Direct Observation Tools in Emergency Medicine: A Systematic Review of the Literature

• Type of Material: Article
• Authors: Michael Gottlieb, Rush University Medical Center; Jaime Jordan, Ronald Reagan UCLA Medical Center; Jeffrey Siegelman, Emory University; Robert Cooney, Geisinger Medical Center; Christine Stehman, South Bend Emergency Physicians; Teresa M Chan, McMaster University
• Language: English
• Date: 2021-07-01
• Publisher: Society for Academic Emergency Medicine
• Publication Version: Final Published Version
• Copyright Statement: © 2020 by the Society for Academic Emergency Medicine
• Final Published Version (URL): http://dx.doi.org/10.1002/aet2.10519
• Title of Journal or Parent Work: AEM Education and Training
• Volume: 5
• Issue: 3
• Start Page: e10519
• End Page: e10519
• Keywords: Emergency Medicine
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Objectives: Direct observation is important for assessing the competency of medical learners. Multiple tools have been described in other fields, although the degree of emergency medicine–specific literature is unclear. This review sought to summarize the current literature on direct observation tools in the emergency department (ED) setting. Methods: We searched PubMed, Scopus, CINAHL, the Cochrane Central Register of Clinical Trials, the Cochrane Database of Systematic Reviews, ERIC, PsycINFO, and Google Scholar from 2012 to 2020 for publications on direct observation tools in the ED setting. Data were dual extracted into a predefined worksheet, and quality analysis was performed using the Medical Education Research Study Quality Instrument. Results: We identified 38 publications, comprising 2,977 learners. Fifteen different tools were described. The most commonly assessed tools included the Milestones (nine studies), Observed Structured Clinical Exercises (seven studies), the McMaster Modular Assessment Program (six studies), Queen’s Simulation Assessment Test (five studies), and the mini-Clinical Evaluation Exercise (four studies). Most of the studies were performed in a single institution, and there were limited validity or reliability assessments reported. Conclusions: The number of publications on direct observation tools for the ED setting has markedly increased. However, there remains a need for stronger internal and external validity data.