Assessing competence in Chest Tube Insertion with the ACTION-tool: A Delphi study

Area of Science:

• Medical Education
• Surgical Simulation
• Procedural Skill Assessment

Background:

• Chest Tube Insertion (CTI) requires standardized training in simulated environments.
• Valid assessment tools are crucial for effective simulation-based medical education and certification.
• Current assessment methods for CTI may lack comprehensive validation.

Purpose of the Study:

• To develop a novel assessment tool for Chest Tube Insertion (CTI).
• To ensure content validity of the CTI assessment tool through expert consensus.
• To establish a reliable method for evaluating CTI competency in simulated settings.

Main Methods:

• A structured Delphi study involving a diverse European expert panel (surgeons, pulmonologists, emergency physicians).
• Multi-round surveys to identify procedural steps and errors, and to achieve consensus on their inclusion and descriptive anchors.
• Consensus defined as ≥80% agreement among participants for item inclusion.

Main Results:

• A multidisciplinary panel achieved consensus on 17 procedural steps and 16 errors for the assessment tool.
• The developed tool, ACTION (Assessment of Competence in Chest Tube Insertion), incorporates a rating scale and a checklist.
• High expert agreement was reached on the final components of the ACTION tool.

Conclusions:

• The ACTION tool, comprising 17 steps and 16 errors, was developed through expert consensus.
• This procedure-specific rating scale offers a novel approach to assessing CTI competence.
• Further research is needed to gather additional validity evidence for the ACTION tool.