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Fernandez R, Rosenman ED, Brolliar S, et al. An Event-based Approach to Measurement: Facilitating Observational Measurement in Highly Variable Clinical Settings. AEM Educ Train. 2019;4(2):147-153doi: 10.1002/aet2.10395.
Fernandez, R., Rosenman, E. D., Brolliar, S., Chipman, A. K., Kalynych, C., Vrablik, M. C., Keebler, J. R., & Lazzara, E. H. (2020). An Event-based Approach to Measurement: Facilitating Observational Measurement in Highly Variable Clinical Settings. AEM education and training, 4(2), 147-153. https://doi.org/10.1002/aet2.10395
Fernandez, Rosemarie, et al. "An Event-based Approach to Measurement: Facilitating Observational Measurement in Highly Variable Clinical Settings." AEM education and training vol. 4,2 (2020): 147-153. doi: https://doi.org/10.1002/aet2.10395
Fernandez R, Rosenman ED, Brolliar S, Chipman AK, Kalynych C, Vrablik MC, Keebler JR, Lazzara EH. An Event-based Approach to Measurement: Facilitating Observational Measurement in Highly Variable Clinical Settings. AEM Educ Train. 2019 Oct 31;4(2):147-153. doi: 10.1002/aet2.10395. eCollection 2020 Apr. PMID: 32313861; PMCID: PMC7163198.
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AEM Educ Train. 2019 Oct 31;4(2):147-153. doi: 10.1002/aet2.10395. eCollection 2020 Apr.

An Event-based Approach to Measurement: Facilitating Observational Measurement in Highly Variable Clinical Settings.

AEM education and training

Rosemarie Fernandez, Elizabeth D Rosenman, Sarah Brolliar, Anne K Chipman, Colleen Kalynych, Marie C Vrablik, Joseph R Keebler, Elizabeth H Lazzara

Affiliations

  1. Department of Emergency Medicine and the Center for Experiential Learning and Simulation, College of Medicine University of Florida Gainesville FL.
  2. Department of Emergency Medicine University of Washington Seattle WA.
  3. Department of Emergency Medicine, Office of Educational Affairs University of Florida College of Medicine-Jacksonville Jacksonville FL.
  4. Department of Human Factors and Behavioral Neurobiology, College of Arts and Sciences Embry-Riddle Aeronautical University Daytona Beach FL.

PMID: 32313861 PMCID: PMC7163198 DOI: 10.1002/aet2.10395

Abstract

BACKGROUND: Translational research in medical education requires the ability to rigorously measure learner performance in actual clinical settings; however, current measurement systems cannot accommodate the variability inherent in many patient care  environments. This is especially problematic in emergency medicine, where patients represent a wide spectrum of severity for a single clinical presentation. Our objective is to describe and implement EBAM, an event-based approach to measurement that can be applied to actual emergency medicine clinical events.

METHODS: We used a four-step event-based approach to create an emergency department trauma resuscitation patient care measure. We applied the measure to a database of 360 actual trauma resuscitations recorded in a Level I trauma center using trained raters. A subset (

RESULTS: The methodology created a metric containing both universal items that are applied to all trauma resuscitation events and conditional items that only apply in certain situations. For clinical trauma events, injury severity scores ranged from 1 to 75 with a mean (±SD) of 21 (±15) and included both blunt (254/360; 74%) and penetrating (86/360; 25%) traumatic injuries, demonstrating the diverse nature of the clinical encounters. The mean (±SD) Cohen's kappa for patient care items was 0.7 (±0.3).

CONCLUSION: We present an event-based approach to performance assessment that may address a major gap in translational education research. Our work centered on assessment of patient care behaviors during trauma resuscitation. More work is needed to evaluate this approach across a diverse array of clinical events.

© 2019 by the Society for Academic Emergency Medicine.

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