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Tytuł pozycji:

Reliable and valid assessment of procedural skills in resuscitative endovascular balloon occlusion of the aorta.

Tytuł:
Reliable and valid assessment of procedural skills in resuscitative endovascular balloon occlusion of the aorta.
Autorzy:
Engberg M; From the Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education (M.E., L.K., M.B.S., M.F., L.R.), Capital Region of Denmark, København; Department of Clinical Medicine, Faculty of Health and Medical Sciences (M.E., L.L., L.K., M.T.), University of Copenhagen; Department of Radiology (L.L., M.T.), Copenhagen University Hospital Rigshospitalet, Copenhagen; The Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care (S.M.), The Prehospital Research Unit (S.M.), Region of Southern Denmark, Odense University Hospital; Department of Regional Health Research (S.M.), University of Southern Denmark, Odense, Denmark; Department of Cardiothoracic and Vascular Surgery and Department of Surgery, Faculty of Life Science (T.H.), Örebro University Hospital, Örebro; Department of Clinical Sciences, Faculty of Medicine (H.L.), Lund University, Lund; Section of Interventional Radiology, Department of Surgery (H.L.), Helsingborg Hospital, Helsingborg, Sweden; Department of Radiology and Nuclear Medicine (E.S.), St. Olavs University Hospital, Trondheim, Norway; Department of Otorhinolaryngology, Head & Neck Surgery and Audiology (M.F.), and Department of Intensive Care (L.R.), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Lönn L
Konge L
Mikkelsen S
Hörer T
Lindgren H
Søvik E
Svendsen MB
Frendø M
Taudorf M
Russell L
Źródło:
The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2021 Oct 01; Vol. 91 (4), pp. 663-671.
Typ publikacji:
Journal Article; Multicenter Study; Validation Study
Język:
English
Imprint Name(s):
Original Publication: Hagerstown, MD : Lippincott, Williams & Wilkins
MeSH Terms:
Balloon Occlusion/*standards
Clinical Competence/*standards
Endovascular Procedures/*education
Out-of-Hospital Cardiac Arrest/*therapy
Resuscitation/*education
Aorta/surgery ; Endovascular Procedures/methods ; Endovascular Procedures/standards ; Humans ; Male ; Manikins ; Reproducibility of Results ; Resuscitation/methods ; Resuscitation/standards ; Simulation Training/methods
References:
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Entry Date(s):
Date Created: 20210705 Date Completed: 20211110 Latest Revision: 20230828
Update Code:
20240105
DOI:
10.1097/TA.0000000000003338
PMID:
34225347
Czasopismo naukowe
Background: Valid and reliable assessment of skills is essential for improved and evidence-based training concepts. In a recent study, we presented a novel tool to assess procedural skills in resuscitative endovascular balloon occlusion of the aorta (REBOA), REBOA-RATE, based on international expert consensus. Although expert consensus is a strong foundation, the performance of REBOA-RATE has not been explored. The study aimed to examine the reliability and validity of REBOA-RATE.
Methods: This was an experimental simulation-based study. We enrolled doctors with three levels of expertise to perform two REBOA procedures in a simulated scenario of out-of-hospital cardiac arrest. Procedures were video-recorded, and videos were blinded and randomized. Three clinical experts independently rated all procedures using REBOA-RATE. Data were analyzed using Messick's framework for validity evidence, including generalizability analysis of reliability and determination of a pass/fail standard.
Results: Forty-two doctors were enrolled: 16 novices, 13 anesthesiologists, and 13 endovascular experts. They all performed two procedures, yielding 84 procedures and 252 ratings. The REBOA-RATE assessment tool showed high internal consistency (Cronbach's α = 0.95) and excellent interrater reliability (intraclass correlation coefficient, 0.97). Assessment using one rater and three procedures could ensure overall reliability suitable for high-stakes testing (G-coefficient >0.80). Mean scores (SD) for the three groups in the second procedure were as follows: novices, 32% (24%); anesthesiologists, 55% (29%); endovascular experts, 93% (4%) (p < 0.001). The pass/fail standard was set at 81%, which all experts but no novices passed.
Conclusion: Data strongly support the reliability and validity of REBOA-RATE, which successfully discriminated between all experience levels. The REBOA-RATE assessment tool requires minimal instruction, and one rater is sufficient for reliable assessment. Together, these are strong arguments for the use of REBOA-RATE to assess REBOA skills, allowing for competency-based training and certification concepts.
Level of Evidence: Diagnostic test, no or poor gold standard, level V.
(Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

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