CHSOS EXAM 100 UPDATED EXAM SCRIPT
WITH COMPLETE ANSWERS
◉ What type of simulation is stopped repeatedly during the
scenario? When is this type of simulation used?
Answer: RAPID CYCLE DELIBERATIVE: Feedback in rapid cycle
deliberative practice comes during multiple pauses, and micro
debriefs within the scenario. Microdebriefing and the subsequent
repetition of some or all of the scenarios allow for the incorporation
of this feedback during iterative cycles of the simulation. Rapid cycle
deliberative practice allows for multiple learning points to be
addressed during different micro debriefs. Highly scripted,
algorithmic cases, such as those in a resuscitation, have been studied
for use in rapid cycle deliberative practice.
◉ A medical simulation program has been started at a facility. While
participants seem to enjoy their simulation scenarios, the post-
course surveys suggest that they would like better-quality feedback
on how they have done. Before the next simulation course, a
literature review of recent trends in simulation debriefing is done,
and a new debriefing technique is considered to improve the
learning experience. Which of the following innovations is most
likely to improve the quality of debriefing for the participants?
Answer: Giving observers specific tasks to complete while they
observe their peers during a scenario and using these during the
feedback session. There is some evidence for the use of
,"collaboration scripts," which are instructional tools with content-
specific roles and activities for non-active participants to complete
while they watch others. These may result in better quality feedback
for the participants at the end of each scenario.
◉ High-fidelity simulation is appropriate at all four levels of Miller's
pyramid of clinical competence. What are all four levels of Miller's
pyramid of clinical competence? And examples of how each level is
tested.
Answer: An understanding of educational principles such as Miller's
pyramid of clinical competence and Benner's novice-to-expert
model, guide the determination of the appropriate level of fidelity.
"Shows how" refers to the demonstration of clinical skills, which can
be tested by OSCE, standardized patients, clinical exams, etc.
(competency).
"Does" refers to the top of the pyramid and correlates to daily
patient care, which can be assessed by direct observation in clinical
settings (performance).
"Knows how" refers to the application of knowledge and can be
tested by clinical problem-solving.
"Knows" refers to the bottom of the pyramid and correlates with
knowledge, which can be tested by written exams.
◉ Miller's pyramid and how it is tested (simplified)
,Answer: Knows- written exams
Knows how- clinical problem solving
Shows how- OSCE, clinical exams
Does- direct observation in clinical setting
In Miller's pyramidal model, a learner progresses from knowledge
(having knowledge about a procedure) to competence (having
knowledge about how to do a procedure) to performance (being
able to demonstrate the procedure) to action (actually performing
the procedure in the field).
◉ What are latent organizational weaknesses?
Answer: unknown human errors in a system from the past that do
not surface until triggered by another event.
"If you pit a good performer against a bad system, the system will
win every time."
◉ what is deliberate practice?
Answer: Deliberate practice is an educational framework that
encompasses defined and achievable learning objectives, focussed
and repetitive practice, and informative and personalized feedback
in the form of a debrief. These factors ensure that set tasks and skills
can be practiced, and feedback can be delivered in a consistent and
highly educational format.
, Simulation with deliberate practice has been shown to be more
effective than traditional methods of teaching in multiple studies.
However, simulation cannot replace the benefits of actual clinical
experience.
Deliberate practice is an insight into the skills we are learning. This
insight allows for further development, and if performed several
times, the learner becomes a teacher and can modify the technique
based on experience.
Deliberate practice is a higher level of understanding and learning
where the mechanical part of a skill has already being dominated as
well as the functionality of the procedure.
Deliberate practice is not just a mechanical achievement. It is also
having an insight into the procedures we are performing as well as
understanding the steps.
◉ Crowd-Sourced Assessment of Technical Skills (C-SATS)
Answer: Crowdsourcing refers to a model used by an organization in
which unbiased observers or "the crowd" perform a service. In
procedural skills assessment, a video recording of the performance
is shared with the crowd, and then they are asked to evaluate the
performance using an assessment instrument.
The crowd is usually comprised of a big number of observers that
are trained to examine the videos using the same instructions.
WITH COMPLETE ANSWERS
◉ What type of simulation is stopped repeatedly during the
scenario? When is this type of simulation used?
Answer: RAPID CYCLE DELIBERATIVE: Feedback in rapid cycle
deliberative practice comes during multiple pauses, and micro
debriefs within the scenario. Microdebriefing and the subsequent
repetition of some or all of the scenarios allow for the incorporation
of this feedback during iterative cycles of the simulation. Rapid cycle
deliberative practice allows for multiple learning points to be
addressed during different micro debriefs. Highly scripted,
algorithmic cases, such as those in a resuscitation, have been studied
for use in rapid cycle deliberative practice.
◉ A medical simulation program has been started at a facility. While
participants seem to enjoy their simulation scenarios, the post-
course surveys suggest that they would like better-quality feedback
on how they have done. Before the next simulation course, a
literature review of recent trends in simulation debriefing is done,
and a new debriefing technique is considered to improve the
learning experience. Which of the following innovations is most
likely to improve the quality of debriefing for the participants?
Answer: Giving observers specific tasks to complete while they
observe their peers during a scenario and using these during the
feedback session. There is some evidence for the use of
,"collaboration scripts," which are instructional tools with content-
specific roles and activities for non-active participants to complete
while they watch others. These may result in better quality feedback
for the participants at the end of each scenario.
◉ High-fidelity simulation is appropriate at all four levels of Miller's
pyramid of clinical competence. What are all four levels of Miller's
pyramid of clinical competence? And examples of how each level is
tested.
Answer: An understanding of educational principles such as Miller's
pyramid of clinical competence and Benner's novice-to-expert
model, guide the determination of the appropriate level of fidelity.
"Shows how" refers to the demonstration of clinical skills, which can
be tested by OSCE, standardized patients, clinical exams, etc.
(competency).
"Does" refers to the top of the pyramid and correlates to daily
patient care, which can be assessed by direct observation in clinical
settings (performance).
"Knows how" refers to the application of knowledge and can be
tested by clinical problem-solving.
"Knows" refers to the bottom of the pyramid and correlates with
knowledge, which can be tested by written exams.
◉ Miller's pyramid and how it is tested (simplified)
,Answer: Knows- written exams
Knows how- clinical problem solving
Shows how- OSCE, clinical exams
Does- direct observation in clinical setting
In Miller's pyramidal model, a learner progresses from knowledge
(having knowledge about a procedure) to competence (having
knowledge about how to do a procedure) to performance (being
able to demonstrate the procedure) to action (actually performing
the procedure in the field).
◉ What are latent organizational weaknesses?
Answer: unknown human errors in a system from the past that do
not surface until triggered by another event.
"If you pit a good performer against a bad system, the system will
win every time."
◉ what is deliberate practice?
Answer: Deliberate practice is an educational framework that
encompasses defined and achievable learning objectives, focussed
and repetitive practice, and informative and personalized feedback
in the form of a debrief. These factors ensure that set tasks and skills
can be practiced, and feedback can be delivered in a consistent and
highly educational format.
, Simulation with deliberate practice has been shown to be more
effective than traditional methods of teaching in multiple studies.
However, simulation cannot replace the benefits of actual clinical
experience.
Deliberate practice is an insight into the skills we are learning. This
insight allows for further development, and if performed several
times, the learner becomes a teacher and can modify the technique
based on experience.
Deliberate practice is a higher level of understanding and learning
where the mechanical part of a skill has already being dominated as
well as the functionality of the procedure.
Deliberate practice is not just a mechanical achievement. It is also
having an insight into the procedures we are performing as well as
understanding the steps.
◉ Crowd-Sourced Assessment of Technical Skills (C-SATS)
Answer: Crowdsourcing refers to a model used by an organization in
which unbiased observers or "the crowd" perform a service. In
procedural skills assessment, a video recording of the performance
is shared with the crowd, and then they are asked to evaluate the
performance using an assessment instrument.
The crowd is usually comprised of a big number of observers that
are trained to examine the videos using the same instructions.
