Abstract
Background: Our goal is to develop metrics that quantify the translation of performance from cadavers to patients. Our primary objective was to develop steps and error checklists from a Delphi questionnaire. Our second objective was to show that our test scores were valid and reliable.
Methods: Sixteen UK experts identified 15 steps conducive to good performance and 15 errors to be avoided during interscalene block on the soft-embalmed cadaver and patients. Thereafter, six experts and six novices were trained, and then tested. Training consisted of psychometric assessment, an anatomy tutorial, volunteer scanning, and ultrasound-guided needle insertion on a pork phantom and on a soft-embalmed cadaver. For testing, participants conducted a single interscalene block on a dedicated soft-embalmed cadaver whilst wearing eye tracking glasses.
Results: We developed a 15-step checklist and a 15-error checklist. The internal consistency of our steps measures were 0.83 (95% confidence interval [CI]: 0.78-0.89) and 0.90 (95% CI: 0.87-0.93) for our error measures. The experts completed more steps (mean difference: 3.2 [95% CI: 1.5-4.8]; P<0.001), had less errors (mean difference: 4.9 [95% CI: 3.5-6.3]; P<0.001), had better global rating scores (mean difference: 6.8 [95% CI: 3.6-10.0]; P<0.001), and more eye-gaze fixations (median of differences: 128 [95% CI: 0-288]; P=0.048). Fixation count correlated negatively with steps (r=-0.60; P=0.04) and with errors (r=0.64; P=0.03).
Conclusions: Our tests to quantify ultrasound-guided interscalene nerve block training and performance were valid and reliable.
| Original language | English |
|---|---|
| Pages (from-to) | 368-377 |
| Number of pages | 10 |
| Journal | British Journal of Anaesthesia |
| Volume | 123 |
| Issue number | 3 |
| Early online date | 27 Jun 2019 |
| DOIs | |
| Publication status | Published - Sep 2019 |
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Keywords
- cadaver
- eye tracking
- interscalene block
- metrics
- regional anaesthesia
- simulation
- ultrasound guidance
- Patient Simulation
- Reproducibility of Results
- Ultrasonography, Interventional/methods
- Humans
- Education, Medical, Graduate/methods
- Psychometrics
- Scotland
- Nerve Block/standards
- Delphi Technique
- Translational Medical Research/methods
- Checklist
- Anesthesiology/education
- Cadaver
Cite this
}
Validity and reliability of metrics for translation of regional anaesthesia performance from cadavers to patients. / McLeod, Graeme (Lead / Corresponding author); McKendrick, Mel; Taylor, Alasdair; Lynch, Joanna; Ker, Jean; Sadler, Amy; Halcrow, Jayne; McKendrick, Gary; Mustafa, Ayman; Seeley, Jonathan; Raju, Pavan; Corner, George.
In: British Journal of Anaesthesia, Vol. 123, No. 3, 09.2019, p. 368-377.Research output: Contribution to journal › Article
TY - JOUR
T1 - Validity and reliability of metrics for translation of regional anaesthesia performance from cadavers to patients
AU - McLeod, Graeme
AU - McKendrick, Mel
AU - Taylor, Alasdair
AU - Lynch, Joanna
AU - Ker, Jean
AU - Sadler, Amy
AU - Halcrow, Jayne
AU - McKendrick, Gary
AU - Mustafa, Ayman
AU - Seeley, Jonathan
AU - Raju, Pavan
AU - Corner, George
PY - 2019/9
Y1 - 2019/9
N2 - Background: Our goal is to develop metrics that quantify the translation of performance from cadavers to patients. Our primary objective was to develop steps and error checklists from a Delphi questionnaire. Our second objective was to show that our test scores were valid and reliable.Methods: Sixteen UK experts identified 15 steps conducive to good performance and 15 errors to be avoided during interscalene block on the soft-embalmed cadaver and patients. Thereafter, six experts and six novices were trained, and then tested. Training consisted of psychometric assessment, an anatomy tutorial, volunteer scanning, and ultrasound-guided needle insertion on a pork phantom and on a soft-embalmed cadaver. For testing, participants conducted a single interscalene block on a dedicated soft-embalmed cadaver whilst wearing eye tracking glasses.Results: We developed a 15-step checklist and a 15-error checklist. The internal consistency of our steps measures were 0.83 (95% confidence interval [CI]: 0.78-0.89) and 0.90 (95% CI: 0.87-0.93) for our error measures. The experts completed more steps (mean difference: 3.2 [95% CI: 1.5-4.8]; P<0.001), had less errors (mean difference: 4.9 [95% CI: 3.5-6.3]; P<0.001), had better global rating scores (mean difference: 6.8 [95% CI: 3.6-10.0]; P<0.001), and more eye-gaze fixations (median of differences: 128 [95% CI: 0-288]; P=0.048). Fixation count correlated negatively with steps (r=-0.60; P=0.04) and with errors (r=0.64; P=0.03).Conclusions: Our tests to quantify ultrasound-guided interscalene nerve block training and performance were valid and reliable.
AB - Background: Our goal is to develop metrics that quantify the translation of performance from cadavers to patients. Our primary objective was to develop steps and error checklists from a Delphi questionnaire. Our second objective was to show that our test scores were valid and reliable.Methods: Sixteen UK experts identified 15 steps conducive to good performance and 15 errors to be avoided during interscalene block on the soft-embalmed cadaver and patients. Thereafter, six experts and six novices were trained, and then tested. Training consisted of psychometric assessment, an anatomy tutorial, volunteer scanning, and ultrasound-guided needle insertion on a pork phantom and on a soft-embalmed cadaver. For testing, participants conducted a single interscalene block on a dedicated soft-embalmed cadaver whilst wearing eye tracking glasses.Results: We developed a 15-step checklist and a 15-error checklist. The internal consistency of our steps measures were 0.83 (95% confidence interval [CI]: 0.78-0.89) and 0.90 (95% CI: 0.87-0.93) for our error measures. The experts completed more steps (mean difference: 3.2 [95% CI: 1.5-4.8]; P<0.001), had less errors (mean difference: 4.9 [95% CI: 3.5-6.3]; P<0.001), had better global rating scores (mean difference: 6.8 [95% CI: 3.6-10.0]; P<0.001), and more eye-gaze fixations (median of differences: 128 [95% CI: 0-288]; P=0.048). Fixation count correlated negatively with steps (r=-0.60; P=0.04) and with errors (r=0.64; P=0.03).Conclusions: Our tests to quantify ultrasound-guided interscalene nerve block training and performance were valid and reliable.
KW - cadaver
KW - eye tracking
KW - interscalene block
KW - metrics
KW - regional anaesthesia
KW - simulation
KW - ultrasound guidance
KW - Patient Simulation
KW - Reproducibility of Results
KW - Ultrasonography, Interventional/methods
KW - Humans
KW - Education, Medical, Graduate/methods
KW - Psychometrics
KW - Scotland
KW - Nerve Block/standards
KW - Delphi Technique
KW - Translational Medical Research/methods
KW - Checklist
KW - Anesthesiology/education
KW - Cadaver
UR - http://www.scopus.com/inward/record.url?scp=85067892974&partnerID=8YFLogxK
U2 - 10.1016/j.bja.2019.04.060
DO - 10.1016/j.bja.2019.04.060
M3 - Article
C2 - 31255289
VL - 123
SP - 368
EP - 377
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
SN - 0007-0912
IS - 3
ER -