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Simulation vs workplace-based assessment in resuscitation: a cross-specialty descriptive analysis and comparison
Jeremy D Seed1, Stephen Gauthier2, Boris Zevin3
1Department of Emergency Medicine, Queen's University, Ontario, Canada.
Canadian Medical Education Journal
|July 19, 2023
Summary
Simulation-based assessment complements workplace training for rare medical skills. While faculty trust simulation for assessments, interpretation of data remains inconsistent across postgraduate programs.
Area of Science:
- Medical Education
- Simulation-Based Learning
- Assessment in Postgraduate Training
Background:
- Simulation-based assessment offers a valuable adjunct to workplace-based assessment for Entrustable Professional Activities (EPAs) that are rare or challenging to evaluate.
- This study investigated the utilization of simulation for resuscitation-focused EPAs across three postgraduate medical training programs.
Purpose of the Study:
- To compare the application of simulation-based assessment for resuscitation-focused EPAs in internal medicine, emergency medicine, and surgical foundations programs.
- To explore faculty perceptions regarding the use and trustworthiness of simulation-based assessment in postgraduate medical education.
Main Methods:
- Retrospective analysis of EPA assessment data from 2017-2020 for residents in three specialties at different training stages.
- Distribution of a questionnaire to clinical competency committee members to gather insights on simulation-based assessment practices and perceptions.
Main Results:
- Simulation constituted 11% of all EPA assessments, with no significant difference in proportion across programs, except for surgical foundations between training stages.
- Entrustment scores varied between simulation and workplace settings in emergency medicine at the transition level.
- A majority of surveyed faculty (70%) trust simulation for both low-stakes (100%) and high-stakes (73%) assessments, though 45% interpret simulation data differently than workplace data.
Conclusions:
- The proportion of simulation-based assessment for resuscitation EPAs was consistent across the three postgraduate programs.
- Inconsistent interpretation of simulation-based assessment data among faculty highlights a need for standardized guidelines.
- Simulation is a trusted tool for both low- and high-stakes assessments, supporting its integration into broader assessment strategies.
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