1. Simulation-Based Assessment Emily M. Hayden, MD, MHPE Associate Director for Curricular Integration Gilbert Program in Medical Simulation Harvard Medical School Director of Simulation Faculty Development Division of Medical Simulation Department of Emergency Medicine Massachusetts General Hospital Simulation-Based Assessment Emily M. Hayden, MD, MHPE Associate Director for Curricular Integration Gilbert Program in Medical Simulation Harvard Medical School Director of Simulation Faculty Development Division of Medical Simulation Department of Emergency Medicine Massachusetts General Hospital

2. Disclosure Nothing to Disclose Nothing to Disclose

3. Goals and Objectives Goal: To Discuss Simulation- Based Assessment (SBA)

4. Goals and Objectives Objectives: 1. Describe reasons for SBA 2. Describe the current state of SBA

5. Why use SBA? Procedural training Procedural training Chance-events of apprenticeships Chance-events of apprenticeships Rare events Rare events Reduced work hours Reduced work hours Teamwork Teamwork

6. Current State of SBA Formative Formative Summative Summative High-stakes High-stakes Recurrent Recurrent

7. Levels of Medical Training Undergraduate medical education (UME) Undergraduate medical education (UME) Graduate medical education (GME) Graduate medical education (GME) Continuing medical education (CME) Continuing medical education (CME)

8. Formative SBA Trainees want feedback Trainees want feedback Trainees want to be observed Trainees want to be observed Debriefing component of simulation Debriefing component of simulation

9. Formative SBA UME UME –HMS preclinical simulation GME GME –MGH Department of Medicine CME CME –Center for Medical Simulation Crisis Resource Management courses

10. Example of UME Formative SBA

11. Formative SBA UME UME –HMS preclinical simulation GME GME –MGH Department of Medicine CME CME –Center for Medical Simulation Crisis Resource Management courses

12. Summative SBA UME: less often used UME: less often used GME: GME: –ACGME Competencies CME: CME: –Workplace-based assessments

13. Summative SBA in GME ACGME Competencies ACGME Competencies –Patient Care –Medical Knowledge –Practice-based Learning and Improvement –Interpersonal and Communication Skills –Professionalism –Systems-based Practice

14. High-stakes SBA UME: UME: –USMLE Clinical Skills Step 2 GME: GME: –Surgical training CME: CME: –Oral boards –Carotid artery stenting

15. Recurrent SBA Ericsson’s Model of Acquisition of Expertise Ericsson’s Model of Acquisition of Expertise –Deliberate practice with immediate feedback –Opportunities for repeated performance Ericsson, KA. Deliberate Practice and Acquisition of Expert Performance: a General Overview. Academic Emergency Medicine. 2008; 15(11), 988-994.