The relationship between performance on computer-based clinical simulations and two written methods of evaluation: cognitive examination and self-evaluation of expertise.

The purpose of this study was to explore the relationship between computer-based clinical simulation performance and two commonly used methods of evaluation: cognitive examination and self-evaluation of expertise. The convenience sample of 68 critical care nurses completed the Basic Knowledge Assessment Tool for Critical Care (BKAT), a cardiovascular self-assessment tool (CST), and two computer-based clinical simulations requiring the management of myocardial infarction patients with tachydysrhythmias (atrial flutter and ventricular tachycardia). Simulation performance was measured by proficiency score and patient outcome (live/die). Proficiency on the atrial simulation was significantly correlated with knowledge as measured by the BKAT (r = 0.46, p 0.001) and with self-evaluation of clinical expertise (r = 0.32, p = 0.008). Atrial patient outcome was also significantly correlated with the BKAT (r = 0.28, p = 0.006) and the CST score (r = 0.22, p = 0.036). However, in the ventricular simulation only proficiency score and self-evaluation of expertise were significantly correlated (r = 0.24, p = 0.049). The modest relationships found in this study may indicate that, while clinical simulation performance is related to knowledge and self-evaluation of expertise, the constructs measured are not synonymous. This evidence provides support for the use of clinical simulations as an adjunct to other methods of evaluation.