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Assessment Tools for Use During Anesthesia-Centric Pediatric Advanced Life Support Training and Evaluation.

Abstract Pediatric perioperative cardiac arrests are rare events that require rapid, skilled and coordinated efforts to optimize outcomes. We developed an assessment tool for assessing clinician performance during perioperative critical events termed Anesthesia-centric Pediatric Advanced Life Support (A-PALS). Here, we describe the development and evaluation of the A-PALS scoring instrument.
PMID
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Authors

Mayor MeshTerms

Pediatric Emergency Medicine

Keywords

Anesthesia

Assessment

Interdisciplinary Education

Simulation

Teamwork

Journal Title the american journal of the medical sciences
Publication Year Start




PMID- 28641713
OWN - NLM
STAT- MEDLINE
DA  - 20170623
DCOM- 20170628
LR  - 20170628
IS  - 1538-2990 (Electronic)
IS  - 0002-9629 (Linking)
VI  - 353
IP  - 6
DP  - 2017 Jun
TI  - Assessment Tools for Use During Anesthesia-Centric Pediatric Advanced Life
      Support Training and Evaluation.
PG  - 516-522
LID - S0002-9629(16)30106-9 [pii]
LID - 10.1016/j.amjms.2016.09.013 [doi]
AB  - BACKGROUND: Pediatric perioperative cardiac arrests are rare events that require 
      rapid, skilled and coordinated efforts to optimize outcomes. We developed an
      assessment tool for assessing clinician performance during perioperative critical
      events termed Anesthesia-centric Pediatric Advanced Life Support (A-PALS). Here, 
      we describe the development and evaluation of the A-PALS scoring instrument.
      METHODS: A group of raters scored videos of a perioperative team managing
      simulated events representing a range of scenarios and competency. We assessed
      agreement with the reference standard grading, as well as interrater and
      intrarater reliability. RESULTS: Overall, raters agreed with the reference
      standard 86.2% of the time. Rater scores concerning scenarios that depicted
      highly competent performance correlated better with the reference standard than
      scores from scenarios that depicted low clinical competence (P < 0.0001).
      Agreement with the reference standard was significantly (P < 0.0001) associated
      with scenario type, item category, level of competency displayed in the scenario,
      correct versus incorrect actions and whether the action was performed versus not 
      performed. Kappa values were significantly (P < 0.0001) higher for highly
      competent performances as compared to lesser competent performances (good: mean =
      0.83 [standard deviation = 0.07] versus poor: mean = 0.61 [standard deviation =
      0.14]). The intraclass correlation coefficient (interrater reliability) was 0.97 
      for the raters' composite scores on correct actions and 0.98 for their composite 
      scores on incorrect actions. CONCLUSIONS: This study provides evidence for the
      validity of the A-PALS scoring instrument and demonstrates that the scoring
      instrument can provide reliable scores, although clinician performance affects
      reliability.
CI  - Copyright (c) 2017 Southern Society for Clinical Investigation. Published by
      Elsevier Inc. All rights reserved.
FAU - Watkins, Scott C
AU  - Watkins SC
AD  - Department of Anesthesiology, Vanderbilt University School of Medicine,
      Nashville, TN. Electronic address: [email protected]
FAU - Nietert, Paul J
AU  - Nietert PJ
AD  - Department of Public Health Sciences, College of Medicine, Medical University of 
      South Carolina, Charleston, SC.
FAU - Hughes, Elisabeth
AU  - Hughes E
AD  - Department of Anesthesiology, Vanderbilt University School of Medicine,
      Nashville, TN.
FAU - Stickles, Eric T
AU  - Stickles ET
AD  - Department of Anesthesiology, Vanderbilt University School of Medicine,
      Nashville, TN.
FAU - Wester, Tracy E
AU  - Wester TE
AD  - Department of Anesthesia and Perioperative Medicine, College of Medicine, Medical
      University of South Carolina, Charleston, SC.
FAU - McEvoy, Matthew D
AU  - McEvoy MD
AD  - Department of Anesthesiology, Vanderbilt University School of Medicine,
      Nashville, TN.
LA  - eng
PT  - Journal Article
DEP - 20161003
PL  - United States
TA  - Am J Med Sci
JT  - The American journal of the medical sciences
JID - 0370506
SB  - AIM
SB  - IM
MH  - Advanced Cardiac Life Support/*education
MH  - Anesthesia/utilization
MH  - Anesthesiology/education
MH  - Clinical Competence
MH  - Heart Arrest/*therapy
MH  - Humans
MH  - *Pediatric Emergency Medicine
MH  - Reproducibility of Results
OTO - NOTNLM
OT  - Anesthesia
OT  - Assessment
OT  - Interdisciplinary Education
OT  - Simulation
OT  - Teamwork
EDAT- 2017/06/24 06:00
MHDA- 2017/06/29 06:00
CRDT- 2017/06/24 06:00
PHST- 2016/02/15 [received]
PHST- 2016/09/15 [revised]
PHST- 2016/09/30 [accepted]
AID - S0002-9629(16)30106-9 [pii]
AID - 10.1016/j.amjms.2016.09.013 [doi]
PST - ppublish
SO  - Am J Med Sci. 2017 Jun;353(6):516-522. doi: 10.1016/j.amjms.2016.09.013. Epub
      2016 Oct 3.