Summary:

For the AMEE Simulation Committee Dr. Dominique Piquette reports on a trial to use simulation to assess resident learning during ICU rotation in Canada

Article:

Strategies to manage residents’ fatigue must balance patient safety, resident education and resident wellbeing. The trade-offs among these are not fully understood. The Intensive Care Unit Resident Scheduling (InCURS) trial is a Canadian cluster-Randomized Control Trial that will provide evidence to inform resident scheduling practices and policies. To evaluate the effects of 16-hour vs. 24-hour resident duty schedules on resident education, we designed a 3-station assessment that residents complete at the end of their 4-week ICU rotation. We use simulation for two of these stations: part-task trainers for the assessment of bag-mask ventilation and central line insertion, and simulated patients for simulated end-of-life discussions with a family member of an ICU patient.

Two independent raters assess residents’ performance with existing assessment tools for which relevant validity evidence existed: the OSATS-GRS for the procedural station, and a 5-item communication GRS for the communication station. Two raters assess residents’ procedural performance via distant review of video-recordings, whereas communication skills are assessed in real-time by the simulated family member and, at a later time, by a second rater through distant review of video-recorded performance.

This study will provide high-quality ICU education outcome data on more than a thousand rotating specialty residents across Canada.