Development of Neurological Emergency Simulations for Assessment: Content Evidence and Response Process

Morris, Nicholas; Chang, Wan‐Tsu W.; Tabatabai, Ali; Gutierrez, Camilo; Phipps, Michael; Lerner, David P.; Bates, O. Jason; Tisherman, Samuel A.

doi:10.1007/s12028-020-01176-y

Cited by 9 publications

(14 citation statements)

References 36 publications

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“…As noted above, we have previously reported on two sources of validity evidence, including the domains of content evidence and response process. 19 We sought to provide further validity evidence to support our findings in the domains of internal structure and relationship to other variables. 20 Internal structure relates to the scoring properties such as reliability and reproducibility.…”

Section: Methodsmentioning

confidence: 89%

“…The final case and critical actions checklist represented a consensus that suggests content validity. 19 …”

Section: Methodsmentioning

confidence: 99%

“… 20 We achieved this through participant pre-briefing to ensure understanding and expectations, simulation operator training, the complementary use of critical action checklists and global rating scales, as well as rater training and calibration. 19 …”

Section: Methodsmentioning

confidence: 99%

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Simulation-based assessment of trainee’s performance in post-cardiac arrest resuscitation

et al. 2022

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Section: Methodsmentioning

confidence: 89%

“…The final case and critical actions checklist represented a consensus that suggests content validity. 19 …”

Section: Methodsmentioning

confidence: 99%

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Simulation-based assessment of trainee’s performance in post-cardiac arrest resuscitation

et al. 2022

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“…We previously provided validity evidence for the development of the cases and checklist action items in the domains of content evidence and response process, according to Messick's framework. 12 We aimed to provide further validity evidence to support our findings in the domains of content evidence, internal structure, and relationship to other variables. 17 After simulation, participants completed a questionnaire indicating how realistic they felt the scenario to be along with their level of engagement using a 7-point Likert scale ranging from "not at all" to "extremely" to provide content evidence.…”

Section: Validity Evidencementioning

confidence: 85%

“…12 The clinical case, critical actions checklist, and rating scale can be found in the supplementary material of our prior publication. 12 We chose the items on the critical action checklist based on the Neurocritical Care Society's Emergency Neurologic Life Support protocols, cross-referenced with guidelines from the Epilepsy Foundation/American Epilepsy Society, 13 the Infectious Disease Society of America, 14,15 and the Neurocritical Care Society. 16 A boardcertified neurologist with certification in neurocritical care (N.A.M.…”

Section: Clinical Simulation Case and Trainee Assessment Developmentmentioning

confidence: 99%

Education Research: High-Fidelity Simulation to Evaluate Diagnostic Reasoning Reveals Failure to Detect Viral Encephalitis in Medical Trainees

Pergakis

Chang

Gutierrez

et al. 2022

Neurology Education

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Background and ObjectivesDelays in treatment of both herpes simplex virus (HSV) encephalitis and seizures are associated with poor patient outcomes, but many physicians fail to recognize HSV despite classic presenting symptoms. Our goal was to assess trainee performance in a simulation-based case to recognize HSV encephalitis as the underlying etiology of refractory status epilepticus.MethodsThis is a prospective, observational, single-center simulation-based study of participants ranging from subinterns to attending physicians managing a patient with viral encephalitis complicated by nonconvulsive status epilepticus. Using a modified Delphi approach, we developed a list of critical actions. The primary outcome measure was critical action item sum score. We compared level of training and performance using analysis of variance as validity evidence to support our findings.ResultsFifty-nine trainees completed the simulation. The mean sum of critical actions completed was 13.9/25 (56%). Eighty percent of trainees administered an appropriately dosed benzodiazepine, and 97% administered a second-line agent. Despite 88% of trainees obtaining a lumbar puncture, only 47% recognized viral encephalitis as the most likely diagnosis with 36% starting appropriate treatment. There was significant effect of training level on critical action sum score (level 1 mean score [SD] = 10.8 [1.5] vs level 2 mean score [SD] = 12.2 [2.5] vs level 3 mean score [SD] = 13.9 [3.0] vs level 4 mean score [SD] = 18.2 [3.2],p< 0.001,R2= 0.38).DiscussionAlthough initial seizure treatment was sufficient, failure to recognize HSV encephalitis was common with few trainees initiating appropriate treatment potentially leading to poor outcomes in real-life scenarios. High-fidelity simulation holds promise as an assessment tool in identifying trainee knowledge gaps and why classic clinical cases escape trainee diagnosis.

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Smartphone Use in the Management of Neurological Emergencies: A Simulation-Based Study

Pergakis,

Ali,

Chang

et al. 2024

Neurocrit Care

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Background and ObjectivesSmartphone use in medicine is nearly universal despite a dearth of research assessing utility in clinical performance. We sought to identify and de ne smartphone use during simulated neuro-emergencies. MethodsIn this retrospective review of a prospective, observational, single-center simulation-based study, participants, ranging from sub-interns to attending physicians and strati ed by training level (novice, intermediate, and advanced) managed a variety of neurological emergencies. The primary outcome was frequency and purpose of smartphone use. Secondary outcomes included success rate of smartphone Discussion Participants commonly used smartphones in simulated neuro-emergencies but use didn't confer improved clinical performance. Less experienced participants were the most likely to use smartphones, were less likely to arrive at correct conclusions, and thus are the most likely to bene t from an evidencebased smartphone application for neuro-emergencies.

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Development of Neurological Emergency Simulations for Assessment: Content Evidence and Response Process

Cited by 9 publications

References 36 publications

Simulation-based assessment of trainee’s performance in post-cardiac arrest resuscitation

Simulation-based assessment of trainee’s performance in post-cardiac arrest resuscitation

Education Research: High-Fidelity Simulation to Evaluate Diagnostic Reasoning Reveals Failure to Detect Viral Encephalitis in Medical Trainees

Smartphone Use in the Management of Neurological Emergencies: A Simulation-Based Study

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