Conventional Medical Education and the History of Simulation in Radiology

Assessment Methods:There are three main categories for assessing simulation skills: psychometric tools for interpersonal/communications skills; checklists for procedural skills; and pretests and posttests for knowledge.Psychometric Tools for Interpersonal/Communications SkillsPsychometrics, instruments, or metrics used to conduct assessment are effective for simulations involving interpersonal/communications skills. Behaviorally anchored rating scale involved the assessment of four elements performed by the physician during the simulations including establishing an appropriate environment, engaging the patient, disclosure/apology, and helping the patient achieve an approach to the event. The encounter is videotaped and rated on a 7-point scale: 1 (extremely ineffective) to 7 (extremely effective). This assessment method can give structured insight to the learner on areas of strength and weakness.Another way is the 360-degree evaluation form, which includes a checklist of 10 items (pertaining to important interpersonal/communication skills), which were each rated using a Likert response format. Feedback from the attending physician and the patient was given to the resident after an observed encounter, and a personal quality improvement interview was conducted.The third way is the Kalamazoo Essential Elements Communication Checklist that consists of seven key elements of physician communications: (1) builds relationships, (2) opens the discussion, (3) gathers information, (4) understands patient’s perspective, (5) shares information, (6) reaches agreement, and (7) provides closure.Procedural SkillsChecklist assesses whether critical actions were performed for specific scenarios.Pretests and Posttests for KnowledgeThese checklists included procedure time, fluoroscopy time, amount of contrast used, and lesion coverage.Observational assessment toolProcedure-specific checklists are based on accurate performance of procedural steps and scoring based on error execution. Components of generic global rating scales that can be applied to a wide variety of simulation scenarios and specialties include items such as respect for tissue, efficiency of time and motion, instrument handling, knowledge of instruments, use of assistants, flow of operation, forward planning, and knowledge of specific procedural steps.

Review of simulation methods

Main categories for assessing simulation skills: •Psychometric Tools for Interpersonal/Communication Skills•Checklists for procedural skills•Pretests and posttests for knowledge

Part-task trainers, computer-enhanced mannequins (CEM), virtual reality simulators, and PACS simulators.

The trainee and evaluators watch the simulation to debrief and assess the performance

The article summarizes the simulation methods used in radiology for different purposes. There is no defined question in the article. Choosing the method depends on the goal of the simulation, such as simple task, complex task covering many clinical competencies or simulation for formal assessment.

According to the authors, further work is required to validate some of the assessment tools so that they can be used to document proficiency.

Advantages of simulation (based on review) for training: -  Allows trainees to gain experience when mitigating the risk of harm to patients-  Allows for an interchangeable curriculum depending on trainees’ level- Affords the trainees’ multiple opportunities to practice and learn in a less stressful environment-  Acquire skills, which can be translated to improve in both technical/ procedural and diagnostic/interpretive skills.

The paper provides a review, but distinguishes possible simulations to be performed:Medical simulators can be organized:- Part-task trainers- Computer-enhanced mannequins (CEM)- Virtual reality simulators- PACS SimulatorsDescribing simulation training for procedural skills, interpretive and noninterpretive skills, team-based training and crisis management, professionalism and communication skills, as well as hybrid and in situ applications of simulation training.