The McGill Simulation Complexity Score

• Published in: Canadian journal of surgery 2023-04, Vol.66 (2), p.206
• Main Authors: Deban, Melina, Deckelbaum, Dan, Bader, Bader Al, Razek, Tarek, Khwaja, Kosar, Iqbal, Sameena, Alowais, Jalal
• Format: Article
• Language: English
• Subjects: Examinations; Medical education; Methods; Scoring; Simulated patients; Study and teaching; Traumatology
• ISSN: 0008-428X
• DOI: 10.1503/cjs.002220

Background: In medical education, simulation can be defined as an activity in which an individual demonstrates skills, procedures and critical thinking using interactive mannequins in a setting closely resembling the clinical environment. To our knowledge, the complexity of trauma simulations has not previously been assessed. We aimed to develop an objective trauma simulation complexity score and assess its interrater reliability. Methods: The McGill Simulation Complexity Score (MSCS) was designed to address the need for objective evaluation of the complexity of trauma scenarios. Components of the score reflected the Advanced Trauma Life Support approach to trauma. The score was developed to take into account the severity of trauma injuries and the complexity of their management. We assessed interrater reliability at 5 highfidelity simulation events. Interrater reliability was calculated using the Pearson correl ation coefficient (PCC) and the intraclass correlation coefficient (ICC). Results: The MSCS has 5 categories: airway, breathing, circulation, disability, and extremities or exposure. The scale has 5 levels for each category, from 0 to 4; level increases with complexity, with 0 corresponding to normal or absent. Cases designed to lead to cardiac arrest, regardless of whether or not the trainee has the ability to resuscitate the simulated patient and regardless of the level of each category, are automatically assigned the maximum score. Between 3 and 9 raters used the MSCS to grade the level of complexity of 26 scenarios at the 5 events. The mean MSCS was 10.2 (range 3.0-20.0). Mean PCC and ICC values were both above 0.7 and therefore statistically significant. Conclusion: The MSCS for trauma is an innovative scoring system with high interrater reliability. Contexte : Dans le contexte de la formation medicale, la simulation peut se definir comme une activite au cours de laquelle une personne demontre ses habiletes, pose des gestes et exerce son jugement critique en se servant de mannequins interactifs dans un environnement qui imite de pres la realite clinique. A notre connaissance, la complexite des simulations en traumatologie n'avait encore jamais ete evaluee. Nous avons voulu mettre au point un indice de complexite objectif des simulations en traumatologie et en evaluer la fabilite interevaluateurs. Methodes : L'indice McGill de complexite des simulations (IMCS) a ete concu pour repondre au besoin d'evaluer objectivement la complexite des scenari