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TopClinical procedures require accurate execution and timing to safely administer care. The human error that occurs in clinical treatment settings is referred to as medical error (Zhang, Patel, & Johnson, 2002), and can be reduced through targeted training (Dror, 2011). Performance assessment within simulation training for medical procedures can assist students in identifying weaknesses in their skills and provide the opportunity for corrective training.
As one example, we developed a simulator for clinicians to practice interacting with patients who may have been exposed to a bioterrorist agent (Kizakevich, Lux, Duncan, Guinn, & McCartney, 2003)—a rare but critical event. Through a systematic process, clinicians interact with the patient to elicit information about the present illness, past medical history, and lifestyle and medical risks, order diagnostic tests, make diagnostic hypotheses, and plan prescriptions, follow-up, and referrals. Along the way a clinician might fail to ask important questions or order laboratory tests that could contribute to a differential diagnosis.
Performance assessment involves the evaluation of students’ learned skills (Lampton, Bliss, & Morris, 2002). For the purposes of this article, students’ knowledge, including facts, concepts, rules, and policies, are measured only as residual artifacts of their ability to accomplish skills. The approach is to do so in a situated environment, putting the students into a situation and monitoring their activity. It is a kind of learning-by-doing (Aldrich, 2005; Frank et al., 2004). For assessment to be actionable, at least these questions need to be answered: What does the student know how to do? What can the student do in what context? Into what situation does the student go next?