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Published on: February 13, 2020
Using failure-to-rescue simulation to assess the performance of advanced practice professionals
Lisa M Blackburn1, Sherri Harkless1, Paula Garvey2
1Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH.
Abstract:
The use of advanced practice professionals (APPs) has been established in oncology care. APPs are frequently the most readily available ordering provider for care guidance when it becomes evident that a patient with cancer is failing. The purpose of the current preliminary descriptive project was to determine the best method for assessing APP performance in oncology-specific circumstances, particularly in the failing patient with cancer. A test group of 14 APPs completed a competency self-assessment, the Basic Knowledge Assessment Tool (BKAT)-8SR, and attended a four-hour simulation and classroom experience. Competency checklists with 30 priority interventions for each scenario had been anticipated by an expert panel. The APP competency self-assessment was measured for knowledge base and critical thinking. All of the APPs scored at or above the level of a critical care nurse with one year of experience on the BKAT-8SR. Twenty-seven of the anticipated interventions were enacted by all APPs. Five additional interventions were ordered that had not been anticipated. The success of this educational strategy has stimulated new learning opportunities, including initiation of a full-team oncology failure-to-rescue simulation, course restructuring, and other innovative simulation experiences.
Insights
This study assessed advanced practice professionals' (APPs) performance in oncology using simulations. Results show APPs demonstrated strong knowledge and critical thinking, exceeding expectations in managing failing cancer patients.
Area of Science:
- Oncology
- Medical Education
- Healthcare Professional Development
Background:
- Advanced practice professionals (APPs) are integral to oncology care, often guiding patients with cancer who are failing treatment.
- Assessing APP performance in these critical situations is essential for optimizing patient outcomes.
Purpose of the Study:
- To determine the most effective method for evaluating APP competency in oncology, specifically for patients experiencing treatment failure.
- To benchmark APP performance against established clinical standards.
Main Methods:
- A preliminary descriptive study involved 14 APPs who completed a self-assessment using the Basic Knowledge Assessment Tool (BKAT)-8SR.
- Participants engaged in a four-hour simulation and classroom experience with competency checklists focused on 30 priority interventions per scenario.
Main Results:
- All APPs scored at or above the benchmark of a critical care nurse with one year of experience on the BKAT-8SR.
- APPs successfully enacted 27 of 30 anticipated interventions, demonstrating proficiency in critical care.
- APPs also introduced five novel interventions, indicating adaptive critical thinking beyond the predefined scenarios.
Conclusions:
- The simulation and assessment strategy effectively measured APP knowledge and critical thinking in oncology failure-to-rescue scenarios.
- This educational approach shows promise for enhancing APP skills and improving care for deteriorating cancer patients.
- Findings support the development of further team-based simulations and curriculum improvements for oncology APPs.
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