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A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

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Development and Pilot Testing of a Programmatic System for Competency Assessment in US Anesthesiology Residency

Glenn E Woodworth¹, Zachary T Goldstein², Aditee P Ambardekar³

¹From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon.

Anesthesia and Analgesia

|October 6, 2023

Summary

A new assessment system for anesthesiology residency training was developed, mapping to ACGME Milestones 2.0. This system shows improved scores with training and provides evidence for validity.

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Area of Science:

Medical Education
Anesthesiology Training
Competency-Based Assessment

Background:

Existing 2018 entrustable professional activities (EPAs) and procedural skills assessments for anesthesiology training did not cover all Accreditation Council for Graduate Medical Education (ACGME) Milestones.
Need for a comprehensive assessment system aligned with revised ACGME Anesthesiology Milestones 2.0.

Purpose of the Study:

Remap existing assessments to Anesthesiology Milestones 2.0.
Develop new assessments to cover all milestones (levels 1-4).
Establish a valid, programmatic assessment system for anesthesiology residency.

Main Methods:

Modified Delphi process by anesthesiology education experts.
Development of new EPAs, nontechnical skills assessments (NTSAs), and objective structured clinical examinations (OSCEs).
24-month pilot at 7 institutions; comparison of assessment scores with Clinical Competency Committee (CCC) data.

Main Results:

A system comprising 5 new EPAs, 11 NTSAs, and 6 OSCEs was created, covering 99% of Milestones 2.0 (levels 1-4).
Aggregate mean scores for EPAs and procedural skills significantly increased with training year.
Subcompetency scores showed significant correlation with 65.2% of CCC scores, but 36.4% had poor correlation (<30.0).

Conclusions:

A comprehensive assessment system including EPAs, procedural skills, NTSAs, and OSCEs was developed for US anesthesiology residency.
The development and pilot testing methodology, score progression, and correlation with CCC data support the validity of this assessment system.