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Use of cognitive task analysis to guide the development of performance-based assessments for intraoperative decision making.

Background: There is a paucity of performance-based assessments that focus on intraoperative decision making. The purpose of this article is to review the performance outcomes and usefulness of two performance-based assessments that were developed using cognitive task analysis (CTA) frameworks.Metho...

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Publicado en:Military Medicine pp. 22 - 28
Autores principales: Pugh, Carla M, Darosa, Debra A
Formato: research Journal Article
Publicado: Oxford University Press / USA Oct2013 Supplement
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Use of cognitive task analysis to guide the development of performance-based assessments for intraoperative decision making.
      aug:
        au:
          Pugh, Carla M
          Darosa, Debra A
        affil: Associate Professor of Surgery, Vice Chair of Education and Patient Safety, University of Wisconsin, Department of Surgery, 600 Highland Ave-CSC 785B, Madison, WI 53792.
      sug:
        subj:
          Clinical Competence
          Decision Making
          Education, Medical
          Task Performance and Analysis
          Cholecystectomy Education
          Cholecystectomy Standards
          Computer Simulation
          Educational Measurement
          Herniorrhaphy Education
          Herniorrhaphy Standards
      ab: Background: There is a paucity of performance-based assessments that focus on intraoperative decision making. The purpose of this article is to review the performance outcomes and usefulness of two performance-based assessments that were developed using cognitive task analysis (CTA) frameworks.Methods: Assessment-A used CTA to create a "think aloud" oral examination that was administered while junior residents (PGY 1-2's, N = 69) performed a porcine-based laparoscopic cholecystectomy. Assessment-B used CTA to create a simulation-based, formative assessment of senior residents' (PGY 4-5's, N = 29) decision making during a laparoscopic ventral hernia repair. In addition to survey-based assessments of usefulness, a multiconstruct evaluation was performed using eight variables.Results: When comparing performance outcomes, both approaches revealed major deficiencies in residents' intraoperative decision-making skills. Multiconstruct evaluation of the two CTA approaches revealed assessment method advantages for five of the eight evaluation areas: (1) Cognitive Complexity, (2) Content Quality, (3) Content Coverage, (4) Meaningfulness, and (5) Transfer and Generalizability.Conclusions: The two CTA performance assessments were useful in identifying significant training needs. While there are pros and cons to each approach, the results serve as a useful blueprint for program directors seeking to develop performance-based assessments for intraoperative decision making.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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