TY - JOUR
T1 - Neonatal Intubation Competency Assessment Tool
T2 - Development and Validation
AU - INSPIRE Research Network
AU - Johnston, Lindsay
AU - Sawyer, Taylor
AU - Nishisaki, Akira
AU - Whitfill, Travis
AU - Ades, Anne
AU - French, Heather
AU - Glass, Kristen
AU - Dadiz, Rita
AU - Bruno, Christie
AU - Levit, Orly
AU - Gangadharan, Sandeep
AU - Scherzer, Daniel
AU - Moussa, Ahmed
AU - Auerbach, Marc
N1 - Funding Information:
Financial disclosure: The authors are members of the International Network for Simulation-based Pediatric Innovation, Research, and Education Research Network, which receives infrastructure support from the Rbaby Foundation, and funding for biannual meetings from the Society for Simulation in Healthcare and the International Pediatric Simulation Society.
Funding Information:
The authors acknowledge the participants in the Delphi process, Ellen Deutsch, Hiroshi Kurosawa, Anne Brayer, Laurie Steiner, Dawn Sweeney, Maria Esperanza, Lee Smith, Antoine Payot, Geraldine Pettersen, Chantal Hickey, Jeranil Nunez, and Arlene Garingo., Financial disclosure: The authors are members of the International Network for Simulation-based Pediatric Innovation, Research, and Education Research Network, which receives infrastructure support from the Rbaby Foundation, and funding for biannual meetings from the Society for Simulation in Healthcare and the International Pediatric Simulation Society., Authorship Statement: L.J. conceptualized and designed the study, coordinated the development of the checklist and the Delphi process, designed the data collection instruments, coordinated and collected data, drafted the initial manuscript and critically reviewed the manuscript for important intellectual content. T.S. conceptualized and designed the study, participated in the development of the checklist, designed the data collection instruments for the Delphi process, carried out the initial analysis, and critically reviewed the manuscript for important intellectual content. M.A. and A.N. conceptualized and designed the study, and reviewed and revised the manuscript. T.W. conceptualized and designed the study, analyzed the data, and reviewed and revised the manuscript. A.A., H.F., K.G., R.D., C.B., and O.L. participated in the conceptualization and design of the study, underwent rater training, collected data, and reviewed and revised the manuscript. S.G, D.S., and A.M. conceptualized and designed the study, participated in the development of the checklist and conduct of the Delphi process, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Publisher Copyright:
© 2018 Academic Pediatric Association
PY - 2019/3
Y1 - 2019/3
N2 - Background: Neonatal tracheal intubation (NTI) is an important clinical skill. Suboptimal performance is associated with patient harm. Simulation training can improve NTI performance. Improving performance requires an objective assessment of competency. Competency assessment tools need strong evidence of validity. We hypothesized that an NTI competency assessment tool with multisource validity evidence could be developed and be used for formative and summative assessment during simulation-based training. Methods: An NTI assessment tool was developed based on a literature review. The tool was refined through 2 rounds of a modified Delphi process involving 12 subject-matter experts. The final tool included a 22-item checklist, a global skills assessment, and an entrustable professional activity (EPA) level. The validity of the checklist was assessed by having 4 blinded reviewers score 23 videos of health care providers intubating a neonatal simulator. Results: The checklist items had good internal consistency (overall α = 0.79). Checklist scores were greater for providers at greater training levels and with more NTI experience. Checklist scores correlated with global skills assessment (ρ = 0.85; P <.05), EPA levels (ρ = 0.87; P <.05), percent glottic exposure (r = 0.59; P <.05), and Cormack-Lehane scores (ρ = 0.95; P <.05). Checklist scores reliably predicted EPA levels. Conclusions: We developed an NTI competency assessment tool with multisource validity evidence. The tool was able to discriminate NTI performance based on experience. The tool can be used during simulation-based NTI training to provide formative and summative assessment and can aid with entrustment decisions.
AB - Background: Neonatal tracheal intubation (NTI) is an important clinical skill. Suboptimal performance is associated with patient harm. Simulation training can improve NTI performance. Improving performance requires an objective assessment of competency. Competency assessment tools need strong evidence of validity. We hypothesized that an NTI competency assessment tool with multisource validity evidence could be developed and be used for formative and summative assessment during simulation-based training. Methods: An NTI assessment tool was developed based on a literature review. The tool was refined through 2 rounds of a modified Delphi process involving 12 subject-matter experts. The final tool included a 22-item checklist, a global skills assessment, and an entrustable professional activity (EPA) level. The validity of the checklist was assessed by having 4 blinded reviewers score 23 videos of health care providers intubating a neonatal simulator. Results: The checklist items had good internal consistency (overall α = 0.79). Checklist scores were greater for providers at greater training levels and with more NTI experience. Checklist scores correlated with global skills assessment (ρ = 0.85; P <.05), EPA levels (ρ = 0.87; P <.05), percent glottic exposure (r = 0.59; P <.05), and Cormack-Lehane scores (ρ = 0.95; P <.05). Checklist scores reliably predicted EPA levels. Conclusions: We developed an NTI competency assessment tool with multisource validity evidence. The tool was able to discriminate NTI performance based on experience. The tool can be used during simulation-based NTI training to provide formative and summative assessment and can aid with entrustment decisions.
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U2 - 10.1016/j.acap.2018.07.008
DO - 10.1016/j.acap.2018.07.008
M3 - Article
C2 - 30103050
AN - SCOPUS:85055115843
SN - 1876-2859
VL - 19
SP - 157
EP - 164
JO - Academic Pediatrics
JF - Academic Pediatrics
IS - 2
ER -