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EVALUATION OF PERFORMANCE Prof. Mohamed Ezzat Moemen Founder of Anaesthesia & Intensive Care, Faculty of Medicine, Zagazig University


Expectations 

What do you expect to learn from this lecture?


Answer  At

the end of this lecture you will be able

to: 

define a new paradigm of clinical performance,

know how it can be implemented,

know how to achieve clinical competence,

know how to evaluate clinical performance.


Performance  The   

performing number of cases, completing number of years, a core of learning by doing,

 The   

past paradigm:

new paradigm:

competence-based knowledge, technical & non-technical skills, Affection : attitude & behavior.


Continued learning

TOT = Patient Safety

Change in Practice


Trainee

TOT frame Scientific supervisor

Trainer


Requirements for Implementation  Change

of culture

Institution & Individuals: 

tools,

real patients,

feedback.


Tools context lectures

simulators

scenarios

cases videos


The Feedback  Dialogue  Fuel

between trainer and trainee,

of the evaluation process,

 Reflection  Informal  Motion

of the positive and negative,

& formal process, not an event,

of trainer round the learning cycle.


Domains of Supervision

Performance

Evaluation


Domains of Supervision Types: Clinical & Educational,  Examples: Appraisal, Mentoring, Coaching,  In Practice: The 7 C’s: 

 

 

 

Conversation Curiosity Contexts Complexity Creativity Caution Care


Promotion of Learning

Miller's Pyramid Educational Model


The Cycle of Appraisal


KOLB’S Learning Cycle


Pendleton Rules  Learner

is ready for feedback,

 Learner

says what he did well,

 Observer

says that he did well,

 Observer

says what should be improved,

 Observer

shows how it can be improved,

 Plan

for improvement is agreed upon,

 Summary

and agenda for next dialogue.


The Competence Model  Unconscious

Incompetence

 Conscious

Incompetence

 Conscious

Competence

 Unconscious

Competence

Log – Book is checked periodically


Learning in the OR A

challenge context for learning,

 Trainer

is willing to learn,

 Trainee

is prepared and oriented,

 Knowledge,

core.

skills and affections are the


Evaluation Aspects  Evaluation

of Knowledge,

 Evaluation

of Skills,

 Evaluation

of Affection,

Needs: Costs, change of culture


What to Evaluate? The SMART Learning Process


How to evaluate?  OSCE  Real  Pre

patients

– and Post - testing


Evaluation of Performance  Goals:   

  

To give feedback on past performance, To chart continuing progress, To identify developmental needs, To prevent developing problems, To root out poorly performing doctors, To help re-validation, re-licensing and re – certification.


Evaluation of knowledge 

Written,

MCQs,

Oral,

Clinical.


Evaluation of Skills Training devices,  Simulators,  Real patients,  Pretest & post test,  OSCE. 


Evaluation of Non-technical Skills  OSCE:  

Ethics and communication skills, Dynamic decision – making,

 Affection:

Observation of attitude,  Safety Attitude Questionnaire,  Observation of behavior,  Incident Report. 


Incident reporting


Evaluation of Technical Skills Doctor – Patient interaction: 

OSCE,

Difficult Airway,  Vascular Access,  CPR,  Pre – and Post – Testing, 

Doctor – Machine interaction: 

Anaesthetic Machine & ventilators, adjuncts,…


Evaluation of Performance in Anaesthesia 

Anesthesia Clinic: 

  

Operating Room:  

History: Ethics and communication skills, Examination: knowledge, Investigations: decision – making.

Anesthesia machine, ventilators, monitors, adjuncts, Skills: technical and non-technical.

PACU: 

Knowledge, skills and affection.


FDRTPC including BLS  Evaluation

by PRE- and POST-

TESTING,  Course Content,  Trainers,  Trainees,  Implementation,  Evaluation,


Conclusions The new paradigm of performance is of value.  Its core is a change in culture and feedback.  The SMART learning process should be 

 

simple and cost – effective.

Education should aim at 

 

skill acquisition knowledge retention and attitude development.


Conclusions(cont’d)  Evaluation  

should include

dynamic decision-making and human-machine interaction

 Evaluation

is of benefit for

the organization,  the line-manager and  the job-holder. 



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