| Title |
The ABCs of DKA: Development and Validation of a Computer-Based Simulator and Scoring System
|
|---|---|
| Published in |
Journal of General Internal Medicine, July 2015
|
| DOI | 10.1007/s11606-015-3273-y |
| Pubmed ID | |
| Authors |
Catherine H. Y. Yu, Sharon Straus, Ryan Brydges PhD |
| Abstract |
Clinical management of diabetic ketoacidosis (DKA) continues to be suboptimal; simulation-based training may bridge this gap and is particularly applicable to teaching DKA management skills given it enables learning of basic knowledge, as well as clinical reasoning and patient management skills. 1) To develop, test, and refine a computer-based simulator of DKA management; 2) to collect validity evidence, according to National Standard's validity framework; and 3) to judge whether the simulator scoring system is an appropriate measure of DKA management skills of undergraduate and postgraduate medical trainees. After developing the DKA simulator, we completed usability testing to optimize its functionality. We then conducted a preliminary validation of the scoring system for measuring trainees' DKA management skills. We recruited year 1 and year 3 medical students, year 2 postgraduate trainees, and endocrinologists (n = 75); each completed a simulator run, and we collected their simulator-computed scores. We collected validity evidence related to content, internal structure, relations with other variables, and consequences. Our simulator consists of six cases highlighting DKA management priorities. Real-time progression of each case includes interactive order entry, laboratory and clinical data, and individualised feedback. Usability assessment identified issues with clarity of system status, user control, efficiency of use, and error prevention. Regarding validity evidence, Cronbach's α was 0.795 for the seven subscales indicating favorable internal structure evidence. Participants' scores showed a significant effect of training level (p < 0.001). Scores also correlated with the number of DKA patients they reported treating, weeks on Medicine rotation, and comfort with managing DKA. A score on the simulation exercise of 75 % had a sensitivity and specificity of 94.7 % and 51.8%, respectively, for delineating between expert staff physicians and trainees. We demonstrate how a simulator and scoring system can be developed, tested, and refined to determine its quality for use as an assessment modality. Our evidence suggests that it can be used for formative assessment of trainees' DKA management skills. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Members of the public | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 112 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | <1% |
| Brazil | 1 | <1% |
| Unknown | 110 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 22 | 20% |
| Student > Ph. D. Student | 12 | 11% |
| Student > Bachelor | 11 | 10% |
| Lecturer | 7 | 6% |
| Researcher | 6 | 5% |
| Other | 25 | 22% |
| Unknown | 29 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 26 | 23% |
| Nursing and Health Professions | 16 | 14% |
| Social Sciences | 8 | 7% |
| Engineering | 6 | 5% |
| Computer Science | 4 | 4% |
| Other | 17 | 15% |
| Unknown | 35 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 July 2015.
All research outputs
#16,223,992
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#6,057
of 7,806 outputs
Outputs of similar age
#157,308
of 265,850 outputs
Outputs of similar age from Journal of General Internal Medicine
#76
of 126 outputs
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