Coming into this selective, I had an
inkling that I wanted to explore simulation training for procedures in internal
medicine and the outcomes used to evaluate it. There were a couple of avenues
that I could have explored- improvements in trainees’ proficiency after
training, satisfaction with the programs, or better patient outcomes.
Dr. Cavalcanti introduced us to an
interesting approach to evaluating and stratifying outcomes called the
Kirkpatrick Model during a meeting where he, Joanne, and myself discussed our
research interests for the selective.
The Kirkpatrick Model for evaluating
training programs creates four levels of outcomes in ascending order of impact
on the trainee.
Level one outcomes would examine the
reaction of the trainees to the training program. Did they enjoy it? Newer iterations
of the model also add whether participants actively participate in the program,
and whether the trainees find it relevant to their day-to-day work.
Level two outcomes evaluate whether
participants in a program acquire the skills that were taught during it. A
participant’s confidence in the skills and intention to use the skills can fall
under the umbrella of level two as well.
Level three outcomes look at whether
participant’s behaviour is changed, and whether they apply the skills they
learned during the training program “on the job”.
Level four outcomes take a look at the
program’s outcomes on a broader scale outside of whether the trainees apply the
knowledge or not. Did the intended impacts of this training program happen? In
medicine this would include metrics like patient outcomes. An example that I’ll
explore in a later post on this blog would include Dr. Jeffery H. Barsuk’s study on the
rates of central venous catheter related infections before and after the
implementation of a simulation-training program.
In terms of my experience in medical
school, I would have to say that I am only exposed to evaluation of level one
and two outcomes regularly. Our evaluation forms after any seminars, lecture
series, rotations, or other training sessions focus mostly on our satisfaction
with the experience and any feedback (positive or negative) that we can offer.
These forms also occasionally ask whether we feel more confident in our
knowledge or skills after the event.
When it comes to level two outcomes, I feel like I might place our
examinations and OSCEs into that category, and I’m sure some analysis and
number crunching goes on in the background that the students don’t necessarily
see.
More information on the Kirkpatrick Model can be found here: http://www.kirkpatrickpartners.com/OurPhilosophy/TheKirkpatrickModel/tabid/302/Default.aspx
-SR
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