Examining the validity argument for the Ottawa Surgical Competency Operating Room Evaluation (OSCORE): a systematic review and narrative synthesis

Should I do a synthesis (i.e. literature review)?

This column is intended to address the kinds of knotty problems and dilemmas with which many scholars grapple in studying health professions education. In this article, the authors address the question of whether one should conduct a literature review or knowledge synthesis, considering the why, when, and how, as well as its potential pitfalls. The goal is to guide supervisors and students who are considering whether to embark on a literature review in education research.

Cognitive load theory in action: e-learning modules improve performance in simulation-based education. A pilot study

PURPOSE

Learners participating in simulation-based education may experience cognitive overload with potential detrimental effects to learning and performance. Multiple strategies have been proposed to mitigate this detrimental response. However, these strategies have not fully considered the potential benefits of using online platforms, such as accessibility, cost-effectiveness, efficiency, and scalability. Addressing this gap in the literature, preparatory online modules were developed by applying concepts from cognitive load theory and simulation-based education. This study assessed whether using preparatory online modules to deliver weekly pre-briefing content could impact cognitive load and performance. The participants were first-year postgraduate medical trainees participating in a simulation-based resuscitation curriculum.

METHODS

Fifty-three trainees were allocated to receive preparatory online modules (online modules group, n = 27) or not (control group, n = 26) during the course component of a simulation-based resuscitation curriculum. Then, these trainees participated in a simulation-based objective structured clinical examination (OSCE). Sources of cognitive load (intrinsic, extraneous, and germane) were measured using a modified cognitive load questionnaire. Performance was assessed using the Ottawa Surgical Competency Operating Room Evaluation. Data were analyzed with descriptive statistics, and principal component analysis.

RESULTS

During the course component, the online modules group was found to have higher intrinsic and germane cognitive load, and lower extraneous cognitive load compared to the control group. During the OSCE, the online modules group scored significantly higher in performance scores (p = 0.0077, d = 0.39, 95% confidence interval = 0.10;0.68) compared to the control group. Principal component analysis supported the results obtained with the modified cognitive load questionnaire.

CONCLUSION

Trainees using preparatory online modules during the course component of a simulation-based resuscitation curriculum experienced cognitive load changes consistent with cognitive optimization. This may have contributed to their superior performance in the subsequent OSCE. Future research should explore the long-term impacts of online preparatory training and consider potential barriers to implementation in diverse healthcare environments.

Twelve tips to develop entrustable professional activities

Entrustable professional activities (EPAs), units of professional practice that require proficient integration of multiple competencies and can be entrusted to a sufficiently competent learner, are increasingly being used to define and inform curricula of health care professionals. The process of developing EPAs can be challenging and requires a deep yet pragmatic understanding of the concepts underlying EPA construction. Based on recent literature and the authors' lessons learned, this article provides the following practical and more or less sequential recommendations for developing EPAs: [1] Assemble a core team; [2] Build up expertise; [3] Establish a shared understanding of the purpose of EPAs; [4] Draft preliminary EPAs; [5] Elaborate EPAs; [6] Adopt a framework of supervision; [7] Perform a structured quality check; [8] Use a Delphi approach for refinement and/or consensus; [9] Pilot test EPAs; [10] Attune EPAs to their feasibility in assessment; [11] Map EPAs to existing curriculum; [12] Build a revision plan.