Patients with critical illnesses are more likely to survive when cared for by Intensive care unit (ICU) specialists, but a shortage of critical care-trained professionals jeopardizes the goal of providing ICU specialty care to these patients. Nurse practitioners, physician assistants and other hospital-based physicians are increasingly called upon to provide care for patients in the ICU, but many of these health professionals do not have the education or experience to safely manage these patients. This project will test the hypothesis that simulation can be used to assess whether health care professionals have the requisite knowledge and skill to provide care for patients in the ICU. Our research team includes critical care physician and nursing educators, who direct educational programs for physicians and advanced practice nurses and simulation experts who have experience in designing and implementing simulation-based assessment strategies. This multidisciplinary investigative team will construct and validate scenarios simulating conditions that require prompt diagnosis and management in the ICU. Expert physicians and nurses will be used to judge performances and their decisions about competence will be used to establish minimum performance standards to care for critically ill patients. This research strategy will provide a common assessment tool that can be used to define competence of health care professionals from the diverse professional and specialty training backgrounds that currently manage ICU patients. The methodology using expert consensus of simulation scenario performance to define a performance standard could be broadly adapted to other domains of practice. Our long-term goal is to develop methodology that uses simulation to define practice standards that could be applied to elevate practice standards and make patient care safer.

Public Health Relevance

Intensive care teams improve the outcome of critically ill patients, but a shortage of health care professionals with intensive care skills limits efforts to implement this team model of care. In this project, a team of intensive care specialists, health care educators and simulation experts will develop a simulation-based performance assessment that will assure health care professionals possess the requisite skills to manage critically ill patients. The simulation methodology offers a means to assess skills and develop a consensus about proficiency that could be widely used to define practice standards and assure provider proficiency ultimately leading to safer patient care.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
Project #
Application #
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Henriksen, Kerm
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Washington University
Schools of Medicine
Saint Louis
United States
Zip Code
Spehar, Brent; Tye-Murray, Nancy; Myerson, Joel et al. (2016) Real-Time Captioning for Improving Informed Consent: Patient and Physician Benefits. Reg Anesth Pain Med 41:65-8
Murray, David J; Freeman, Brad D; Boulet, John R et al. (2015) Decision making in trauma settings: simulation to improve diagnostic skills. Simul Healthc 10:139-45
Nykiel-Bailey, Sydney M; McAllister, John D; Schrock, Charles R et al. (2015) Difficult airway consultation service for children: steps to implement and preliminary results. Paediatr Anaesth 25:363-71
Murray, David J (2014) Progress in simulation education: developing an anesthesia curriculum. Curr Opin Anaesthesiol 27:610-5