Competency-based assessment in surgeon-performed head and neck ultrasonography: A validity study

Area of Science:

• Medical Imaging
• Otolaryngology
• Ultrasound Technology

Background:

• Head and neck ultrasonography (HNUS) is a valuable point-of-care tool for otolaryngologists.
• Ultrasonography (US) is operator-dependent, necessitating skill assessment.

Purpose of the Study:

• To evaluate the diagnostic accuracy of surgeon-performed HNUS.
• To validate an objective structured assessment of ultrasound skills (OSAUS) for competency-based evaluation.

Main Methods:

• Prospective experimental study involving six otolaryngologists and 11 novices.
• Participants performed focused HNUS on patients with suspected head and neck lesions.
• Diagnostic accuracy was assessed, and video-recorded performances were evaluated using the OSAUS scale by blinded raters.

Main Results:

• Otolaryngologists achieved 88% diagnostic accuracy vs. 38% for novices (P < 0.001).
• The OSAUS scale showed good reliability (inter-case 0.85, inter-rater 0.76) and discriminated between skill levels (P < 0.001).
• A strong correlation (Spearman's ρ = 0.85, P < 0.001) was found between OSAUS scores and diagnostic accuracy, with a pass/fail threshold of 2.8.

Conclusions:

• The OSAUS scale provides strong validity evidence for assessing HNUS competence.
• The scale demonstrates reliability, discriminates skill levels, and correlates with diagnostic accuracy.
• An established OSAUS pass/fail score can support competence-based assessment in surgeon-performed HNUS.