An Italian version of the Ottawa Crisis Resource Management Global Rating Scale: a reliable and valid tool for assessment of simulation performance.

Objective measurement of simulation performance requires a validated and reliable tool. However, no published Italian language assessment tool is available. Translation of a published English language tool, the Ottawa Crisis Resource Management Global Rating Scale (GRS), may lead to a validated and reliable tool. After developing an Italian language translation of the English language tool, the study measured the reliability of the new tool by comparison with the English language tool used independently in the same simulation scenarios. In addition, the validity of the Italian language tool was measured by comparison to a skills score also applied independently. The correlation coefficient between the Italian language overall GRS and the English language overall GRS was 0.82 (adjusted 95 % confidence interval: 0.62-0.92). The correlation coefficient between the Italian language overall GRS and the skill score was 0.85 (adjusted 95 % confidence interval 0.68-0.94). This study demonstrated that the Italian language GRS has acceptable reliability when compared with the English language tool, suggesting that it can be used reliably to evaluate the performance during simulated emergencies. The study also suggests that the tool has acceptable validity for assessing the simulation performance. The study suggests that the Italian language GRS translation has reasonable reliability when compared with the English language GRS and reasonable validity when compared with the assessment of the skills scores. Data suggest that the instrument is adequately reliable for informal and formative type of examinations, but may require further confirmation before use for high-stake examinations such as licensing.

Identifying deficiencies in national and foreign medical team responses through expert opinion surveys: implications for education and training.

INTRODUCTION: Unacceptable practices in the delivery of international medical assistance are reported after every major international disaster; this raises concerns about the clinical competence and practice of some foreign medical teams (FMTs). The aim of this study is to explore and analyze the opinions of disaster management experts about potential deficiencies in the art and science of national and FMTs during disasters and the impact these opinions might have on competency-based education and training. METHOD: This qualitative study was performed in 2013. A questionnaire-based evaluation of experts' opinions and experiences in responding to disasters was conducted. The selection of the experts was done using the purposeful sampling method, and the sample size was considered by data saturation. Content analysis was used to explore the implications of the data. RESULTS: This study shows that there is a lack of competency-based training for disaster responders. Developing and performing standardized training courses is influenced by shortcomings in budget, expertise, and standards. There is a lack of both coordination and integration among teams and their activities during disasters. The participants of this study emphasized problems concerning access to relevant resources during disasters. CONCLUSION: The major findings of this study suggest that teams often are not competent during the response phase because of education and training deficiencies. Foreign medical teams and medically related nongovernmental organizations (NGOs) do not always provide expected capabilities and services. Failures in leadership and in coordination among teams are also a problem. All deficiencies need to be applied to competency-based curricula.