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Emergency Undocking in Robotic Surgery: A Simulation Curriculum
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Assessment of Emergency Medicine Resident Performance in an Adult Simulation Using a Multisource Feedback Approach.

Michael Jong1, Nicole Elliott1,2, Michael Nguyen1,2

  • 1Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, Bethlehem, Pennsylvania.

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|January 16, 2019
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The Queen's Simulation Assessment Tool (QSAT) reliably provides multisource feedback (MSF) for emergency medicine (EM) residents. Excluding self-assessments enhances the reliability of this valuable feedback for competency evaluations.

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Area of Science:

  • Medical Education
  • Emergency Medicine
  • Simulation-Based Assessment

Background:

  • The Accreditation Council for Graduate Medical Education (ACGME) emphasizes multisource feedback (MSF) for emergency medicine (EM) resident assessment.
  • High-fidelity simulation offers a controlled environment for collecting MSF from diverse healthcare professionals.
  • The Queen's Simulation Assessment Tool (QSAT) was previously validated for faculty assessment of residents.

Purpose of the Study:

  • To evaluate the utility of the QSAT for collecting MSF from various healthcare professionals using a standardized simulation case.
  • To determine the reliability of the QSAT when used for MSF in an EM residency program.

Main Methods:

  • A prospective study involving EM residents (PGY 1-4) and a standardized resuscitation after overdose simulation case.
  • The QSAT, with Likert anchors, was used for self-assessment by the resident team leader and by peer residents, EMS providers, nurses, and faculty.
  • Intraclass correlation coefficients (ICC) were calculated to assess inter-rater reliability of QSAT scores.

Main Results:

  • Faculty provided higher QSAT scores compared to other MSF sources.
  • Inter-rater reliability for all MSF sources was 0.754, increasing to 0.838 when self-assessment was excluded.
  • Agreement was lower between faculty and nurses than between faculty and EMS or peer evaluators.

Conclusions:

  • The QSAT demonstrates excellent reliability for collecting MSF in a simulated EM environment.
  • Excluding self-assessment significantly improves the reliability of MSF.
  • The QSAT is a potentially valuable tool for gathering data for clinical competency committees.