Use of cognitive task analysis to guide the development of performance-based assessments for intraoperative decision making.
Mil Med
; 178(10 Suppl): 22-7, 2013 Oct.
Article
in En
| MEDLINE
| ID: mdl-24084302
BACKGROUND: There is a paucity of performance-based assessments that focus on intraoperative decision making. The purpose of this article is to review the performance outcomes and usefulness of two performance-based assessments that were developed using cognitive task analysis (CTA) frameworks. METHODS: Assessment-A used CTA to create a "think aloud" oral examination that was administered while junior residents (PGY 1-2's, N = 69) performed a porcine-based laparoscopic cholecystectomy. Assessment-B used CTA to create a simulation-based, formative assessment of senior residents' (PGY 4-5's, N = 29) decision making during a laparoscopic ventral hernia repair. In addition to survey-based assessments of usefulness, a multiconstruct evaluation was performed using eight variables. RESULTS: When comparing performance outcomes, both approaches revealed major deficiencies in residents' intraoperative decision-making skills. Multiconstruct evaluation of the two CTA approaches revealed assessment method advantages for five of the eight evaluation areas: (1) Cognitive Complexity, (2) Content Quality, (3) Content Coverage, (4) Meaningfulness, and (5) Transfer and Generalizability. CONCLUSIONS: The two CTA performance assessments were useful in identifying significant training needs. While there are pros and cons to each approach, the results serve as a useful blueprint for program directors seeking to develop performance-based assessments for intraoperative decision making.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Task Performance and Analysis
/
Clinical Competence
/
Decision Making
/
Education, Medical
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Mil Med
Year:
2013
Document type:
Article
Country of publication:
United kingdom