EVALUATION OF PERFORMANCE Prof. Mohamed Ezzat Moemen Founder of Anaesthesia & Intensive Care, Faculty of Medicine, Zagazig University
Expectations 
What do you expect to learn from this lecture?
Answer At
the end of this lecture you will be able
to:
define a new paradigm of clinical performance,
know how it can be implemented,
know how to achieve clinical competence,
know how to evaluate clinical performance.
Performance The
performing number of cases, completing number of years, a core of learning by doing,
The
past paradigm:
new paradigm:
competence-based knowledge, technical & non-technical skills, Affection : attitude & behavior.
Continued learning
TOT = Patient Safety
Change in Practice
Trainee
TOT frame Scientific supervisor
Trainer
Requirements for Implementation Change
of culture
Institution & Individuals:
tools,
real patients,
feedback.
Tools context lectures
simulators
scenarios
cases videos
The Feedback Dialogue Fuel
between trainer and trainee,
of the evaluation process,
Reflection Informal Motion
of the positive and negative,
& formal process, not an event,
of trainer round the learning cycle.
Domains of Supervision
Performance
Evaluation
Domains of Supervision Types: Clinical & Educational, Examples: Appraisal, Mentoring, Coaching, In Practice: The 7 C’s:
Conversation Curiosity Contexts Complexity Creativity Caution Care
Promotion of Learning
Miller's Pyramid Educational Model
The Cycle of Appraisal
KOLB’S Learning Cycle
Pendleton Rules Learner
is ready for feedback,
Learner
says what he did well,
Observer
says that he did well,
Observer
says what should be improved,
Observer
shows how it can be improved,
Plan
for improvement is agreed upon,
Summary
and agenda for next dialogue.
The Competence Model Unconscious
Incompetence
Conscious
Incompetence
Conscious
Competence
Unconscious
Competence
Log – Book is checked periodically
Learning in the OR A
challenge context for learning,
Trainer
is willing to learn,
Trainee
is prepared and oriented,
Knowledge,
core.
skills and affections are the
Evaluation Aspects Evaluation
of Knowledge,
Evaluation
of Skills,
Evaluation
of Affection,
Needs: Costs, change of culture
What to Evaluate? The SMART Learning Process
How to evaluate? OSCE Real Pre
patients
– and Post - testing
Evaluation of Performance Goals:
To give feedback on past performance, To chart continuing progress, To identify developmental needs, To prevent developing problems, To root out poorly performing doctors, To help re-validation, re-licensing and re – certification.
Evaluation of knowledge
Written,
MCQs,
Oral,
Clinical.
Evaluation of Skills Training devices, Simulators, Real patients, Pretest & post test, OSCE.
Evaluation of Non-technical Skills OSCE:
Ethics and communication skills, Dynamic decision – making,
Affection:
Observation of attitude, Safety Attitude Questionnaire, Observation of behavior, Incident Report.
Incident reporting
Evaluation of Technical Skills Doctor – Patient interaction:
OSCE,
Difficult Airway, Vascular Access, CPR, Pre – and Post – Testing,
Doctor – Machine interaction:
Anaesthetic Machine & ventilators, adjuncts,…
Evaluation of Performance in Anaesthesia
Anesthesia Clinic:
Operating Room:
History: Ethics and communication skills, Examination: knowledge, Investigations: decision – making.
Anesthesia machine, ventilators, monitors, adjuncts, Skills: technical and non-technical.
PACU:
Knowledge, skills and affection.
FDRTPC including BLS Evaluation
by PRE- and POST-
TESTING, Course Content, Trainers, Trainees, Implementation, Evaluation,
Conclusions The new paradigm of performance is of value. Its core is a change in culture and feedback. The SMART learning process should be
simple and cost – effective.
Education should aim at
skill acquisition knowledge retention and attitude development.
Conclusions(cont’d) Evaluation
should include
dynamic decision-making and human-machine interaction
Evaluation
is of benefit for
the organization, the line-manager and the job-holder.