Development and Pilot Testing of a Programmatic System for Competency Assessment in US Anesthesiology Residency Training.

Autor:	Woodworth GE; From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon., Goldstein ZT; Department of Anesthesiology, Cedars Sinai Medical Center, Los Angeles, California., Ambardekar AP; Department of Anesthesiology and Pain Management, University of Texas, Southwestern Medical Center, Dallas, Texas., Arthur ME; Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia., Bailey CF; Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia., Booth GJ; Uniformed Services University of the Health Sciences, Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia., Carney PA; Division of Hospital Medicine, Department of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, Oregon., Chen F; Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina., Duncan MJ; Department of Anesthesiology, University of Missouri-Kansas City, Kansas City, Missouri., Fromer IR; Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota., Hallman MR; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington., Hoang T; From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon., Isaak R; Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina., Klesius LL; Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Ladlie BL; Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota., Mitchell SA; Department of Anesthesiology, Indiana University, Indianapolis, Indiana., Miller Juve AK; From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon., Mitchell JD; Department of Anesthesiology, Critical Care, and Perioperative Medicine, Henry Ford Health, Detroit, Michigan., McGrath BJ; Department of Anesthesiology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida., Shepler JA; Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Sims CR 3rd; Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota., Spofford CM; Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin., Tanaka PP; Department of Anesthesiology, Stanford University, Stanford, California., Maniker RB; Department of Anesthesiology, Columbia University, New York, New York.
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2024 May 01; Vol. 138 (5), pp. 1081-1093. Date of Electronic Publication: 2023 Oct 06.
DOI:	10.1213/ANE.0000000000006667
Abstrakt:	Background: In 2018, a set of entrustable professional activities (EPAs) and procedural skills assessments were developed for anesthesiology training, but they did not assess all the Accreditation Council for Graduate Medical Education (ACGME) milestones. The aims of this study were to (1) remap the 2018 EPA and procedural skills assessments to the revised ACGME Anesthesiology Milestones 2.0, (2) develop new assessments that combined with the original assessments to create a system of assessment that addresses all level 1 to 4 milestones, and (3) provide evidence for the validity of the assessments. Methods: Using a modified Delphi process, a panel of anesthesiology education experts remapped the original assessments developed in 2018 to the Anesthesiology Milestones 2.0 and developed new assessments to create a system that assessed all level 1 through 4 milestones. Following a 24-month pilot at 7 institutions, the number of EPA and procedural skill assessments and mean scores were computed at the end of the academic year. Milestone achievement and subcompetency data for assessments from a single institution were compared to scores assigned by the institution's clinical competency committee (CCC). Results: New assessment development, 2 months of testing and feedback, and revisions resulted in 5 new EPAs, 11 nontechnical skills assessments (NTSAs), and 6 objective structured clinical examinations (OSCEs). Combined with the original 20 EPAs and procedural skills assessments, the new system of assessment addresses 99% of level 1 to 4 Anesthesiology Milestones 2.0. During the 24-month pilot, aggregate mean EPA and procedural skill scores significantly increased with year in training. System subcompetency scores correlated significantly with 15 of 23 (65.2%) corresponding CCC scores at a single institution, but 8 correlations (36.4%) were <30.0, illustrating poor correlation. Conclusions: A panel of experts developed a set of EPAs, procedural skill assessment, NTSAs, and OSCEs to form a programmatic system of assessment for anesthesiology residency training in the United States. The method used to develop and pilot test the assessments, the progression of assessment scores with time in training, and the correlation of assessment scores with CCC scoring of milestone achievement provide evidence for the validity of the assessments. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 International Anesthesia Research Society.)
Databáze:	MEDLINE
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