Dataset Information

Pediatric Airway Assessment Tool (PAAT): A Rating Tool to Assess Resident Proficiency in Simulated Pediatric Airway Skills Performance.

ABSTRACT: Introduction:The Accreditation Council for Graduate Medical Education has identified the need for assessment of core skills for pediatric and emergency medicine residents, which includes pediatric airway management. Although there are standard courses for pediatric airway management, there is no validated tool to assess basic and advanced pediatric airway skills performance. Our objective was to develop a simulation-based tool for the formative assessment of resident pediatric airway skills performance that was concise, yet comprehensive, and to evaluate the evidence supporting the argument for the tool's validity. Methods:We developed a pediatric airway assessment tool (PAAT) to assess six major domains of pediatric airway skills performance: basic airway maneuvers, airway adjuncts, bag-valve mask ventilation, advanced airway equipment preparation, direct laryngoscopy, and video laryngoscopy. This tool consisted of a 72-item pediatric airway skills assessment checklist to be used in simulation. We enrolled 12 subjects at four different training levels to participate. Assessment scores were rated by two independent expert raters. Results:The interrater agreement was high, ranging from 0.92 (adult bagging rate) to 1 (basic airway maneuvers). There was a significant trend of increasing scores with increased training level. Discussion:The PAAT demonstrated excellent interrater reliability and provided evidence of the construct's validity. Although further validation of this assessment tool is needed, these results suggest that the PAAT may eventually be useful for assessment of resident proficiency in pediatric airway skills performance.

SUBMITTER: Wing R

PROVIDER: S-EPMC7586756 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Pediatric Airway Assessment Tool (PAAT): A Rating Tool to Assess Resident Proficiency in Simulated Pediatric Airway Skills Performance.

Wing Robyn R Baird Janette J Duffy Susan S Brown Linda L Overly Frank F Kelley Mariann Nocera MN Merritt Chris C

MedEdPORTAL : the journal of teaching and learning resources 20201019

<h4>Introduction</h4>The Accreditation Council for Graduate Medical Education has identified the need for assessment of core skills for pediatric and emergency medicine residents, which includes pediatric airway management. Although there are standard courses for pediatric airway management, there is no validated tool to assess basic and advanced pediatric airway skills performance. Our objective was to develop a simulation-based tool for the formative assessment of resident pediatric airway ski ...[more]

PMID: 33117887

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Project description:Purpose: The aim of this study was to develop a tool to assess physical therapists' knowledge, skills, and judgement in performing airway suctioning with intubated and non-intubated adults. Method: A modified Delphi methodology was used to develop the tool and to evaluate its sensibility (i.e., common-sense nature). Participants were experienced cardiorespiratory physical therapists who perform airway suctioning and physical therapists employed in academic positions related to cardiorespiratory physical therapy at Canadian universities. Round 1 focused on refining which items to include in the tool, Round 2 focused on finalizing the items, and Round 3 focused on evaluating a preliminary version of the tool. Results: A total of 34 individuals participated in Round 1, 30 participated in Round 2, and 25 participated in Round 3. A literature review identified 11 relevant domains and 69 supporting competencies. In Round 1, consensus was achieved for all domains; however, it was borderline for the professionalism domain. Multiple participants suggested that it was redundant because it is a global requirement for all physical therapists. Consensus was also achieved for 64 of the 69 supporting competencies; however, it was borderline for 5 of these items, and 5 achieved no consensus. In Round 2, participants rated a series of recommendations related to items requiring further consideration, as well as 9 new items suggested by the participants in Round 1. In Round 3, the preliminary tool was found to be globally sensible, but concerns were expressed about the inclusion of redundant factors and the tool's length. The tool was revised, resulting in a tool with 4 domains, 6 sub-domains and 43 supporting competencies, as well as an item rating the individual's overall performance. Conclusions: The final-round sensibility questionnaire provided preliminary evidence of the tool's face and content validity. We will investigate the tool's measurement properties in a future study.

Project description:BackgroundDuring workplace-based clinical placements, best practice assessment states students should expect consistency between assessors rating their performance. To assist clinical educators (CEs) to provide consistent assessment of physiotherapy student performance, nine paediatric vignettes depicting various standards of simulated student performance, as assessed by the Assessment of Physiotherapy Practice (APP), were developed. The APP defines adequate on the global rating scale (GRS) as the minimally acceptable standard for an entry-level physiotherapist. The project aimed to evaluate consistency of paediatric physiotherapy educators assessing simulated student performance using the APP GRS.MethodsThree paediatric scenarios representing neurodevelopment across three age ranges, infant, toddler and adolescent, were developed and scripted that depicted a 'not adequate', 'adequate' and 'good-excellent' performance based on the APP GRS. An expert panel (n = 9) conducted face and content validation. Once agreement was reached for all scripts, each video was filmed. A purposive sample of physiotherapists providing paediatric clinical education in Australia were invited to participate in the study. Thirty-five CEs, with minimum 3-years clinical experience and had supervised a student within the past year, were sent three videos at four-week intervals. Videos depicted the same clinical scenario, however performance varied with each video. Participants rated the performance on the four categories: 'not adequate', 'adequate', 'good' and 'excellent' Consistency among raters was assessed using percentage agreement to establish reliability.ResultsThe vignettes were assessed a combined total of 59 times. Across scenarios, percentage agreement at the not adequate level was 100%. In contrast, the adequate scenarios for the Infant, Toddler and Adolescent video failed to meet the 75% agreement level. However, when combining adequate or good-excellent, percentage agreement was > 86%. The study demonstrated strong consensus when comparing not adequate to adequate or better performance. Importantly, no performance scripted as not adequate was passed by any assessor.ConclusionsExperienced educators demonstrate consistency in identifying not adequate from adequate or good-excellent performance when assessing a simulated student performance using the APP. Recommendation for practice: These validated video vignettes will be a valuable training tool to improve educator consistency when assessing student performance in paediatric physiotherapy.

Project description:The development of operative skills during general surgery residency depends largely on the resident surgeons' (residents) ability to accurately self-assess and identify areas for improvement. We compared evaluations of laparoscopic skills and comfort level of residents from both the residents' and attending surgeons' (attendings') perspectives.We prospectively observed 111 elective cholecystectomies at the University of Michigan as part of a larger quality improvement initiative. Immediately after the operation, both residents and attendings completed a survey in which they rated the residents' operative proficiency, comfort level, and the difficulty of the case using a previously validated instrument. Residents' and attendings' evaluations of residents' performance were compared using 2-sided t tests.The University of Michigan Health System in Ann Arbor, MI. Large academic, tertiary care institution.All general surgery residents and faculty at the University of Michigan performing laparoscopic cholecystectomy between June 1 and August 31, 2013. Data were collected for 28 of the institution's 54 trainees.Attendings rated residents higher than what residents rated themselves on a 5-point Likert-type scale regarding depth perception (3.86 vs. 3.38, p < 0.005), bimanual dexterity (3.75 vs. 3.36, p = 0.005), efficiency (3.58 vs. 3.18, p < 0.005), tissue handling (3.69 vs. 3.23, p < 0.005), and comfort while performing a case (3.86 vs. 3.38, p < 0.005). Attendings and residents were in agreement on the level of autonomy displayed by the resident during the case (3.31 vs. 3.34, p = 0.85), the level of difficulty of the case (2.98 vs. 2.85, p = 0.443), and the degree of teaching done by the attending during the case (3.61 vs. 3.54, p = 0.701).A gap exists between residents' and attendings' perception of residents' laparoscopic skills and comfort level in performing laparoscopic cholecystectomy. These findings call for improved communication between residents and attendings to ensure that graduates are adequately prepared to operate independently. In the context of changing methods of resident evaluations that call for explicitly defined competencies in surgery, it is essential that residents are able to accurately self-assess and be in general agreement with attendings on their level of laparoscopic skills and comfort level while performing a case.

Dataset Information

Pediatric Airway Assessment Tool (PAAT): A Rating Tool to Assess Resident Proficiency in Simulated Pediatric Airway Skills Performance.

Publications

Pediatric Airway Assessment Tool (PAAT): A Rating Tool to Assess Resident Proficiency in Simulated Pediatric Airway Skills Performance.

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