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by which they are assessed and taught. A common theme in the process of developing core competencies is the use of consensus agreement and a focus on providing high quality patient care. Well defined core competencies provide a strong framework for simulation based assessments. Curriculum developers and simulationists may use the competencies to ensure global coverage of important clinical areas. Transitioning from a list of competencies to an actual assessment requires careful attention to the desired learning outcomes. While this can be facilitated by defining the knowledge, skills and attitudes necessary for successful patient care interactions, the wide variety of behaviors, responses and situations in clinical practice adds considerable complexity to the process.2 In a 2003 article entitled “Reliability and Validity of a Simulation-based Acute Care Skills Assessment for Medical Students and Residents”3 the authors detail the process of developing and evaluating a simulation based assessment of acute care skills. Figure 1 highlights the

major steps in this process. The starting point for this process was a needs assessment. In reviewing the literature, the group found that the knowledge base for acute care skills was traditionally assessed using a pencil and paper test. In addition, the physical examination skills had traditionally been assessed using standardized patients. In review of their assessment, it was duly noted that critical care events are not easily modeled with standardized patients. Moreover, the ability to cite and describe acute care management strategies does not ensure that the physician can actually provide treatment. Despite these known weaknesses in the current curriculum, graduate physicians are expected to be able to manage acute care patients. Developing the simulation based assessment of acute care skills was a multistep process. Once a full body physiologic simulator was chosen, faculty used a consensus approach to select 10 clinical scenarios that fairly represented the content domain and skills unique to critical and emergency situations. The next step

Figure 1. The multi-step process of developing valid and reliable simulation based assessments. Source: Carla Pugh, MD.

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22/11/2013 15:45

MEdSim Magazine - Issue 4/2013  

The Journal for Healthcare Education, Simulation and Training.