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  • 1. ADLT 672: Instructional Strategies Thursday, October 31, 2013
  • 2. What are Checklists and How are They Used? Origin Used in many disciplines:  Originated in Aviation  Pre-Flight Checklist (Jablonski, 1965)  Anatomy (Hofer et al, 2001)  Use in Medicine  Guides physician through complex procedure  Family Medicine (Ferrell et al, 1996)  Anesthesiology (DuBose et al, 2008)  Neonatal Medicine (McCurdy et al, 1995), etc.
  • 3. Various Types of Checklists (Hales et al, 2007)  Laundry List (no order; e.g. Examples  Assignment Checklist medical equipment)  Sequential (order is relevant; e.g. procedure checklist)  McCurdy et al (1995) p. 50  Iterative (items require repeated passes; e.g. CPR)  Diagnostic (flowchart; e.g. diagnosis of brain death)  Hettinga et al (2010) p. 877
  • 4. Steps in Development (Hettinga et al, 2010)  Draft using operational knowledge  Revise based on input from colleagues Good Practice (Hales et al, 2007)  Incorporate peer-reviewed guidelines; add specific customs and behaviors in accordance with teaching goals.  Present checklist in logical, functional order.  List should not be so onerous that  Experimental use in pilot it interferes with learning activity.  Clearly space and delineate items.  Revise as necessary (or repeat process)  Items can be “general” so that individual creativity is still allowed.
  • 5. What Checklists Do: What Checklists Don’t Do:  Simplify complex tasks  Learners may focus on  Allow learner to focus on one checklist and not overall functioning (Norman, 2005). task at a time  Can inhibit “holisticism” and  “Real Time” self efficacy  Model desired behavior  Decrease anxiety synthesis  Some studies show benefit (Hofer et al, 2011; O’Conner and McGraw, 1997), while others do not (McCurdy et al, 1995; at least student perceptions improved).
  • 6. References  DuBose JJ, Inaba K, Shiflett A, Trankiem C, Teixeira PG, Salim A, Rhee P, Demetriades D,         Belzberg H (2010). Measurable outcomes of quality improvement in the trauma intensive care unit: the impact of a daily quality rounding checklist. Journal of Trauma. 64: 22-27. Ferrell BG (1996). A critical elements approach to developing checklists for a clinical performance evaluation. Medical Online Education. 1(5). Hales B, Terblanche M, Fowler R, Sibbald W (2007). Development of medical checklists for improved quality of patient care. International Journal for Quality in Health Care. 20(1): 22-30. Hettinga AM, Denessen E, Postma CT (2010). Checking the checklist: a content analysis of expert- and evidence-based case-specific checklist items. Medical Education. 44: 874-883. Hofer RE, Nikolaus OB, Pawlina W (2011). Using checklists in a gross anatomy laboratory improves learning outcomes and dissection quality. Anatomical Sciences Education. 4: 249-255. Jablonski E (1965). Flying fortress: the illustrated biography of the B-17s and the men who flew them. 1st Edition. Garden City, NY: Doubleday & Company. McCurdy FA, Wesiman LE (1995). Teaching newborn medicine to third-year medical students. Use of a Checklist. Archives of Pediatric and Adolescent Medicine. 149: 49-52. Norman G (2005). Editorial – checklists vs. ratings, the illusion of objectivity, the demise of skills and the debasement of evidence. Advances in Health Sciences Education. 10: 1-3. O’Conner HM, McGraw RC (1997). Clinical skills training: developing objective assessment instruments. Medical Education. 31: 359-363.