title: Development of an objective scoring system for measurement of resident performance on the human patient simulator.
abstract: BACKGROUND
  The decrease in the percentage of patients having cesarean delivery during general anesthesia has led some educators to advocate the increased use of simulation-based training for this anesthetic. The authors developed a scoring system to measure resident performance of this anesthetic on the human patient simulator and subjected the system to tests of validity and reliability.
  
  
  METHODS
  A modified Delphi technique was used to achieve a consensus among several experts regarding a standardized scoring system for evaluating resident performance of general anesthesia for emergency cesarean delivery on the human patient simulator. Eight third-year and eight first-year anesthesiology residents performed the scenario and were videotaped and scored by four attending obstetric anesthesiologists.
  
  
  RESULTS
  Third-year residents scored an average of 150.5 points, whereas first-year residents scored an average of 128 points (P = 0.004). The scoring instrument demonstrated high interrater reliability with an intraclass correlation coefficient of 0.97 (95% confidence interval, 0.94-0.99) compared with the average score.
  
  
  CONCLUSIONS
  The developed scoring tool to measure resident performance of general anesthesia for emergency cesarean delivery on the patient simulator seems both valid and reliable in the context in which it was tested. This scoring system may prove useful for future studies such as those investigating the effect of simulator training on objective assessment of resident performance.
authors.affiliation: Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. bscavone@nmff.org
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Scavone
authors.forename: Michele T
authors.initials: MT
authors.lastname: Sproviero
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McCarthy
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Wong
authors.forename: John T
authors.initials: JT
authors.lastname: Sullivan
authors.forename: Viva J
authors.initials: VJ
authors.lastname: Siddall
authors.forename: Leonard D
authors.initials: LD
authors.lastname: Wade
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000776:Anesthesiology / Q000193:education* / Q000592:standards*; D002585:Cesarean Section; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007430:Intraoperative Care / Q000706:statistics & numerical data; D007442:Intubation, Intratracheal; D015588:Observer Variation; D016544:Patient Simulation; D011247:Pregnancy; D011300:Preoperative Care; D015203:Reproducibility of Results