SESSION TITLE: Education and Teaching in Critical Care
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Wednesday, October 29, 2014 at 07:30 AM - 08:30 AM
PURPOSE: Assessment of trainees for competency in performing procedures is required by The Accreditation Council for Graduate Medical Education. The method for such assessments is neither specified nor standardized. We report current practices for assessment of procedural competence in pulmonary/critical care training programs in the United States.
METHODS: We surveyed 134 pulmonary/critical care fellowship programs in February 2014.
RESULTS: A total of 98 programs (73%) responded. All programs assess procedural competency in their trainees but less than half (46/98, 47%) use a formal competency assessment tool. In most instances this tool is a checklist (42/46, 91%), used with direct observation of procedural skills in a simulated environment (12%), or in real patients (50%), or both (38%). In addition to checklist assessment of hand skills, 27/46 programs (59%) require completion of a specified number of procedures;11/46 (24%) use observation by faculty alone, and 4/46 programs (8.7%) accept completion of a minimum number of procedures as the only criterion for competency. Trainees designated to be competent in any procedure during residency are re-tested by 54.2% of fellowship programs. Several programs (22/98, 22.5%) allow trainees to perform procedures independently prior to assessment of competency. Unlike programs that require competency assessments, most of these 22 programs do not re-test their trainees if they were previously designated competent in a procedure during residency training (73% vs. 38%, p=0.004). The most frequently cited barriers to assessment of procedural competency are time, paucity of trained faculty, and unavailability of assessment tools such as validated checklists.
CONCLUSIONS: Assessment of competency in procedural skills in pulmonary/critical care trainees is not uniform. A majority of training programs do not use any formal procedural competency assessment tools.
CLINICAL IMPLICATIONS: Validated and readily available checklists for evaluation of directly observed procedures, combined with faculty development, should help standardize assessment of procedural competency in training programs in the United States.
DISCLOSURE: The following authors have nothing to disclose: Subani Chandra, Gabriel Bosslet
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