CUH pioneers development of new programme to assess technical performances of clinicians


The Department of Anaesthesia at Cork University Hospital (CUH) and University College Cork (UCC) currently lead an international team of medical clinicians, computer scientists and psychologists looking at new techniques for assessing clinician's performance of medical procedures (MEDCap

Funded by the European Commission's Leonardo da Vinci Lifelong Learning Programme, the research team comprises of members from Cork University Hospital, University College Cork, the Interaction Design Centre UL, University of Graz, Austria, University of Pecs, Hungary, and the Australian medical devices company, Medic Vision. Concentrating on one procedure, performance of spinal anaesthesia, the project addresses the questions "what is competence?" and "how can competence be assessed in the simulated environment?"

The MEDCap project is timely - the worldwide move to competence-based training in medicine has made clear the need for valid and reliable assessment procedures. In Ireland, for instance, the Medical Practitioners Act 2007 stipulates that the Medical Council has a statutory obligation to ensure that the competence of physicians is demonstrated throughout their career.

The challenges in developing assessment procedures lie in defining each skill while taking account of the many factors which influence doctors' learning and performance. These include cognitive, motor, communication, and human (e.g. fatigue, anxiety and fear) factors. In other areas (including digital gaming and human resource management), an innovative theory, 'competence based knowledge space theory', has been successfully applied to enhance learning, assess competence and to facilitate personalised learning. This theory is applied by developing a "problem set" designed to test all aspects of the practitioner's proficiency. The manner in which an individual clinician copes with the various problems provides a profile of his/her competence at any one point in time. This profile (described using mathematical formulae) can be used to judge / monitor a trainee's progress over time, to compare practitioner's performance with a standard and, importantly, provide detailed feedback to the clinician to facilitate "personalised" learning. The MEDCap project applies this approach to a medical procedure for the first time.

The Cork group has recently been awarded further EU funding to undertake a related project, Ortho-on-Line, in the area of e-learning. The partners (from Ireland, Greece, and Bulgaria) will develop a web-based platform to support training in the care of patients undergoing Orthopaedic surgery. Doctors will be able to log on to the system simultaneously with their colleagues in other countries and solve problems that arise in the management of these patients.

Professor George Shorten, Department of Anaesthesia, Cork University Hospital said, "Both of these projects have the potential to improve the way that clinicians develop and maintain their skills. If, as a community, we do not provide an effective means of demonstrating that we are good at what we do, some other less sensible system may be foisted upon us. The principles employed in both the MEDCap and Ortho-on-Line projects could be extrapolated to other medical procedural skills".



Last updated on: 12 / 12 / 2008