Web-based Simulation as a Component of Continuing Medical Education: Data from the CSAT Project

Tristan Gorrindo MD, Division of Post-Graduate Medical Education, Massachusetts General Hospital
Elizabeth Goldfarb, BA, Division of Post-Graduate Medical Education, Massachusetts General Hospital
Lee Baer, PhD, Division of Post-Graduate Medical Education, Massachusetts General Hospital
Robert J Birnbaum, MD, PhD, Division of Post-Graduate Medical Education, Massachusetts General Hospital
John A Fromson, MD, Division of Post-Graduate Medical Education, Massachusetts General Hospital

The Computer Simulation Assessment Tool (CSAT) is designed to address specific needs within psychiatry and is driven by a three-fold educational approach to: serve as an educational intervention, provide a performance assessment for each user, and conduct a documented knowledge gap analysis. CSAT simulations are accessed online. The user views an introduction and selects items from clinical lines of inquiry corresponding to learning objectives. For each item chosen, a video shows a patient and clinician completing the action. To approximate real-life encounters, the simulation includes embedded decoys and a time limit. CSATs have been used for a wide range of clinical scenarios ranging from management of stroke to informed consent for medication. CSAT provides an educational intervention upon completion of a simulation. Participants are provided with immediate, personalized remediation in the form of explanations of incorrect actions (omitted or completed in error) and links to relevant peer-reviewed manuscripts. Data collected from CSAT include errors of commission and omission, order choice, time management, and a virtual medical-chart note. When combined, these items create a rich assessment of performance. Finally, when data is aggregated across participants, specific measurements (e.g. which required items are consistently omitted, or which terms were not mentioned in the virtual note) can determine gaps in knowledge, thus providing learning objectives in future courses.