Simulations Differentiate Novice From Skilled Physicians


May 14, 2010

May 14, 2010 – Research published in the April issue of The Journal of Simulation in Healthcare demonstrates the potential for high-fidelity simulations in assessing the performance of interventional cardiologists. The analysis, led by researchers at the American Board of Internal Medicine (ABIM), found that simulations can be used to identify physicians who are extremely poor performers and may not be providing appropriate patient care.

The research examined the results of sophisticated mannequin simulators that electronically record detailed operator’s actions and the patient’s state. The study simulated cases with 115 physicians at three levels of expertise – novice, skilled or expert. The evaluation of performance of the physician effectively distinguished the novice group from the skilled and expert group. The cases and scoring methodology used in the study were developed by a panel of interventional cardiology experts, with technical assistance from Medical Simulation Corporation.

Interventional cardiologists in the United States perform more than 1 million procedures per year, many of them highly complex.

The case scenarios evaluated physicians’ technical and cognitive skills around specific competencies needed to practice interventional cardiology, including stent positioning. The simulations also introduced unexpected complications, such as coronary perforation. The subjects completed a questionnaire, one practice case and six test cases on Medical Simulation Corporation’s SimSuite simulators to evaluate their experience. Approximately 90 percent of the study participants thought that the cases were well simulated and presented situations encountered in practice.

“ABIM continues to look for authentic and rigorous ways to assess physician performance as part of the maintenance of certification program,” said Rebecca Lipner, vice president for psychometrics and research analysis. “This pilot project demonstrates the potential for ABIM to use high-fidelity simulations in physician assessments.”

ABIM offers simulations for interventional cardiologists at Medical Simulation Corporation’s SimSuite education centers, and several society meetings and conferences each year.

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