PURPOSE: High-fidelity patient simulation provides a unique opportunity to develop clinical skills through participation in controlled scenarios. At our institution, simulation plays an integral role in the education of senior medical students during a mandatory 4 week clerkship in critical care. As a part of the final examination, students are required to assess and manage patients with progressive circulatory shock and acute respiratory failure. Previous studies have demonstrated that evaluation of performance is aided by the use of a global score of performance and a checklist score of expected actions. The purpose of this study was to determine the correlation between a global score and a checklist score in this setting.
METHODS: One hundred consecutive senior medical students were tested on the final day of a critical care clerkship. Performance was assessed during a 15 minute patient simulation by use of a validated binary checklist of 25 expected actions including intubation, placement of a central venous catheter and use of vasoactive agents. In addition a validated global score on a scale of 1 to 10 was generated. This score was based on evaluator assessment of student confidence, ability to integrate data, and speed of decision making. A scatter plot was used to relate the two scores and a best-fit line was generated.
RESULTS: A correlation for the data revealed that the checklist and global scores were significantly related, r = + 0.65, p < 0.001, 2 tails.
CONCLUSION: There is a moderate positive relationship between checklist scoring and global scoring of student performance during simulation of a critically ill patient after completion of a clerkship incorporating simulation-based activities. These scoring instruments are complimentary. Their combined use enhances overall assessment of student performance.
CLINICAL IMPLICATIONS: Both scoring instruments should be used in the comprehensive evaluation of student performance in this educational setting.
DISCLOSURE: Rajesh Balagani, No Financial Disclosure Information; No Product/Research Disclosure Information