Assessment of procedural skills in residents working in a research and training institute: An effort to ensure patient safety and quality control

Abstract

Background:To ensure patient safety, it is important to regularly assess the knowledge and practical skills of anesthesia trainees. This study was conducted to evaluate the competency of the residents and the impact of various corrective measures in the form of didactic lectures and clinical skill demonstrations on the conduct of various procedural skills by the residents.Materials and Methods:Ninety-five junior residents were enrolled in this study. Assessment of competency of 1st, 2nd, and 3rd year residents in performing various procedure skills of anesthesia was done in two stages using procedure specific checklist (PSC) and Global Rating Scales (GRSs). Preliminary results of the first assessment (Score 1) were discussed with the residents; deficiencies were identified and corrective measures suggested by didactic lectures and clinical skill demonstrations which were followed by a subsequent assessment after 3 months (Score 2).Results:There was a statistically significant improvement in the PSC and GRS scores after corrective measures for all the procedural interventions studied. Percentage increase in scores was maximum in 1st year (42.98 ± 6.62) followed by 2nd year (34.62 ± 5.49) and minimum in 3rd year residents (18.06 ± 3.69). The percentage increase of scores was almost similar for all subset of procedural skills; low, intermediate, and high skill anesthetic procedures.Conclusion:For assessment of procedural skills of residents, use of PSC and GRS scores should be incorporated and the same should be used to monitor the impact of various corrective measures (didactic lectures and clinical skill demonstrations) on the conduct of various procedural skills by the resident.

Identifying patient safety competences among anesthesiology residents: systematic review

“…Hence, during clinical care or adverse events, residents must always honestly report what is the actual situation to the patient and family; obtain consent to perform procedures; perform shared (with patient and team) and individual anesthetic plans; be clear and assertive; show mutual respect; be interactive, empathetic and a good listener; be willing to give and receive feedback. 12 , 15 , 16 , 17 , 19 , 22 , 24 Teamwork and the demonstration of leadership through recognition of their role and that of other team members; decision-making; self-confidence; and good communication were also valued. 13 , 15 , 16 , 17 , 22 , 23 , 24 In order for all the aforementioned skills to be developed, interdisciplinarity during the anesthesiology residents’ learning is critical in order to ensure an integral perception of the health-disease process.…”

“… 12 , 15 , 16 , 17 , 19 , 22 , 24 Teamwork and the demonstration of leadership through recognition of their role and that of other team members; decision-making; self-confidence; and good communication were also valued. 13 , 15 , 16 , 17 , 22 , 23 , 24 In order for all the aforementioned skills to be developed, interdisciplinarity during the anesthesiology residents’ learning is critical in order to ensure an integral perception of the health-disease process. 17 , 21 …”

“…In the attitude category, that is, the behavior while facing a scenario, was underlined: the management of stress and fatigue through the awareness of one's self-limitations, acting according to an adequate workload, use of coping techniques, and requesting help when required 14 , 15 , 16 , 22 ; and infection control by hand hygiene, antiseptic techniques and proper use of personal protective equipment (gloves, mask and gown). 14 , 17 , 24 …”

“…Additional studies were carried out by other investigators, like Gauger et al, 2 who assessed 12 residents after being trained to perform needle cricothyroidotomy; Kumari et al, 24 in which 95 residents received suggestions on corrective measures during lectures and practical training sessions; and Blum et al, 22 who enrolled 67 residents to participate in seven simulation scenarios focusing on perioperative care. These three groups of investigators revealed that, after the administration of simulation scenarios and feedback, there is significant improvement in residents' skills in the three categories (knowledge, skills, and attitude).…”

Implementing an Interdisciplinary Procedure Curriculum

“…Formative assessments by dedicated faculty would help ensure that we are also improving the quality of procedural skills and outcomes for our trainees. We hope to create the assessments with the mindset of providing feedback in person and demonstrate knowledge of a procedure in a checklist format and a global rating of procedural skill for each resident [ 32 , 33 ]. If we are able to garner more interest after this, we hope to add a team-based learning style where residents can teach one another, which could provide more facilitators and motivation for individuals to take advantage of procedural opportunities [ 32 ].…”