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Simulation-Based Assessment Emily M. Hayden, MD, MHPEAssociate Director for Curricular IntegrationGilbert Program in Medical SimulationHarvard Medical SchoolDirector of Simulation Faculty DevelopmentDivision of Medical SimulationDepartment of Emergency MedicineMassachusetts General Hospital
Disclosure • Nothing to Disclose
Goals and Objectives Goal: To Discuss Simulation-Based Assessment (SBA)
Goals and Objectives Objectives: 1. Describe reasons for SBA 2. Describe the current state of SBA
Why use SBA? • Procedural training • Chance-events of apprenticeships • Rare events • Reduced work hours • Teamwork
Current State of SBA • Formative • Summative • High-stakes • Recurrent
Levels of Medical Training • Undergraduate medical education (UME) • Graduate medical education (GME) • Continuing medical education (CME)
Formative SBA • Trainees want feedback • Trainees want to be observed • Debriefing component of simulation
Formative SBA • UME • HMS preclinical simulation • GME • MGH Department of Medicine • CME • Center for Medical Simulation Crisis Resource Management courses
Formative SBA • UME • HMS preclinical simulation • GME • MGH Department of Medicine • CME • Center for Medical Simulation Crisis Resource Management courses
Summative SBA • UME: less often used • GME: • ACGME Competencies • CME: • Workplace-based assessments
Summative SBA in GME • ACGME Competencies • Patient Care • Medical Knowledge • Practice-based Learning and Improvement • Interpersonal and Communication Skills • Professionalism • Systems-based Practice
High-stakes SBA • UME: • USMLE Clinical Skills Step 2 • GME: • Surgical training • CME: • Oral boards • Carotid artery stenting
Recurrent SBA • Ericsson’s Model of Acquisition of Expertise • Deliberate practice with immediate feedback • Opportunities for repeated performance Ericsson, KA. Deliberate Practice and Acquisition of Expert Performance: a General Overview. Academic Emergency Medicine. 2008; 15(11), 988-994.