Use of Simulation in High-Stakes Summative Assessments in Surgery

Abstract

The recent emphasis on advancing competency-based education and training, focus on improving processes of credentialing and privileging using objective data, and evolving requirements for Maintenance of Certification have underscored the use of simulation in high-stakes summative assessments in surgery. This chapter includes review of key issues relating to the use of simulation in high-stakes summative assessments in surgery, addresses validity evidence as it relates to high-stakes assessments, defines competence for high-stakes decisions, and emphasizes the necessity of standard setting to establish passing scores that may help to affirm competence and proficiency. The chapter also highlights specific simulation-based examinations that have been developed and used to make high-stakes summative decisions and provides examples from both surgical and nonsurgical domains. Lastly, the chapter includes review of advantages and disadvantages relating to the use of simulation in high-stakes summative assessments that may be linked to certification, credentialing, and privileging and provides insight to the future of the use of simulation for such assessments.