Simulation in healthcare : journal of the Society for Simulation in Healthcare
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In medicine, standard setting methodologies have been developed for both selected-response and performance-based assessments. For simulation-based tasks, research efforts have been directed primarily at assessments that incorporate standardized patients. Mannequin-based evaluations often demand complex, time-sensitive, hierarchically ordered, sequential actions that are difficult to evaluate and score. Moreover, collecting reliable proficiency judgments, necessary to estimate meaningful cut points, can be challenging. The purpose of this investigation was to explore whether expert judgments obtained using an examinee-centered standard setting method that was previously validated for standardized patient-based assessments could be used to set defensible standards for acute-care, mannequin-based scenarios. ⋯ An examinee-centered approach, using aggregate expert judgments of audio-video performances, was suitable for setting standards on most acute-care, mannequin-based scenarios. It is necessary, however, to have valid scores for the chosen scenarios and to sample performances across the ability spectrum.
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Team performance measurement is a critical and frequently overlooked component of an effective simulation-based training system designed to build teamwork competencies. Quality team performance measurement is essential for systematically diagnosing team performance and subsequently making decisions concerning feedback and remediation. However, the complexities of team performance pose a challenge to effectively measuring team performance. This article synthesizes the scientific literature on this topic and provides a set of best practices for designing and implementing team performance measurement systems in simulation-based training.
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Resuscitation science is a dynamic part of healthcare training, with an expanding role for simulation. Historically, performance measurement and documentation relied upon the presence of an instructor, an expensive and potentially inaccurate assessment tradition that tied performance testing to a fixed facility. We hypothesize that an automated system might be developed and validated to document performance in airway management for self assessment in the absence of a human trainer. The system would also store and transmit data to a central registry to document skill acquisition and maintenance. ⋯ This system was successfully used to document student performance of BVM, orotracheal intubation, and ventilation via ETT. The system easily integrates documentation, including text reports, airway pressure readings, still images and videos of task performance. Such digital documentation could guide skill acquisition and quantitatively certify performance with minimal reliance upon an instructor and evaluator.
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The use of simulation in graduate medical education affords unique opportunities for increasing the quality of a resident's educational experiences. Additionally, simulation poses a set of challenges that must be met to realize the full potential on learning and assessment practices. ⋯ The SMARTER methodology is discussed in detail and 3 examples of scenario content and measurement tools generated with the SMARTER approach are provided. Additionally, results from an initial evaluation of the practicability and utility of the SMARTER measurement tools are discussed.
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Although a traditional simulation laboratory may have excellent installed audio/visual capabilities, often large classes overwhelm the limited space in the laboratory. With minimal monetary investment, it is possible to create a portable audio/visual stand from an old IV pole. ⋯ The modified IV pole is a cost-effective and portable solution to limited space or the need for audio/visual capabilities outside of a simulation laboratory. The familiarity of an IV pole in a clinical setting reduces the visual disturbance of relocated audio/visual equipment in a room previously void of such instrumentation.