Table.

Assessment Methods

Method	Pros	Cons	Feedback Source
Direct observation (sole source)6,7,9,17–20	Individualized feedback Versatile as to setting (simulation vs real life) and skill being assessed Can teach observer the skills necessary to do this well	Most reliable with validated instrument Subject to the opinion of the observer so works best with trained observer	Standardized patient Live patient Observed structured clinical examination
Direct observation (multisource)9–11,13,21	Individualized feedback Versatile as to setting (simulation vs real life) and skill being assessed	Subject to the biases of the observer as often the observers have not undergone formal training and lack specific skills	Standardized patient Live patient Observed structured clinical examination
Team assessment12,22–24	Team feedback Team building Works with simulated and real-life scenarios	Unique to the composition of that team Can be subject to the power dynamics of the team hierarchy	Team members Direct observers Formal debriefing session
Recording of interaction9,10,17	Allows trainee to see themselves	Added pressure of recording process may alter behavior	Standardized patient Live patient Observed structured clinical examination