Gorrindo - CSAT - Medbiquitous 2011 - Baltimore, MD
Web-based Simulation as a Component of Continuing Medical Education: Data from the CSAT Project Tristan Gorrindo MD, Division of Post-Graduate Medical Education, Massachusetts General Hospital Elizabeth Goldfarb, BA, Division of Post-Graduate Medical Education, Massachusetts General Hospital Lee Baer, PhD, Division of Post-Graduate Medical Education, Massachusetts General Hospital Robert J Birnbaum, MD, PhD, Division of Post-Graduate Medical Education, Massachusetts General Hospital John A Fromson, MD, Division of Post-Graduate Medical Education, Massachusetts General Hospital The Computer Simulation Assessment Tool (CSAT) is designed to address specific needs within psychiatry and is driven by a three-fold educational approach to: serve as an educational intervention, provide a performance assessment for each user, and conduct a documented knowledge gap analysis. CSAT simulations are accessed online. The user views an introduction and selects items from clinical lines of inquiry corresponding to learning objectives. For each item chosen, a video shows a patient and clinician completing the action. To approximate real-life encounters, the simulation includes embedded decoys and a time limit. CSATs have been used for a wide range of clinical scenarios ranging from management of stroke to informed consent for medication. CSAT provides an educational intervention upon completion of a simulation. Participants are provided with immediate, personalized remediation in the form of explanations of incorrect actions (omitted or completed in error) and links to relevant peer-reviewed manuscripts. Data collected from CSAT include errors of commission and omission, order choice, time management, and a virtual medical-chart note. When combined, these items create a rich assessment of performance. Finally, when data is aggregated across participants, specific measurements (e.g. which required items are consistently omitted, or which terms were not mentioned in the virtual note) can determine gaps in knowledge, thus providing learning objectives in future courses.
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Gorrindo - CSAT - Medbiquitous 2011 - Baltimore, MD
- 1. www.mghcme.org Click to edit Master subtitle style Web-based Simulation as a Component of Continuing Medical Education: Data from the CSAT Project Tristan Gorrindo, MD Assistant Director Dept of Post Graduate Education Massachusetts General Hospital tristan.gorrindo@mgh.harvard.edu 1 www.MGHcme.org
- 3. What is a Clinical Simulation? Introduction Simulation Virtual Note Feedback www.psychsimulation.com
- 4. www.mghcme.org What is CSAT? Data Per User: • Errors of commission and omission • Order choice • Time management • Virtual medical-chart note • Demographics Aggregate Data: • Error patterns • Most commonly selected items by order • Average time spent • Connections between demographics and performance 4
- 5. www.mghcme.org What is CSAT? Non-US Registrants by Country US Registrants by State Total Non-US Countries: 23 Total US States: 45 N = 358 5
- 6. www.mghcme.org What is CSAT? Degree Average # Patients Seen Weekly N = 247 Est. Patient Impact: 20,839 per Week 6
- 8. www.mghcme.org CSAT: As an Educational Intervention 8
- 9. www.mghcme.org CSAT: Education Intervention CTNI Personalized Homebase Web- Engaging MHEP Program based LMS CSAT MGH MGH Psychiatry Interactive Asynchronous Academy Academy 9
- 10. www.mghcme.org System Usability Scale Score (n Range: 0 "Low Usability" to 4 "High Usability" I did NOT need to learn a lot of things before I could get going with this system I felt very confident using the system I did NOT find the system very cumersome to use I imagine that most people would learn to use this system very quickly I did NOT think there was too much inconsistency in this system I found the various functions in this system were well integrated I do NOT think that I would need the support of a technical person to use this ( system I thought the system was easy to use I did NOT find the system unnecessarily complex I would like to use this system frequently 0 1 2 3 4 Item Score SUS Score 0 10 20 30 40 50 60 70 80 90 100 Total Score 10
- 11. www.mghcme.org Simulation Interface Feedback Interface 11
- 13. www.mghcme.org CSAT: Performance Assessment Simulation Live Lecture Moore’s Model 13
- 14. www.mghcme.org CSAT: Performance Assessment User Interface 14
- 15. www.mghcme.org CSAT: Performance Assessment Teacher Interface Drop-Down Menu Options IDs Link to User Actions Separated by User Demographics 15 Action Selection and Order
- 16. www.mghcme.org CSAT: As a Gap Analysis 16
- 17. www.mghcme.org CSAT: Gap Analysis Assessing Suicidality in Patient with Depression Introductory Information: 23 y/o female. You started treating with fluoxetine for depression four weeks ago. Presenting for follow-up. Revealed During Simulation: Patient is non- compliant with medication. Shows symptoms indicative of bipolar disorder. 17
- 18. www.mghcme.org CSAT: Gap Analysis Assessing Suicidality in Patient with Depression 100% 23% 90% 80% Asked 70% 60% Did Not 50% C Ask 40% 30% 20% 77% 10% 0% 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th After 10th 49.3% N = 90 18
- 19. www.mghcme.org Treatment of Bipolar Depression 19 x2 = 24.41, p < .01
- 22. www.mghcme.org QUESTIONS ? Tristan Gorrindo, MD mghacademy.org Robert Birnbaum Elizabeth Goldfarb John Fromson Jamie Moody Lee Baer Meghan Rieu-Werden Anan Nathif Kristin Iodice Rose Desilets Sarah Romeo Bret Waters Kelly Sutton-Skinner 22