Testing a communication assessment tool for ethically sensitive scenarios: Protocol of a validation study

Background: Although well-designed instruments to assess communication during medical interviews and complex encounters exist, assessment tools that differentiate between communication, empathy, decision-making, and moral judgment are needed to assess different aspects of communication during situations defined by ethical conflict. To address this need, we developed an assessment tool that differentiates competencies associated with practice in ethically challenging situations. The competencies are grouped into three distinct categories

Prestige technology in the evolution and social organization of early psychological science

Instruments have become a central feature of psychological science. Their introduction into a research paradigm is typically framed in terms of their practical utility in offering calibration and precision in the presentation, representation, and rec

Beyond fidelity: Deconstructing the seductive simplicity of fidelity in simulator-based education in the health care professions

Summary Statement Fidelity has become a ubiquitous feature of discourse in simulation studies. Recent studies have highlighted the often ambiguous and contradictory manner in which fidelity has been defined, with each definition emphasizing different physical and functional features of simulation. We suggest that regarding fidelity as an objective property of a simulation obscures the interactive nature of the educator-learner relationship and should be abandoned. Rather than conceiving training as tasks performed by an individual in isolation, we suggest that it is more accurately understood as the social learning of affordances. Affordances represent the functional features of a simulator, which are taken as relevant in a specific learning context by means of analogy. Training is successful to the extent that educators and learners share an understanding of those affordances. Even when explicitly formulated, the concept of fidelity has greater difficulty accounting for the complex, interactional features of the training situation in comparison with accounts based on social learning. We conclude that continued attempts to redefine and use fidelity in the context of training will likely yield little benefit to the field compared with an interactive social learning framework

Subjective awareness of ultrasound expertise development: individual experience as a determinant of overconfidence

Medical decision-making requires years of experience in order to develop an adequate level of competence to successfully engage in safe practice. While diagnostic and technical skills are essential, an awareness of the extent and limits of our own knowledge and skills is critical. The present study examines clinicians’ subjective awareness in a diagnostic cardiac ultrasound task. Clinicians answered diagnostic and treatment related questions for a range of pathologies. Following these questions, clinicians indicated their level of confidence in their response. A comparison of response accuracy and confidence revealed that clinicians were generally overconfident in their responses. Critically, we observed that a clinician’s overconfidence was negatively correlated with prior experience: clinicians that had more prior experience expressed less overconfidence in their performance such that some clinicians were in fact underconfident. We discuss the implications for training in medical education and decision-making

Outcomes from extensive training in critical care echocardiography: Identifying the optimal number of practice studies required to achieve competency

Purpose Optimal instruction and assessment of critical care ultrasound (CCUS) skills requires an assessment tool to measure learner competency and changes over time. In this study, a previously published tool was used to monitor the development of critical care echocardiography (CCE) competencies, the attainment of performance plateaus, and the extent to which previous experience influenced learning. Materials and methods A group of experts used the Rapid Assessment of Competency in Echocardiography (RACE) scale to rate a large pool of CCE studies performed by novices in a longitudinal design. A total of 380 studies performed by twelve learners were assessed; each study was independently rated by two experts. Results Learners demonstrated improvement