Simulation-Based Assessment to Evaluate Cognitive Performance in an Anesthesiology Residency Program

Abstract Background Problem solving in a clinical context requires knowledge and experience, and most traditional examinations for learners do not capture skills that are required in some situations where there is uncertainty about the proper course of action. Objective We sought to evaluate anesthesiology residents for deficiencies in cognitive performance within and across 3 clinical domains (operating room, trauma, and cardiac resuscitation) using simulation-based assessment. Methods Individual basic knowledge and cognitive performance in each simulation-based scenario were assessed in 47 residents using a 15- to 29-item scenario-specific checklist. For every scenario and item we calculated group error scenario rate (frequency) and individual (resident) item success. For all analyses, alpha was designated as 0.05. Results Postgraduate year (PGY)-3 and PGY-4 residents' cognitive items error rates were higher and success rates lower compared to basic and technical performance in each domain tested (P < ....