Using Unannounced Standardized Patients to Assess Residents' Competency in Asthma Severity Classification

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Abstract

Objective: The aim of this study was to test the hypothesis that an educational intervention would increase the competency of pediatric residents in classifying asthma severity as assessed using unannounced standardized patients (SPs). Methods: Six SPs were trained to represent mild-intermittent, mild-persistent, moderate-persistent, and severe-persistent asthma. Data from a control group were obtained in 2002-2003. In 2003-2004, after an intervention, data were collected from an intervention group. The intervention consisted of a didactic session and posting the criteria for asthma severity classification. During precepting, faculty obtained a commitment from residents (N = 12) regarding the severity classification. Faculty and residents were blinded to the presence of SPs. The assigned severity of each SP was used as the criterion standard. Residents' severity classification was compared with the criterion standard. To test whether competency improved postintervention, we compared residents' performance by using intervention group versus control group and within-subject control comparisons. Bivariate analyses tested differences in proportions of categorical variables. Results: Fifty resident-SP encounters were analyzed. The intervention group performed significantly better than controls at each level of training in identifying persistent asthma: postgraduate year 3 (PGY3, 100% vs 71%), PGY2 (71% vs 50%), and PGY1 (50% vs 43%). They also performed significantly better in determining subclassifications of persistent asthma: PGY3 (87% vs 40%), PGY2 (67% vs 33%), and PGY1 (50% vs 33%). All had P < .05. Similarly, for within-subject control comparison, residents performed significantly better postintervention at identification and subclassification of persistent asthma than did the same residents at baseline. Conclusions: An educational intervention resulted in significant improvements in the competency of residents in asthma severity classification.

Original languageEnglish (US)
Pages (from-to)139-142
Number of pages4
JournalAmbulatory Pediatrics
Volume8
Issue number2
DOIs
StatePublished - Mar 17 2008

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Asthma
Control Groups
Pediatrics

Keywords

  • asthma severity classification
  • educational intervention
  • resident competency
  • unannounced standardized patients

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Using Unannounced Standardized Patients to Assess Residents' Competency in Asthma Severity Classification",
abstract = "Objective: The aim of this study was to test the hypothesis that an educational intervention would increase the competency of pediatric residents in classifying asthma severity as assessed using unannounced standardized patients (SPs). Methods: Six SPs were trained to represent mild-intermittent, mild-persistent, moderate-persistent, and severe-persistent asthma. Data from a control group were obtained in 2002-2003. In 2003-2004, after an intervention, data were collected from an intervention group. The intervention consisted of a didactic session and posting the criteria for asthma severity classification. During precepting, faculty obtained a commitment from residents (N = 12) regarding the severity classification. Faculty and residents were blinded to the presence of SPs. The assigned severity of each SP was used as the criterion standard. Residents' severity classification was compared with the criterion standard. To test whether competency improved postintervention, we compared residents' performance by using intervention group versus control group and within-subject control comparisons. Bivariate analyses tested differences in proportions of categorical variables. Results: Fifty resident-SP encounters were analyzed. The intervention group performed significantly better than controls at each level of training in identifying persistent asthma: postgraduate year 3 (PGY3, 100{\%} vs 71{\%}), PGY2 (71{\%} vs 50{\%}), and PGY1 (50{\%} vs 43{\%}). They also performed significantly better in determining subclassifications of persistent asthma: PGY3 (87{\%} vs 40{\%}), PGY2 (67{\%} vs 33{\%}), and PGY1 (50{\%} vs 33{\%}). All had P < .05. Similarly, for within-subject control comparison, residents performed significantly better postintervention at identification and subclassification of persistent asthma than did the same residents at baseline. Conclusions: An educational intervention resulted in significant improvements in the competency of residents in asthma severity classification.",
keywords = "asthma severity classification, educational intervention, resident competency, unannounced standardized patients",
author = "Ozuah, {Philip O.} and Marina Reznik",
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T1 - Using Unannounced Standardized Patients to Assess Residents' Competency in Asthma Severity Classification

AU - Ozuah, Philip O.

AU - Reznik, Marina

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N2 - Objective: The aim of this study was to test the hypothesis that an educational intervention would increase the competency of pediatric residents in classifying asthma severity as assessed using unannounced standardized patients (SPs). Methods: Six SPs were trained to represent mild-intermittent, mild-persistent, moderate-persistent, and severe-persistent asthma. Data from a control group were obtained in 2002-2003. In 2003-2004, after an intervention, data were collected from an intervention group. The intervention consisted of a didactic session and posting the criteria for asthma severity classification. During precepting, faculty obtained a commitment from residents (N = 12) regarding the severity classification. Faculty and residents were blinded to the presence of SPs. The assigned severity of each SP was used as the criterion standard. Residents' severity classification was compared with the criterion standard. To test whether competency improved postintervention, we compared residents' performance by using intervention group versus control group and within-subject control comparisons. Bivariate analyses tested differences in proportions of categorical variables. Results: Fifty resident-SP encounters were analyzed. The intervention group performed significantly better than controls at each level of training in identifying persistent asthma: postgraduate year 3 (PGY3, 100% vs 71%), PGY2 (71% vs 50%), and PGY1 (50% vs 43%). They also performed significantly better in determining subclassifications of persistent asthma: PGY3 (87% vs 40%), PGY2 (67% vs 33%), and PGY1 (50% vs 33%). All had P < .05. Similarly, for within-subject control comparison, residents performed significantly better postintervention at identification and subclassification of persistent asthma than did the same residents at baseline. Conclusions: An educational intervention resulted in significant improvements in the competency of residents in asthma severity classification.

AB - Objective: The aim of this study was to test the hypothesis that an educational intervention would increase the competency of pediatric residents in classifying asthma severity as assessed using unannounced standardized patients (SPs). Methods: Six SPs were trained to represent mild-intermittent, mild-persistent, moderate-persistent, and severe-persistent asthma. Data from a control group were obtained in 2002-2003. In 2003-2004, after an intervention, data were collected from an intervention group. The intervention consisted of a didactic session and posting the criteria for asthma severity classification. During precepting, faculty obtained a commitment from residents (N = 12) regarding the severity classification. Faculty and residents were blinded to the presence of SPs. The assigned severity of each SP was used as the criterion standard. Residents' severity classification was compared with the criterion standard. To test whether competency improved postintervention, we compared residents' performance by using intervention group versus control group and within-subject control comparisons. Bivariate analyses tested differences in proportions of categorical variables. Results: Fifty resident-SP encounters were analyzed. The intervention group performed significantly better than controls at each level of training in identifying persistent asthma: postgraduate year 3 (PGY3, 100% vs 71%), PGY2 (71% vs 50%), and PGY1 (50% vs 43%). They also performed significantly better in determining subclassifications of persistent asthma: PGY3 (87% vs 40%), PGY2 (67% vs 33%), and PGY1 (50% vs 33%). All had P < .05. Similarly, for within-subject control comparison, residents performed significantly better postintervention at identification and subclassification of persistent asthma than did the same residents at baseline. Conclusions: An educational intervention resulted in significant improvements in the competency of residents in asthma severity classification.

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