Evaluation of medical students' performance using the anaesthesia simulator

Objectives A pilot project assessing clinical performance was undertaken using the Anaesthesia Simulation Centre at the University of Toronto. The purpose of this study was to determine the reliability of assessments of medical students' performance using the simulator as an evaluation tool, to compare these assessments to written and clinical evaluations and to elicit student opinion. Simulator assessments were performed at the completion of the anaesthesia rotation. Design Twenty-four of 177 University of Toronto medical students participated in a videotaped simulator session with an attending faculty. These 24 students were based at Sunnybrook Health Science Centre. During the session, each student worked through one of six predetermined cases involving discrete patient problems based on the list of core objectives. Five evaluators independently assessed each student's videotaped performance using standardized performance evaluation criteria and data were examined for inter-rater reliability. Clinical and written examination marks were compared to simulator assessments. A student questionnaire was administered and descriptive data obtained. Setting The University of Toronto. Subjects Medical students. Results The intraclass correlation coefficient (ICC) of inter-rater reliability was 0.87. There was poor correlation between the simulator and written examination marks (r=0.19, P=0.38) and between the simulator and clinical marks (r=0.04, P=0.87). The simulator experience was highly rated by students: learning experience 4.6 +/- 0.51, appropriate content 4.4 +/- 0.74, use as evaluation tool, 4.1 +/- 0.92 (1=poor, 5=excellent). Conclusions Our pilot data suggest that the simulator is a reliable assessment method for medical students' performance. Further work may justify the inclusion of the simulator as an evaluation and education tool and expanded to incorporate learning objectives of other medical disciplines.