When used in daily practice, the de Oliveira Filho supervision instrument is reliable and valid when measuring the quality of supervision of CRNAs by anesthesiologists. (Image source: Thinkstock)

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Anesthesiologists frequently supervise Certified Registered Nurse Anesthetists (CRNAs). The quality of supervision is an important metric in assessing the quality of anesthesia care. Dr. de Oliveira Filho developed a tool to measure the quality of supervision of CRNAs and residents by the attending anesthesiologist.  It is important to assess the reliability of this instrument before it is widely adopted.

Dr. Franklin Dexter, Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa, sought to determine the reliability of the supervision assessment instrument in their manuscript published in this month’s issue of Anesthesia & Analgesia “Reliability and Validity of the Anesthesiologist Supervision Instrument When Certified Registered Nurse Anesthetists Provide Scores.â€

In the authors’ department, CRNAs and anesthesiology residents provide a daily evaluation of the anesthesiologist who supervised them in the operating room. The evaluations utilize the 9 questions developed by de Oliveira Filho to assess anesthesiologist supervision by residents. Each question is answered on a four-point Likert scale (1=never, 2=rarely, 3=frequently, 4=always).  From July 1, 2013 through June 30, 2014 the authors collected 7273 daily faculty supervision scores and 1088 comments from CRNAs and 6246 daily faculty supervision scores and 681 comments from residents. The authors used these data to demonstrate that the instrument is reliable and valid when used in daily practice by the CRNAs. Part of the validation was based on the demonstration that anesthesiologists who received low mean scores from the CRNAs also received low mean scores from the residents.

Based on these results, the de Oliveira Filho instrument is a valid instrument to assess the quality of supervision provided by the attending anesthesiologist.