Decision-making skills improve with critical care training: Using simulation to measure progress.

Area of Science:

• Medical Education
• Critical Care Medicine
• Healthcare Simulation

Background:

• Assessing decision-making skills in healthcare professionals is challenging.
• There is a need for reliable methods to evaluate skill acquisition during training.

Purpose of the Study:

• To determine if simulation methodology can assess improvements in decision-making skills.
• To evaluate the efficacy of critical care training in enhancing provider decision-making.

Main Methods:

• Sixteen simulated scenarios were developed for critical care providers.
• Seventeen providers completed 8 scenarios early in training (T1) and 8 scenarios at the conclusion (T2).

Main Results:

• Mean global scenario scores significantly increased from T1 to T2 (5.64 to 6.54).
• A large effect size (1.3) indicated substantial improvement in decision-making.
• Acute care nurse practitioners and fellows achieved comparable high scores at training completion.

Conclusions:

• Simulation-based methods are valid for assessing decision-making skill progression.
• Simulation can establish performance standards for independent clinical decision-making.