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Comparing Real-time Versus Delayed Video Assessments for Evaluating ACGME Sub-competency Milestones in Simulated

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Delayed video assessment is as reliable as real-time assessment for evaluating resident trainees in simulated patient care. This finding supports using either method for Accreditation Council for Graduate Medical Education sub-competency milestone assessments.

Keywords:
anesthesiologygraduate medical educationmilestone assessmentoscesimulationvideo assessment

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Area of Science:

  • Medical Education
  • Simulation-Based Assessment
  • Anesthesiology Training

Background:

  • Simulation is vital for objective resident assessment.
  • Real-time assessment (RTA) in simulation is logistically difficult for large groups.
  • Limited data compares RTA with delayed assessment (DA) for Accreditation Council for Graduate Medical Education (ACGME) milestones.

Purpose of the Study:

  • To compare the equivalence of sub-competency milestone evaluation scores from delayed assessment (DA) versus real-time assessment (RTA).
  • To evaluate the reliability of video-based delayed assessment in simulation-based medical education.

Main Methods:

  • Forty-one anesthesiology residents participated in three simulated scenarios.
  • Faculty performed both real-time assessment (RTA) and delayed assessment (DA) via video recordings.
  • Scores from RTA were compared to averaged scores from DA using paired t-tests and variance component analysis.

Main Results:

  • No significant difference was found between RTA and averaged DA scores across all scenarios.
  • Intraclass correlation coefficients (ICCs) between RTA and DA scores ranged from 0.50 to 0.85.
  • Rater variance accounted for only 4% to 15% of the total score variation.

Conclusions:

  • Video-based delayed assessment (DA) is a reliable alternative to real-time assessment (RTA) for simulation-based evaluations.
  • Both RTA and DA yield comparable scores for assessing ACGME sub-competency milestones.
  • The choice between RTA and DA can be based on departmental needs and logistical feasibility.