Comparison of Checklist and Anchored Global Rating Instruments for Performance Rating of Simulated Pediatric Emergencies

Department of Pediatrics, Feinberg School of Medicine, Augusta Webster, MD, USA.
Simulation in healthcare: journal of the Society for Simulation in Healthcare (Impact Factor: 1.59). 02/2011; 6(1):18-24. DOI: 10.1097/SIH.0b013e318201aa90
Source: PubMed

ABSTRACT To compare the psychometric performance of two rating instruments used to assess trainee performance in three clinical scenarios.
This study was part of a two-phase, randomized trial with a wait-list control condition assessing the effectiveness of a pediatric emergency medicine curriculum targeting general emergency medicine residents. Residents received 6 hours of instruction either before or after the first assessment. Separate pairs of raters completed either a dichotomous checklist for each of three cases or the Global Performance Assessment Tool (GPAT), an anchored multidimensional scale. A fully crossed person×rater×case generalizability study was conducted. The effect of training year on performance is assessed using multivariate analysis of variance.
The person and person×case components accounted for most of the score variance for both instruments. Using either instrument, scores demonstrated a small but significant increase as training level increased when analyzed using a multivariate analysis of variance. The inter-rater reliability coefficient was >0.9 for both instruments.
We demonstrate that our checklist and anchored global rating instrument performed in a psychometrically similar fashion with high reliability. As long as proper attention is given to instrument design and testing and rater training, checklists and anchored assessment scales can produce reproducible data for a given population of subjects. The validity of the data arising for either instrument type must be assessed rigorously and with a focus, when practicable, on patient care outcomes.

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    Anales de Pediatría 09/2012; 77(3):165–170. DOI:10.1016/j.anpedi.2012.01.020 · 0.72 Impact Factor
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    Medical Education 02/2015; 49(2). DOI:10.1111/medu.12621 · 3.62 Impact Factor
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    ABSTRACT: The process of developing checklists to rate clinical performance is essential for ensuring their quality; thus, the authors applied an integrative approach for designing checklists that evaluate clinical performance. The approach consisted of five predefined steps (taken 2012-2013). Step 1: On the basis of the relevant literature and their clinical experience, the authors drafted a preliminary checklist. Step 2: The authors sent the draft checklist to five experts who reviewed it using an adapted Delphi technique. Step 3: The authors devised three scoring categories for items after pilot testing. Step 4: To ensure the changes made after pilot testing were valid, the checklist was submitted to an additional Delphi review round. Step 5: To weight items needed for accurate performance assessment, 10 pediatricians rated all checklist items in terms of their importance on a scale from 1 (not important) to 5 (essential). The authors have illustrated their approach using the example of a checklist for a simulation scenario of infant septic shock. The five-step approach resulted in a valid, reliable tool and proved to be an effective method to design evaluation checklists. It resulted in 33 items, most consisting of three scoring categories. This approach integrates published evidence and the knowledge of domain experts. A robust development process is a necessary prerequisite of valid performance checklists. Establishing a widely recognized standard for developing evaluation checklists will likely support the design of appropriate measurement tools and move the field of performance assessment in health care forward.
    Academic medicine: journal of the Association of American Medical Colleges 05/2014; 89(7). DOI:10.1097/ACM.0000000000000289 · 3.47 Impact Factor