Endobronchial Ultrasound Skills and Tasks Assessment Tool Assessing the Validity Evidence for a Test of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Operator Skill
Endobronchial Ultrasound Skills and Tasks Assessment Tool Assessing the Validity Evidence for a Test of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Operator Skill
复制标题
DOI：
10.1164/rccm.201111-1968oc
复制
发表时间：
2012-10-15
影响因子：
24.7
通讯作者：
Mullon, John I.
中科院分区：
文献类型：
--
作者：
Davoudi, Mohsen;Colt, Henri G.;Mullon, John I.
基本原理：支气管内超声引导下经支气管针吸活检（EBUS-TBNA）正在成为纵隔淋巴结病采样的标准护理。对安全、有效、准确的操作的需求使得EBUS-TBNA成为掌握培训和测试的理想选择。目的：支气管内超声技能和任务评估工具（EBUS-STAT）是作为EBUS-TBNA技能和知识的客观能力导向评估工具而创建的。本研究证明了这种工具的可靠性和有效性evidence of this tool.Methods：EBUS-STAT客观地评分EBUS-TBNA操作员的技能，包括无创气道引入和导航，超声图像采集和优化，纵隔淋巴结和血管结构的识别，EBUS-TBNA采样，以及纵隔结构的EBUS/CT图像的识别。它可以在床边或使用低和高保真模拟平台的组合进行管理。两名独立的测试人员在三个机构对三个EBUS-TBNA经验水平的24名操作员（8名初学者，8名中级人员和8名经验丰富的操作员）进行EBUS-STAT管理;操作员还被要求自我评估他们的技能。对测试者之间的信度、与先前EBUS-TBNA经验的相关性以及与自我assessment. Measures的相关性进行了分析，主要结果：测试者之间的测试者之间的信度非常高（r 0.9991，P < .00005）。初学者、中级和有经验组的平均EBUS-STAT评分分别为31.1、74.9和93.6/100（F-2，F-21 = 118.6，P < 0.0001）。组是不重叠的：事后检验显示每组与其他组有显著差异（P <0.001）。结论：EBUS-STAT可用于EBUS-TBNA操作者从新手到专家的客观、可靠的评分和分类。它用于评估和记录知识和技能的获得是EBUS-TBNA掌握培训目标的一步。
Rationale: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming standard of care for the sampling of mediastinal adenopathy. The need for a safe, effective, accurate procedure makes EBUS-TBNA ideal for mastery training and testing.Objectives: The Endobronchial Ultrasound Skills and Tasks Assessment Tool (EBUS-STAT) was created as an objective competency-riented assessment tool of EBUS-TBNA skills and knowledge. This study demonstrates the reliability and validity evidence of this tool.Methods: The EBUS-STAT objectively scores the EBUS-TBNA operator's skills, including atraumatic airway introduction and navigation, ultrasound image acquisition and optimization, identification of mediastinal nodal and vascular structures, EBUS-TBNA sampling, and recognition of EBUS/computed tomography images of mediastinal structures. It can be administered at the bedside or using combination of low- and high-fidelity simulation platforms. Two independent testers administered the EBUS-STAT to 24 operators at three levels of EBUS-TBNA experience (8 beginners, 8 intermediates, and 8 experienced) at three institutions; operators were also asked to self-assess their skills. Scores were analyzed for intertester reliability, correlation with prior EBUS-TBNA experience, and association with self-assessments.Measurements and Main Results: Intertester reliability between testers was very high (r 0.9991, P < .00005). Mean EBUS-STAT scores for beginner, intermediate, and experienced groups, respectively, were 31.1, 74.9, and 93.6 out of 100 (F-2,F-21 = 118.6, P < 0.0001). Groups were nonoverlapping: post hoc tests showed each group differed significantly from the others (P < .001). Self-assessments corresponded closely to actual EBUS-STAT scores (r(2) = 0.81, P < 0.001).Conclusions: The EBUS-STAT can be used to reliably and objectively score and classify EBUS-TBNA operators from novice to expert. Its use to assess and document the acquisition of knowledge and skill is a step toward the goal of mastery training in EBUS-TBNA.