Journal article
Nurse anesthetists' evaluations of anesthesiologists' operating room performance are sensitive to anesthesiologists' years of postgraduate practice
Journal of Clinical Anesthesia, Vol.54, pp.102-110
05/2019
DOI: 10.1016/j.jclinane.2018.10.027
PMID: 30415149
Abstract
The first aim of this study was to test whether a 7 item evaluation scale developed by our department's certified registered nurse anesthetists (CRNAs) was psychometrically reliable. The second aim was to test whether anesthesiologists' performance changed with their years of postgraduate experience. Sixty-two University of Iowa CRNAs evaluated 81 anesthesiologists during one weekend. Anesthesiologists' scores were adjusted for CRNA rater leniency. Anesthesiologists' scores were tested for sensitivity to CRNA-anesthesiologist case-specific variables. Scores also were tested against anesthesiologists' years of postgraduate experience. The latter association was tested for sensitivity to case-specific variables, anesthesiologists' clinical supervision scores provided by residents, and anesthesiologist clinical assignment variables. The 7 items demonstrated a single-factor structure, allowing calculation of mean score over the 7 items. Individual anesthesiologist scores were reliable when scores were provided by at least 10 different CRNAs. Anesthesiologists' scores (mean 3.34 [SD 0.41]) were not affected by the interval since last CRNA-anesthesiologist interaction, number of interactions, or case-specific variables. There was a negative association between leniency-adjusted anesthesiologist scores and years of anesthesiologist postgraduate practice (coefficient −0.20 per decade, t = −19.39, P < 0.0001). The association remained robust when accounting for case-specific variables, resident clinical supervision scores, and overall clinical assignment variables. Anesthesiologists' operating room performance can be evaluated reliably by non-physician anesthesia providers (CRNAs). The evaluation process can be done reliably and validly using an assessment scale consisting of only a few (<10) items and with evaluations by only a few individuals (≥10 CRNA raters). There is no indication evaluations provided by CRNAs were significantly influenced by the interval between interaction and evaluation, number of interactions, or other case-specific variables. From CRNAs' perspectives, on average, as anesthesiologists gain experience, anesthesiologists' behaviors in the operating room change, providing CRNAs with less direct assistance in patient care. •US anesthesia departments must provide metrics to confirm physicians' competence.•Certified registered nurse anesthetist (CRNA)-based assessments may be feasible.•A 7 item evaluation developed by our department's CRNAs was psychometrically reliable.•Anesthesiologists' scores decreased with increasing postgraduate practice.
Details
- Title: Subtitle
- Nurse anesthetists' evaluations of anesthesiologists' operating room performance are sensitive to anesthesiologists' years of postgraduate practice
- Creators
- Mary K O'Brien - The University of Iowa College of Nursing. College of Nursing Building, 50 Newton Road, Iowa City, IA 52242-1121, USAFranklin Dexter - The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Department of Anesthesia, Division of Management Consulting, 200 Hawkins Drive, Iowa City, IA 52242-1089, USAClarence D Kreiter - The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Office of Consultation and Research in Medical Education, 1204 Medical Education Building. Iowa City, IA 52242-1000, USAChad Slater-Scott - The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Department of Anesthesia, 200 Hawkins Drive, Iowa City, IA 52242-1089, USABradley J Hindman - The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Department of Anesthesia, 200 Hawkins Drive, Iowa City, IA 52242-1089, USA
- Resource Type
- Journal article
- Publication Details
- Journal of Clinical Anesthesia, Vol.54, pp.102-110
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jclinane.2018.10.027
- PMID
- 30415149
- ISSN
- 0952-8180
- eISSN
- 1873-4529
- Language
- English
- Date published
- 05/2019
- Academic Unit
- Health Management and Policy; Family and Community Medicine; Anesthesia
- Record Identifier
- 9983806379002771
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