2019 HSC Section 2 - Practice Management

Simulation-based Clinical Performance Assessment

Afib/STEMI (n = 76)

% Satisfactory global binary score ( i.e. , yes rating)†‡§ HS 69.7 (198/284) 85.1 (57/67) 56.8 (46/81) 76.7 (46/60) 64.5 (49/76) Team 79.6 (226/284) 88.1 (59/67) 79.0 (64/81) 81.7 (49/60) 71.1 (54/76) BARS: overall‡ — 5.4 (3.5–7.1) [1.8, 9.0] 6.5 (5.0–7.3) [2.5, 9.0] 4.3 (3.0–6.8) [2.0, 8.8] 6.1 (4.0, 7.6) [2.0, 8.8] 4.8 (3.5–6.8) [1.8, 8.3]

% of CPEs rated as completed* — 81.3 (75.0–89.5) [42.1, 100.0] Technical score*†‡ HS 5 (3–7) [1, 9] 6 (5–7) [2, 9] 4 (3–6) [1, 8] 6 (4–7) [2, 9] 5 (3–6) [1, 9] Team 6 (4–7) [1, 9] 7 (5–8) [3, 9] 5 (4–6) [1, 8] 6 (4–8) [2, 9] 5 (3–7) [2, 9] Behavioral score*†‡ HS 5 (4–7) [1, 9] 6 (5–7) [2, 9] 4 (3–7) [2, 8] 6 (4–8) [1, 9] 5 (3–7) [2, 9] Team 5 (4–7) [1, 9] 7 (5–8) [3, 9] 5 (4–7) [2, 8] 6 (4–8) [1, 9] 5 (4–7) [2, 9] 76.5 (70.6–88.2) [58.8, 100.0] 85.0 (75.0–85.0) [55.0, 95.0] 84.2 (73.7, 89.5) [42.1, 100.0] 81.3 (75.0–93.8) [50.0, 100.0]

BARS: communication‡ — 5 (4–7) [1, 9] 7 (5–8) [2, 9] 4 (3–7) [2, 9] 6 (5–8) [1, 9] 5 (3–7) [2, 9] BARS: decision‡ — 5 (3–7) [1, 9] 6 (5–7) [2, 9] 4 (3–6) [1, 8] 6 (4–8) [2, 9] 5 (3–6) [1, 8] BARS: teamwork‡ — 6 (4–7) [1, 9] 7 (5–8) [2, 9] 4 (3–7) [2, 8] 6 (4–8) [1, 9] 5 (3–7) [2, 9] BARS: vigilance‡ — 5 (3–7) [2, 9] 7 (5–7) [2, 9] 4 (3–7) [2, 8] 6 (4–8) [2, 9] 5 (3–7) [2, 9]

MH

(n = 60)

Ratings by Scenario

LA Toxicity (n = 81)

Hemorrhage (n = 67)

Overall Ratings (n = 284)

*Technical and behavioral ratings (1 to 9 range) and CPE (%) completion are presented as median (IQR) [minimum, maximum]. †Significant ( P < 0.001) differences by team versus HS using McNemar test are shown.

‡Significant ( P < 0.05) differences by scenario using likelihood ratio test are shown. §Global binary (yes/no) ratings are presented as % yes (fraction). Afib = atrial fibrillation; BARS = behaviorally anchored rating scales; CPE = critical performance element; HS = hot shot; IQR = interquartile range; LA = local anesthetic; MH = malignant hyperthermia; STEMI = ST segment elevation myocardial infarction.

Table 3.  Overall Performance Ratings by Scenario Performance Metric

Weinger et al .

Anesthesiology 2017; 127:475-89

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