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J Crit Care. 2018 Oct;47:133-138. doi: 10.1016/j.jcrc.2018.06.021. Epub 2018 Jun 25.

Decision-making skills improve with critical care training: Using simulation to measure progress.

Author information

1
Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, United States of America; Howard and Joyce Wood Simulation Center, Washington University School of Medicine, St Louis, MO, United States of America. Electronic address: murrayd@wustl.edu.
2
Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, United States of America; Critical Care Medicine Division, Department of lgnesthesiology, Washington University School of Medicine, St Louis, MO, United States of America.
3
Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, United States of America; Critical Care Medicine Division, Department of lgnesthesiology, Washington University School of Medicine, St Louis, MO, United States of America; Goldfarb School of Nursing at Barnes-Jewish College, St Louis, MO, United States of America.
4
Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, United States of America; Howard and Joyce Wood Simulation Center, Washington University School of Medicine, St Louis, MO, United States of America.
5
Foundation for Advancement of International Medical Education and Research, Philadelphia, PA, United States of America.

Abstract

PURPOSE:

Health care professionals are expected to acquire decision-making skills during their training, but few methods are available to assess progress in acquiring these essential skills. The purpose of this study was to determine whether a simulation methodology could be used to assess whether decision-making skills improve during critical care training.

MATERIALS AND METHODS:

Sixteen simulated scenarios were designed to assess a critical care provider's ability to make decisions in the care of a critical ill patient. Seventeen (17) critical care providers managed 8 of the scenarios early during their training and then managed a second set of 8 scenarios (T2) at the conclusion of their training.

RESULTS:

Provider's mean global scenario scores (0-9) increased significantly fromT1 and T2 (5.64 ± 0.74) and (6.54 ± 0.64) with a large effect size (1.3). Acute care nurse practitioners and fellows achieved similar overall scores at the conclusion of their training (ACNP 6.43 ± 0.57; Fellows 6.64 ± 0.72).

CONCLUSIONS:

These findings provide evidence to support the validity of a simulation-based method to assess progress in decision-making skills. A simulation methodology could be used to establish a performance standard that determined a provider's ability to make independent decisions.

KEYWORDS:

Critical care; Diagnostic skills, acute care nurse practitioners; Educational measurement; Intensive care units; Simulation

PMID:
29981998
DOI:
10.1016/j.jcrc.2018.06.021
[Indexed for MEDLINE]

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