Workplace-based assessment for anesthesia residents: efficacy and competence issues

Autor: K. Bielka, I. Kuchyn, H. Fomina, S. Tarasenko, B. Savchenko, L. Skolska, O. Khomenko, M. Omelchuk, I. Lisnyy, S. Yaroslavska, V. Maznichenko, O. Naumenko, V. Kovalenko
Jazyk: English<br />Ukrainian
Rok vydání: 2023
Předmět:
Zdroj: Медицина неотложных состояний, Vol 19, Iss 5, Pp 352-360 (2023)
Druh dokumentu: article
ISSN: 2224-0586
2307-1230
DOI: 10.22141/2224-0586.19.5.2023.1611
Popis: Background. Workplace-based assessment (WPBA) is a new technology for evaluating medical residents that is believed to be more effective than traditional multiple-choice tests or exam-based assessment methods. The aim of the study was to investigate the WPBA efficacy in final-year medical residents: multi-source feedback (360°) assessment, direct procedure assessment (Anaesthesia-Clinical Evaluation Exercise (A-CEX)) and clinical case-based assessment, and to identify difficult competencies, which graduate residents acquire the least successfully. Materials and methods. From April 1 to June 15, 2023, 36 residents were evaluated at the workplace: the multi-source feedback 360°-evaluation form was filled out by three representatives of the medical team where the resident worked during the on-site part of the residency (1 anesthesiologist, 1 nurse and 1 other specialist); the form of direct procedure assessment was filled out by the teacher on face-to-face bases directly during the resident’s performance of the general anesthesia in low-risk patients (American Society of Anesthesiologists (ASA) I or II), preoperative examination of low-risk patients (ASA I or II) and neuraxial anesthesia in low-risk patients (ASA I or II) with the following feedback; assessment based on a clinical case was carried out by teachers during the conference of residents, where each of them presented a clinical case of anesthetic management or treatment of a critically ill patient. Results. According to the results of the multi-source feedback (360°) evaluation, most of the residents have received 7 or more points out of 10 possible. Communication with the medical team (odds ratio (OR) 1.9 [1.05–3.5], p = 0.048) and management in a critical situation (OR 2 [1.14–3.83], p = 0.024) were most difficult competencies during the multi-source feedback (360°) assessment. During direct procedure of general anesthesia, the most difficult competencies were: 1) management in a critical situation — knowledge/recognition of risks and how to avoid and treat them (OR 5.29 [1.9–14.4], p = 0.001 compared to documentation); 2) solving problems, making decisions (OR 12.6 [1.5–10,4], p = 0.007 compared to documentation); 3) interaction in the team (OR 2.7 [1.1–6.5], p = 0.049). No problematic competencies were identified during the assessment of neuraxial anesthesia competencies and preoperative examination. Conclusions. WPBA techniques such as multi-source feedback (360°) assessment, direct procedure evaluation (A-CEX) and clinical case-based assessment are effective in final year residents, improving their communication skills, readiness to work independently, help identify skill deficiencies. Communication with the medical team and management in a critical situation were difficult competencies during the multi-source feedback (360°) evaluation. Difficult competences during the direct evaluation of general anesthesia turned out to be the management in a critical situation; solving problems, making decisions; interaction in the team. No problematic competencies were identified during the assessment of neuraxial anesthesia competencies and preoperative examination.
Databáze: Directory of Open Access Journals
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