Simulation-Based Simulation-Based Assessment Assessment

Emily M. Hayden, MD, MHPEEmily M. Hayden, MD, MHPE

Associate Director for Curricular Associate Director for Curricular IntegrationIntegration

Gilbert Program in Medical SimulationGilbert Program in Medical SimulationHarvard Medical SchoolHarvard Medical School

Director of Simulation Faculty DevelopmentDirector of Simulation Faculty DevelopmentDivision of Medical SimulationDivision of Medical Simulation

Department of Emergency MedicineDepartment of Emergency MedicineMassachusetts General HospitalMassachusetts General Hospital

DisclosureDisclosure

Nothing to DiscloseNothing to Disclose

Goals and ObjectivesGoals and Objectives

Goal: To Discuss Goal: To Discuss Simulation-Based Simulation-Based Assessment (SBA)Assessment (SBA)

Goals and ObjectivesGoals and Objectives

Objectives:Objectives:

1. Describe reasons for 1. Describe reasons for SBASBA

2. Describe the current 2. Describe the current state state of SBAof SBA

Why use SBA?Why use SBA?

Procedural trainingProcedural training Chance-events of Chance-events of

apprenticeshipsapprenticeships Rare eventsRare events Reduced work hoursReduced work hours TeamworkTeamwork

Current State of SBACurrent State of SBA

FormativeFormative SummativeSummative High-stakesHigh-stakes RecurrentRecurrent

Levels of Medical Levels of Medical TrainingTraining Undergraduate medical Undergraduate medical

education (UME)education (UME) Graduate medical education Graduate medical education

(GME)(GME) Continuing medical education Continuing medical education

(CME)(CME)

Formative SBAFormative SBA

Trainees want feedbackTrainees want feedback Trainees want to be observedTrainees want to be observed Debriefing component of Debriefing component of

simulationsimulation

Formative SBAFormative SBA

UMEUME– HMS preclinical simulationHMS preclinical simulation

GMEGME– MGH Department of MedicineMGH Department of Medicine

CMECME– Center for Medical Simulation Crisis Center for Medical Simulation Crisis

Resource Management coursesResource Management courses

Example of UME Example of UME Formative SBAFormative SBA

Formative SBAFormative SBA

UMEUME– HMS preclinical simulationHMS preclinical simulation

GMEGME– MGH Department of MedicineMGH Department of Medicine

CMECME– Center for Medical Simulation Crisis Center for Medical Simulation Crisis

Resource Management coursesResource Management courses

Summative SBASummative SBA

UME: less often usedUME: less often used GME: GME:

– ACGME CompetenciesACGME Competencies CME: CME:

– Workplace-based assessmentsWorkplace-based assessments

Summative SBA in Summative SBA in GMEGME ACGME CompetenciesACGME Competencies

– Patient CarePatient Care– Medical KnowledgeMedical Knowledge– Practice-based Learning and Practice-based Learning and

ImprovementImprovement– Interpersonal and Communication Interpersonal and Communication

SkillsSkills– ProfessionalismProfessionalism– Systems-based PracticeSystems-based Practice

High-stakes SBAHigh-stakes SBA

UME: UME: – USMLE Clinical Skills Step 2USMLE Clinical Skills Step 2

GME:GME:– Surgical trainingSurgical training

CME: CME: – Oral boardsOral boards– Carotid artery stentingCarotid artery stenting

Recurrent SBARecurrent SBA

Ericsson’s Model of Ericsson’s Model of Acquisition of ExpertiseAcquisition of Expertise– Deliberate practice with Deliberate practice with

immediate feedbackimmediate feedback– Opportunities for repeated Opportunities for repeated

performanceperformanceEricsson, KA. Deliberate Practice and Acquisition of Expert Performance: a General Overview. Academic Emergency Medicine. 2008; 15(11), 988-994.