Michael Gottlieb1, Jaime Jordan2, Jeffrey N Siegelman3, Robert Cooney4, Christine Stehman5, Teresa M Chan6. 1. Department of Emergency Medicine Rush University Medical Center Chicago IL USA. 2. Department of Emergency Medicine Ronald Reagan UCLA Medical Center Los Angeles CA USA. 3. Department of Emergency Medicine Emory University School of Medicine Atlanta GA USA. 4. Department of Emergency Medicine Geisinger Medical Center Danville PA USA. 5. South Bend Emergency Physicians South Bend IN USA. 6. Department of Medicine Division of Emergency Medicine McMaster University Hamilton Ontario Canada.
Abstract
OBJECTIVES: Direct observation is important for assessing the competency of medical learners. Multiple tools have been described in other fields, although the degree of emergency medicine-specific literature is unclear. This review sought to summarize the current literature on direct observation tools in the emergency department (ED) setting. METHODS: We searched PubMed, Scopus, CINAHL, the Cochrane Central Register of Clinical Trials, the Cochrane Database of Systematic Reviews, ERIC, PsycINFO, and Google Scholar from 2012 to 2020 for publications on direct observation tools in the ED setting. Data were dual extracted into a predefined worksheet, and quality analysis was performed using the Medical Education Research Study Quality Instrument. RESULTS: We identified 38 publications, comprising 2,977 learners. Fifteen different tools were described. The most commonly assessed tools included the Milestones (nine studies), Observed Structured Clinical Exercises (seven studies), the McMaster Modular Assessment Program (six studies), Queen's Simulation Assessment Test (five studies), and the mini-Clinical Evaluation Exercise (four studies). Most of the studies were performed in a single institution, and there were limited validity or reliability assessments reported. CONCLUSIONS: The number of publications on direct observation tools for the ED setting has markedly increased. However, there remains a need for stronger internal and external validity data.
OBJECTIVES: Direct observation is important for assessing the competency of medical learners. Multiple tools have been described in other fields, although the degree of emergency medicine-specific literature is unclear. This review sought to summarize the current literature on direct observation tools in the emergency department (ED) setting. METHODS: We searched PubMed, Scopus, CINAHL, the Cochrane Central Register of Clinical Trials, the Cochrane Database of Systematic Reviews, ERIC, PsycINFO, and Google Scholar from 2012 to 2020 for publications on direct observation tools in the ED setting. Data were dual extracted into a predefined worksheet, and quality analysis was performed using the Medical Education Research Study Quality Instrument. RESULTS: We identified 38 publications, comprising 2,977 learners. Fifteen different tools were described. The most commonly assessed tools included the Milestones (nine studies), Observed Structured Clinical Exercises (seven studies), the McMaster Modular Assessment Program (six studies), Queen's Simulation Assessment Test (five studies), and the mini-Clinical Evaluation Exercise (four studies). Most of the studies were performed in a single institution, and there were limited validity or reliability assessments reported. CONCLUSIONS: The number of publications on direct observation tools for the ED setting has markedly increased. However, there remains a need for stronger internal and external validity data.
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