Competency-based assessment tools for regional anaesthesia: a narrative review

Chuan, Alwin; Wan, Anthony; Royse, Colin; Forrest, Kirsty

doi:10.1016/j.bja.2017.09.007

Cited by 25 publications

(18 citation statements)

References 86 publications

(85 reference statements)

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“…This involved defining the minimum competency for each RA task, and to reach consensus on which assessment tools should be used to evaluate competency. A systematic review has recently summarised the available assessment tools for RA procedures 23…”

Section: Discussionmentioning

confidence: 99%

Research priorities in regional anaesthesia education and training: an international Delphi consensus survey

Chuan

Ramlogan

2019

BMJ Open

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ObjectivesEducation in regional anaesthesia covers several complex and diverse areas, from theoretical aspects to procedural skills, professional behaviours, simulation, curriculum design and assessment. The objectives of this study were to summarise these topics and to prioritise these topics in order of research importance.DesignElectronic structured Delphi questionnaire over three rounds.SettingInternational.Participants38 experts in regional anaesthesia education and training, identified through the American Society of Regional Anesthesia Education Special Interest Group research collaboration.Results82 topics were identified and ranked in order of prioritisation. Topics were categorised into themes of simulation, curriculum, knowledge translation, assessment of skills, research methodology, equipment and motor skills. Thirteen topics were ranked as essential research priority, with four topics each on simulation and curriculum, three topics on knowledge translation, and one topic each on methodology and assessment.ConclusionsResearchers and educators can use these identified topics to assist in planning and structuring their research and training in regional anaesthesia education.

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Section: Discussionmentioning

confidence: 99%

Research priorities in regional anaesthesia education and training: an international Delphi consensus survey

Chuan

Ramlogan

2019

BMJ Open

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“…7 Our view is that, in order to show any benefits of simulation, we need to develop valid and reliable metrics 8,9 that are simple to use and specifically measure the translation of skills from the cadaver to the operating room. 10 However, current tools, such as procedure duration and cumulative sum charts, 4 do not measure the quality of clinical intervention; direct observation of procedural skills lacks reliability for formative assessment; 11 and dynamic confidence scores remain unvalidated. 12 The global rating scale (GRS) 13À15 is summative and descriptive.…”

mentioning

confidence: 99%

Validity and reliability of metrics for translation of regional anaesthesia performance from cadavers to patients

McLeod

McKendrick

Taylor

et al. 2019

British Journal of Anaesthesia

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Background: Our goal is to develop metrics that quantify the translation of performance from cadavers to patients. Our primary objective was to develop steps and error checklists from a Delphi questionnaire. Our second objective was to show that our test scores were valid and reliable. Methods: Sixteen UK experts identified 15 steps conducive to good performance and 15 errors to be avoided during interscalene block on the soft-embalmed cadaver and patients. Thereafter, six experts and six novices were trained, and then tested. Training consisted of psychometric assessment, an anatomy tutorial, volunteer scanning, and ultrasoundguided needle insertion on a pork phantom and on a soft-embalmed cadaver. For testing, participants conducted a single interscalene block on a dedicated soft-embalmed cadaver whilst wearing eye tracking glasses. Results: We developed a 15-step checklist and a 15-error checklist. The internal consistency of our steps measures were 0.83 (95% confidence interval [CI]: 0.78e0.89) and 0.90 (95% CI: 0.87e0.93) for our error measures. The experts completed more steps (mean difference: 3.2 [95% CI: 1.5e4.8]; P<0.001), had less errors (mean difference: 4.9 [95% CI: 3.5e6.3]; P<0.001), had better global rating scores (mean difference: 6.8 [95% CI: 3.6e10.0]; P<0.001), and more eye-gaze fixations (median of differences: 128 [95% CI: 0e288]; P¼0.048). Fixation count correlated negatively with steps (r¼e0.60; P¼0.04) and with errors (r¼0.64; P¼0.03). Conclusions: Our tests to quantify ultrasound-guided interscalene nerve block training and performance were valid and reliable.

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“…Medical education has progressively migrated towards a competence-based training approach, so valid evaluation tools are needed to be able to account for the achievement of these competences 27. There are different ways of evaluating the acquisition of procedural competences and none of them are perfect 28. The conformance analysis presented in this research shows the potential of using it as an evaluation tool from the control-flow perspective.…”

Section: Discussionmentioning

confidence: 95%

Control-flow analysis of procedural skills competencies in medical training through process mining

Fuente

Fuentes

Muñoz-Gama

et al. 2019

Postgraduate Medical Journal

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BackgroundProcedural skills are key to good clinical results, and training in them involves a significant amount of resources. Control-flow analysis (ie, the order in which a process is performed) can provide new information for those who train and plan procedural training. This study outlines the steps required for control-flow analysis using process mining techniques in training in an ultrasound-guided internal jugular central venous catheter placement using a simulation.MethodsA reference process model was defined through a Delphi study, and execution data (event logs) were collected from video recordings from pretraining (PRE), post-training (POST) and expert (EXP) procedure executions. The analysis was performed to outline differences between the model and executions. We analysed rework (activity repetition), alignment-based fitness (conformance with the ideal model) and trace alignment analysis (visual ordering pattern similarities).ResultsExpert executions do not present repetition of activities (rework). The POST rework is lower than the PRE, concentrated in the steps of the venous puncture and guidewire placement. The adjustment to the ideal model measure as alignment-based fitness, expressed as a median (25th–75th percentile) of PRE 0.74 (0.68–0.78) is less than POST 0.82 (0.76–0.86) and EXP 0.87 (0.82–0.87). There are no significant differences between POST and EXP. The graphic analysis of alignment and executions shows a progressive increase in order from PRE to EXP executions.ConclusionProcess mining analysis is able to pinpoint more difficult steps, assess the concordance between reference mode and executions, and identify control-flow patterns in procedural training courses.

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Competency-based assessment tools for regional anaesthesia: a narrative review

Cited by 25 publications

References 86 publications

Research priorities in regional anaesthesia education and training: an international Delphi consensus survey

Research priorities in regional anaesthesia education and training: an international Delphi consensus survey

Validity and reliability of metrics for translation of regional anaesthesia performance from cadavers to patients

Control-flow analysis of procedural skills competencies in medical training through process mining

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