Gersten Jonker

A better transition with the ACTY   109 5 are provided in Appendix 1). The ACTY EPAs served as an assessment blueprint, i.e. as assessment elements we included the knowledge, skills, attitudes, and competencies listed in the EPA descriptions (Chapter 2). Assessors Clinicians with appropriate expertise for the stations volunteered to assess when available. Assessors evaluated all participants as if they were a PNIT with six months of clinical experience. Assessors were not made aware whether participants were from intervention or comparison groups, nor whether they did a pre-test or a post-test. The investigators briefed all assessors individually on the use of the scoring rubric, expected performance level and station duration. Assessors scored participants’ performance live on a paper checklist. TABLE 1: multimodal acute care assessment Assessment modality Test description Examples of stations Written knowledge exam • 40 minutes • around 40 closed and 6 open format questions • paper-based • to assess factual and applied knowledge and higher order thinking Case-based discussions (CBDs) • 2x 10 minutes • patients requiring urgent attendance at the ED • one-on-one structured questioning • to assess information gathering, clinical reasoning, and know-how of case management A 65-year old male presenting with chest pain at the ED A 38-year old female presenting with dyspnea and sharp pain on breathing at the ED Skills stations • 5-7x 5 minutes • OSCE format • to assess skill performance Bag-mask ventilation Defibrillation ECG interpretation High-fidelity simulations • 3x approximately 12 minutes • challenges a PNIT could encounter at the ED or on the ward • participant enacted the role of first responding doctor. A non- obstructive nurse was present, who only acted on instruction. • real-time scenarios with standardized scripts • to assess clinical reasoning, clinical judgment, technical skills, and behavioral skills, including communication and crisis resource management • certified simulation facilitators • debriefing after each scenario to foster learning and well-being A 60-year old male is reported to be“just not right” in the urology ward A 21-year old comatose male is brought in from a party to the ED by paramedics OSCE= Objective Structured Clinical Examination , ED= Emergency Department, ECG= electrocardiogram