title: Frame-of-reference training for simulation-based intraoperative communication assessment.
abstract: BACKGROUND
  The purpose of this study was to examine the impact of frame-of-reference (FOR) training on assessments of intraoperative communication skills and identify areas of need to inform curricular efforts.
  
  
  METHODS
  Simulation instructors (M.D., Ph.D., Research Fellow, Simulation Technician) underwent a 2-hour FOR training session with the operating room communication instrument. They then independently rated communication skills of 19 PGY1s who participated in a team-based simulation. Residents completed self-assessments via video review of the scenario. Intraclass correlation coefficients were used to examine inter-rater reliability. Relationships between trained raters and resident scores were assessed with Pearson correlation coefficients and paired sample t tests.
  
  
  RESULTS
  Inter-reliability after FOR training was .91. The correlation between trained rater scores and resident evaluations was nonsignificant. Residents significantly underestimated their intraoperative communication skills (P < .05). Use of names, closed loop communication, and sharing information with team members demonstrated consistently low ratings among all residents.
  
  
  CONCLUSIONS
  These findings reveal that a number of individuals can be trained to reliably rate resident intraoperative communication performance and that residents tend to under-rate their communication skills.
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA. Electronic address: aimee.gardner@utsouthwestern.edu.
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Gardner
authors.affiliation: Smart Dimensions Weight Loss, Fountain Valley, CA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Russo
authors.affiliation: Department of Surgery, Maricopa Medical Center, Phoenix, AZ.
authors.forename: Ibrahim I
authors.initials: II
authors.lastname: Jabbour
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kosemund
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Scott
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D009873:Operating Rooms; D015203:Reproducibility of Results
keywords: Frame of reference training; Intraoperative communication; Residents; Simulation; Team training