Advances in Medical Education and Practice
Development and Pilot Evaluation of the ECALM Program: A Bedside Clinical Assessment Tool for First-Year Residents in the Emergency Department
By Siiri Astudillo Kunnas, Lilia Rotari, Farès Moustafa and 1 others.
Abstract
Objectives
To describe the development and pilot evaluation of the ECALM program ("bedside clinical evaluation”, in French), a formative bedside assessment framework designed for first-year residents during emergency department (ED) rotations.
Methods
The ECALM program was developed prospectively in three stages, in accordance with Stufflebeam’s "context, input, process, product” framework: (i) a baseline needs assessment survey, (ii) the development of standardized clinical scenarios via a structured expert consensus process, and (iii) a single-center pilot implementation. Six core clinical themes were selected (chest pain, abdominal pain, limb trauma, syncope, fever, and confusion), on the basis of epidemiological data from French EDs. A pilot study involving 12 first-year residents was conducted at Amiens University Medical Center’s ED (Amiens, France). Each resident was evaluated with a single scenario, and each session included a structured briefing, passive bedside observation by paired, independent, senior evaluators, and a formative debriefing. Psychometric evaluation of the ECALM tool was based on inter-rater reliability, using the intraclass correlation coefficient (ICC(2,1)) calculated using a two-way random-effects model for absolute agreement based on a single measurement, the weighted kappa, and a Bland–Altman analysis of inter-observer differences.
