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Competency‐based assessment in surgeon‐performed head and neck ultrasonography: A validity study
Author(s) -
Todsen Tobias,
Melchiors Jacob,
Charabi Birgitte,
Henriksen Birthe,
Ringsted Charlotte,
Konge Lars,
von Buchwald Christian
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26841
Subject(s) - otorhinolaryngology , medicine , competence (human resources) , diagnostic accuracy , ultrasonography , head and neck surgery , radiology , validity , medical physics , physical therapy , surgery , psychometrics , psychology , clinical psychology , social psychology
Objective Head and neck ultrasonography (HNUS) increasingly is used as a point‐of‐care diagnostic tool by otolaryngologists. However, ultrasonography (US) is a very operator‐dependent image modality. Hence, this study aimed to explore the diagnostic accuracy of surgeon‐performed HNUS and to establish validity evidence for an objective structured assessment of ultrasound skills (OSAUS) used for competency‐based assessment. Study Design A prospective experimental study. Methods Six otolaryngologists and 11 US novices were included in a standardized test setup for which they had to perform focused HNUS of eight patients suspected for different head and neck lesions. Their diagnostic accuracy was calculated based on the US reports, and two blinded raters assessed the video‐recorded US performance using the OSAUS scale. Results The otolaryngologists obtained a high diagnostic accuracy on 88% (range 63%–100%) compared to the US novices on 38% (range 0–63%); P < 0.001. The OSAUS score demonstrated good inter‐case reliability (0.85) and inter‐rater reliability (0.76), and significant discrimination between otolaryngologist and US novices; P < 0.001. A strong correlation between the OSAUS score and the diagnostic accuracy was found (Spearman's ρ, 0.85; P < P 0.001), and a pass/fail score was established at 2.8. Conclusion Strong validity evidence supported the use of the OSAUS scale to assess HNUS competence with good reliability, significant discrimination between US competence levels, and a strong correlation of assessment score to diagnostic accuracy. An OSAUS pass/fail score was established and could be used for competence‐based assessment in surgeon‐performed HNUS. Level of Evidence NA. Laryngoscope , 128:1346–1352, 2018