seventeen (17) critical care providers managed 8 of the scenarios early during their training and then managed a second set of 8 scenarios (T2) at the conclusion of their training.ResultsProvider's mean global scenario scores (0-9) increased significantly fromT1 and T2 (5.64 ± 0.74) and (6.54 ± 0.64) with a large effect size (1.3). Acute care nurse practitioners and fellows achieved similar overall scores at the conclusion of their training (ACNP 6.43 ± 0.57; Fellows 6.64 ± 0.72).ConclusionsThese findings provide evidence to support the validity of a simulation-based method to assess progress in decision-making skills. A simulation methodology could be used to establish a performance standard that determined a provider's ability to make independent decisions.Copyright © 2018. Published by Elsevier Inc.

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