1
|
Castellanos-Ortega Á, Broch MJ, Palacios-Castañeda D, Gómez-Tello V, Valdivia M, Vicent C, Madrid I, Martinez N, Párraga MJ, Sancho E, Fuentes-Dura MDC, Sancerni-Beitia MD, García-Ros R. Competency assessment of residents of Intensive Care Medicine through a simulation-based objective structured clinical evaluation (OSCE). A multicenter observational study. Med Intensiva 2022; 46:491-500. [PMID: 36057440 DOI: 10.1016/j.medine.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The current official model of training in Intensive Care Medicine (ICM) in Spain is based on exposure to experiences through clinical rotations. The main objective was to determine the level of competency (I novice to V independent practitioner) achieved by the residents at the end of the 3rd year of training (R3) in ICM through a simulation-based OSCE. Secondary objectives were: (1) To identify gaps in performance, and (2) To investigate the reliability and feasibility of conducting simulation-based assessment at multiple sites. DESIGN Observational multicenter study. SETTING Thirteen Spanish ICU Departments. PARTICIPANTS Thirty six R3. INTERVENTION The participants performed on five, 15-min, high-fidelity crisis scenarios in four simulation centers. The performances were video recorded for later scoring by trained raters. MAIN VARIABLES OF INTEREST Via a Delphi technique, an independent panel of expert intensivists identified critical essential performance elements (CEPE) for each scenario to define the levels of competency. RESULTS A total of 176 performances were analyzed. The internal consistency of the check-lists were adequate (KR-20 range 0.64-0.79). Inter-rater reliability was strong [median Intraclass Correlation Coefficient across scenarios: 0.89 (0.65-0.97)]. Competency levels achieved by R3 were: Level I (18.8%), II (35.2%), III (42.6%), IV/V (3.4%). Overall, a great heterogeneity in performance was observed. CONCLUSION The expected level of competency after one year in the ICU was achieved only in half of the performances. A more evidence-based educational approach is needed. Multiple center simulation-based assessment showed feasibility and reliability as an evaluation method of competency. TRIAL REGISTRATION COBALIDATION. NCT04278976. (https://register. CLINICALTRIALS gov).
Collapse
Affiliation(s)
- Á Castellanos-Ortega
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M J Broch
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - V Gómez-Tello
- Intensive Care Department, University Hospital Moncloa, Madrid, Spain
| | - M Valdivia
- Intensive Care Department, Hospital Puerta de Hierro-Majadahonda, Spain
| | - C Vicent
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - I Madrid
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - N Martinez
- Intensive Care Department, Hospital Puerta de Hierro-Majadahonda, Spain
| | - M J Párraga
- Intensive Care Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - E Sancho
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M D C Fuentes-Dura
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - M D Sancerni-Beitia
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - R García-Ros
- Department of Developmental and Educational Psychology, University of Valencia, Spain.
| |
Collapse
|
2
|
Castellanos-Ortega A, Broch MJ, Barrios M, Fuentes-Dura MC, Sancerni-Beitia MD, Vicent C, Gimeno R, Ramírez P, Pérez F, García-Ros R. Acceptance and validity of the methods used to implement a competency based medical education programme in an Intensive Care Department of a teaching referral center. Med Intensiva 2021; 45:411-420. [PMID: 34563341 DOI: 10.1016/j.medine.2019.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/02/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES 1. To determine the satisfaction of tutors and residents with a specific methodology used to implement CoBaTrICE. 2. To determine the reliability and validity of the global rating scales designed ad hoc to assess the performance of the residents for training purposes. DESIGN Prospective cohort study. PARTICIPANTS All the residents and tutors of the ICU Department of the Hospital Universitario y Politécnico la Fe de Valencia. INTERVENTION CoBaTrICE implementation started in March 2016, it was based on: (1) Training the tutors in feedback techniques; (2) Performing multiple objective and structured work based assessments to achieve the competences of the program; and (3) The use of an electronic portfolio to promote learning reflection and to collect the evidence that learning was taking place. METHODS The acceptance of CoBaTrICE was explored through a satisfaction survey conducted after 9 months of implementation of the training program. The 15 residents and 5 tutors of the ICU Department were asked about the methodology of the formative assessments, the quality of the feedback, self-learning regulation and the electronic portfolio usefulness. The validity of the global rating scales was assessed through the tests alfa de Cronbach, reliability and generalizability indexes, and intraclass correlation coefficient. RESULTS The implementation of CoBaTrICE was satisfactory in all the dimensions studied. The global rating scales used for formative purposes showed reliability and validity. CONCLUSIONS The methodology used to implement CoBaTrICE was highly valued by tutors and residents. The global rating scales used for formative purposes showed reliability and validity.
Collapse
Affiliation(s)
- A Castellanos-Ortega
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M J Broch
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M Barrios
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M C Fuentes-Dura
- Departamento de Metodología de Ciencias del Comportamiento, Universidad de Valencia, Valencia, Spain
| | - M D Sancerni-Beitia
- Departamento de Metodología de Ciencias del Comportamiento, Universidad de Valencia, Valencia, Spain
| | - C Vicent
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R Gimeno
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - F Pérez
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R García-Ros
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Valencia, Valencia, Spain.
| |
Collapse
|
5
|
Török T, Kardos A, Rudas L, Paprika D, McLuckie A, Beale RJ, Bihari D, Keller H, Seltzer N, Weimer A, Menning H, Ulrich P, Staedt U, Kirschstein W, Kasai T, Endo S, Arakawa N, Sato N, Suzuki T, Taniguchi S, Inada K, Hiramori K, Schmidt W, Meineke I, Nottrott M, Frerichs I, Müller S, Hellige G, De Blasio E, De Sio A, Sibilio G, Papa A, Golia D, Grassia V, Bove G, Zehelgruber M, Mundigler G, Christ G, Merhaut C, Klaar U, Kratochwill C, Hofmann S, Siostrzonek P, Suarez F, Corrales M, Rábago R, Gonzalez-Arenas P, Morales R, Sanchez J, Fraile J, Rey M, Martinell J, Niederst PN, Mellwig KP, Schmidt HK, Gleichmann U, Körfer R, Di Bartolomeo S, Bertolissi M, Nardi G, De Monte A, Janssens U, Ochs JG, Klues HG, Hanrath P, Sajjanhar T, Tibby SM, Hatherill M, Anderson D, Murdoch IA, Krivec B, Voga G, Žuran I, Skale R, Parežnik R, Podbregar M, Bonnefoy E, Chevalier P, Kirkorian G, Guidolet J, Marchand A, Bouchayer D, Marcaz PB, Touboul P, Welte T, Molling J, Jepsen MS, Claus G, Klein H, Cinnella G, Dambrosio M, Brienza N, Conte M, Maggiore SM, Leone AM, Brienza A, DiVenere N, Vandewoude K, Poelaert J, Vogelaers D, Garcia RB, Buylaert W, Roosens C, Colardyn F, Annane D, Béllissant E, Pussard E, Asmar R, Lacombe F, Lanata E, Madonna O, Safar M, Giudicelli JF, Raphael JC, Gajdos P, Mattys M, Dumont L, Annaert JF, Mardirosoff C, Goldstein J, Verbeet T, Massaut J, Haas NA, Uhlemann F, Daehnert I, Berger F, Stiller B, Dittrich S, Schulze-Neick I, Eweit P, Lange PE, Langenherp CJM, Pietersen H, Geskes G, Wagenmakers A, Soeters P, Maggiorini M, Brimioulle S, Lejeune P, Delcroix M, Vermeulen F, Stephanazzi J, Naeije R, Kunert M, Stolzenburg H, Scheuble L, Emmerich K, Ulbricht LJ, Krakau I, Gülker H, Broch MJ, Valentín V, Murcia B, Bartual E, Málaga A, Miralles LL, Valls F, Wallin CJ, Sidenö B, Vaage J, Leksell LG, Stuchlinger HG, Seidler D, Hollenstein U, Janata K, Muellner M, Loeffler W, Gamper G, Bur A, Malzer R, Laggner AN, Hirschl MM, Binder M, Herkner H, Bur A, Laggner AN, Turani F, Ceraso C, Lironcurti A, Senesi P, Leonardis C, Sabato AF, Pietersen HG, Langenberg CJM, Geskes G, Wagenmakers AJM, de Lange S, Soeters PB, Royira A, Oussedik L, Cambray C, Glmeno C, Cerda M, Sanchez MA, Lesmes A, Guerrero M, Vigil E, Ortega F, Lucena F, Righini ER, Alvisi R, Marangoni E, Gritti G, Ordóñez A, Hernández A, Pérez-Bernal J, Hinojosa R, Borrego JM, Franco A, López-Barneo J, Pérez-Bernal J, Gutiérrez E, Hinojosa R, Hernández A, Borrego JM, Cerro J, Rincón D, Ordóñez A, Martin R, Saussine M, Sany CL, Calvet B, Raison D, Frapier JM, Wallin CJ, Olsson Å, Nordländer R, Leksell LG, Vasilkov V, Safronov A, Marinchev V, Rodrigues AC, Moraes A, Galas F, Angelim V, Medeiros C, Auler JO, Bellotti G, Pilleggi F, Carmona MJ, Messias ERR, Joseph D, Baigorri F, Artigas A, Blanch L, Wagner F, Dandel M, Günther G, Schulze-Neick I, Weng Y, Loebe M, Hetzer R, Colreavy F, Balea M, Cahalan M, Carpintero JL, de la Fuente MC, Estecha MA, Molina JM, del Fresno LR, Daga D, Toro R, Poullet A, de la Torre MV, Garcia AJ, Michalopoulos A, Rellos K, Skambas D, Liakopoulos O, Geroulanos S. Posters. Intensive Care Med 1996. [DOI: 10.1007/bf03216414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|