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British Journal of Anaesthesia, 2003, Vol. 90, No. 1 43-47
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Evaluation of high fidelity patient simulator in assessment of performance of anaesthetists

J. M. Weller*,1, M. Bloch2, S. Young3, M. Maze2, S. Oyesola2, J. Wyner2, D. Dob2, K. Haire2, J. Durbridge2, T. Walker2 and D. Newble4

1 Department of Surgery, Wellington School of Medicine, Otago University, Private Bag 7343, Wellington South, New Zealand. 2 Magill Department of Anaesthetics, Chelsea and Westminster Hospital, London, UK. 3 Department of Clinical Engineering, Charing Cross Hospital, London, UK. 4 Department of Medical Education, Northern General Hospital, Sheffield, UK E-mail: jennifer.weller@wnmeds.ac.nz

Background. There is increasing emphasis on performance-based assessment of clinical competence. The High Fidelity Patient Simulator (HPS) may be useful for assessment of clinical practice in anaesthesia, but needs formal evaluation of validity, reliability, feasibility and effect on learning. We set out to assess the reliability of a global rating scale for scoring simulator performance in crisis management.

Methods. Using a global rating scale, three judges independently rated videotapes of anaesthetists in simulated crises in the operating theatre. Five anaesthetists then independently rated subsets of these videotapes.

Results. There was good agreement between raters for medical management, behavioural attributes and overall performance. Agreement was high for both the initial judges and the five additional raters.

Conclusions. Using a global scale to assess simulator performance, we found good inter-rater reliability for scoring performance in a crisis. We estimate that two judges should provide a reliable assessment. High fidelity simulation should be studied further for assessing clinical performance.

Br J Anaesth 2003; 90: 43–7


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