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"GIOSAT": a tool to assess CanMEDS competencies during simulated crises
Victor M Neira1, M Dylan Bould, Amy Nakajima
1Department of Anesthesia, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, ON, Canada. vneira@cheo.on.ca
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|January 22, 2013
Summary
The Generic Integrated Objective Structured Assessment Tool (GIOSAT) demonstrates substantial inter-rater reliability for assessing medical expert competencies in anesthesia crisis simulations. Construct validity was supported, but not for intrinsic CanMEDS competencies.
Area of Science:
- Medical Education
- Anesthesiology
- Simulation-Based Assessment
Background:
- Objective Structured Assessment Tools (OSATs) are crucial for evaluating clinical skills.
- Integrating various competencies (Medical Expert, intrinsic CanMEDS, non-technical skills) into a single tool is challenging.
- Existing tools may not comprehensively assess all facets of performance in crisis scenarios.
Purpose of the Study:
- To develop and evaluate a Generic Integrated Objective Structured Assessment Tool (GIOSAT).
- To integrate Medical Expert, intrinsic CanMEDS, and non-technical skills for crisis simulation assessment.
- To assess the reliability and validity of the GIOSAT in pediatric anesthesia scenarios.
Main Methods:
- Designed and piloted the GIOSAT using pediatric anesthesia scenarios.
- Utilized video recordings of 50 anesthesia residents managing intraoperative Advanced Cardiac Life Support (ACLS) scenarios.
- Assessed inter-rater reliability using intraclass correlations (ICCs) and construct validity by correlating scores with postgraduate year (PGY).
Main Results:
- Total GIOSAT scores showed substantial inter-rater reliability (average measure ICC = 0.85).
- Medical Expert and intrinsic competencies demonstrated substantial inter-rater reliability (average measure ICCs = 0.90 and 0.82, respectively).
- Significant correlations were found between PGY level and total GIOSAT scores (r=0.36) and Medical Expert competencies (r=0.42), supporting construct validity.
Conclusions:
- The GIOSAT exhibits substantial inter-rater reliability for total scores and Medical Expert competencies.
- The correlation between PGY level and GIOSAT scores supports the tool's construct validity for Medical Expert competencies.
- Evidence of validity was not obtained for intrinsic CanMEDS competencies using this tool.
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