Dataset Information

The Ottawa Emergency Department Shift Observation Tool (O-EDShOT): A New Tool for Assessing Resident Competence in the Emergency Department.

ABSTRACT: Objectives:The outcome of emergency medicine (EM) training is to produce physicians who can competently run an emergency department (ED) shift. However, there are few tools with supporting validity evidence specifically designed to assess multiple key competencies across an entire shift. The investigators developed and gathered validity evidence for a novel entrustment-based tool to assess a resident's ability to safely run an ED shift. Methods:Through a nominal group technique, local and national stakeholders identified dimensions of performance that are reflective of a competent ED physician and are required to safely manage an ED shift. These were included as items in the Ottawa Emergency Department Shift Observation Tool (O-EDShOT), and each item was scored using an entrustment-based rating scale. The tool was implemented in 2018 at the University of Ottawa Department of Emergency Medicine, and quantitative data and qualitative feedback were collected over 6 months. Results:A total of 1,141 forms were completed by 78 physicians for 45 residents. An analysis of variance demonstrated an effect of training level with statistically significant increases in mean O-EDShOT scores with each subsequent postgraduate year (p < 0.001). Scores did not vary by ED treatment area. Residents rated as able to safely run the shift had significantly higher mean ± SD scores (4.8 ± 0.3) than those rated as not able (3.8 ± 0.6; p < 0.001). Faculty and residents reported that the tool was feasible to use and facilitated actionable feedback aimed at progression toward independent practice. Conclusions:The O-EDShOT successfully discriminated between trainees of different levels regardless of ED treatment area. Multiple sources of validity evidence support the O-EDShOT as a tool to assess a resident's ability to safely run an ED shift. It can serve as a stimulus for daily observation and feedback making it practical to use within an EM residency program.

SUBMITTER: Cheung WJ

PROVIDER: S-EPMC7592826 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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The Ottawa Emergency Department Shift Observation Tool (O-EDShOT): A New Tool for Assessing Resident Competence in the Emergency Department.

Cheung Warren J WJ Wood Timothy J TJ Gofton Wade W Dewhirst Sebastian S Dudek Nancy N

AEM education and training 20191219 4

<h4>Objectives</h4>The outcome of emergency medicine (EM) training is to produce physicians who can competently run an emergency department (ED) shift. However, there are few tools with supporting validity evidence specifically designed to assess multiple key competencies across an entire shift. The investigators developed and gathered validity evidence for a novel entrustment-based tool to assess a resident's ability to safely run an ED shift.<h4>Methods</h4>Through a nominal group technique, l ...[more]

PMID: 33150278

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Project description:BackgroundThe Ottawa Ankle Rules, Ottawa Knee Rule, and Canadian C-Spine Rule-together known as The Ottawa Rules-are a set of internationally validated clinical decision rules developed to decrease unnecessary diagnostic imaging in the emergency department. In this study, we sought to develop and evaluate the use of a mobile app version of The Ottawa Rules.ObjectiveThe primary objective of this study was to determine acceptability of The Ottawa Rules app among emergency department clinicians. The secondary objective was to evaluate the effect of publicity efforts on uptake of The Ottawa Rules app.MethodsThe Ottawa Rules app was developed and publicly released for free on iOS and Android operating systems in April 2016. Local and national news and academic media coverage coincided with app release. This study was conducted at a large tertiary trauma care center in Ottawa, Canada. The study was advertised through posters and electronically by email. Emergency department clinicians were approached in person to enroll via in-app consent for a 1-month study during which time they were encouraged to use the app when evaluating patients with suspected knee, foot, or neck injuries. A 23-question survey was administered at the end of the study period via email to determine self-reported frequency, perceived ease of use of the app, and participant Technology Readiness Index scores.ResultsA total of 108 emergency department clinicians completed the study including 42 nurses, 33 residents, 20 attending physicians, and 13 medical students completing emergency department rotations. The median Technology Readiness Index for this group was 3.56, indicating a moderate degree of openness for technological adoption. The majority of survey respondents indicated favorable receptivity to the app including finding it helpful to applying the rules (73/108, 67.6%), that they would recommend the app to colleagues (81/108, 75.0%), and that they would continue using the app (73/108, 67.6%). Feedback from study participants highlighted a desire for access to more clinical decision rules and a higher degree of interactivity of the app. Between April 21, 2016, and June 1, 2017, The Ottawa Rules app was downloaded approximately 4000 times across 89 countries.ConclusionsWe have found The Ottawa Rules app to be an effective means to disseminate the Ottawa Ankle Rules, Ottawa Knee Rule, and Canadian C-Spine Rule among all levels of emergency department clinicians. We have been successful in monitoring uptake and access of the rules in the app as a result of our publicity efforts. Mobile technology can be leveraged to improve the accessibility of clinical decision tools to health professionals.

Project description:BackgroundPatient handover between prehospital care and the emergency department plays a key role in patient safety. Therefore, we aimed to create a validated tool for measuring quality of communication and interprofessional relations during handover in this specific setting.MethodsBased on a theoretical framework a comprehensive item pool on information transfer and human factors in emergency department handovers was created and refined in a modified Delphi survey involving clinical experts. Based on a pre-test, items were again revised. The resulting Emergency Department Human Factors in Handover tool (ED-HFH) was validated in a field test at the emergency department of a German university hospital from July to December 2017. The ED-HFH was completed by emergency department and ambulance service staff participating in handovers and by an external observer. Description of item characteristics, exploratory factor analysis, analyses on internal consistency and interrater reliability by intraclass-correlation. Construct validity was analysed by correlation with an overall rating on quality of the handover.ResultsThe draft of the ED-HFH contained 24 items, 90 of 102 eligible staff members participated in the field test completing 133 questionnaires on 38 observed handovers. Four items were deleted after analysis of item characteristics. Factor analysis supported a single factor explaining 39% of variance in the items. Therefore, a sum-score was calculated with a possible range between 14 and 70. The median value of the sum-score in the sample was 61.5, Cronbach's α was 0.83, intraclass-correlation was 0.52, the correlation with the overall rating of hand-over quality was ρ = 0.83 (p ≤ 0.001).ConclusionsThe ED-HFH showed its feasibility, reliability and validity as a measure of quality of information transfer and human factors in handovers between ambulance services and the emergency department. It promises to be a useful tool for quality assurance and staff training.

Dataset Information

The Ottawa Emergency Department Shift Observation Tool (O-EDShOT): A New Tool for Assessing Resident Competence in the Emergency Department.

Publications

The Ottawa Emergency Department Shift Observation Tool (O-EDShOT): A New Tool for Assessing Resident Competence in the Emergency Department.

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