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Assessing Chest Tube Insertion Skills Using a Porcine Rib Model-A Validity Study
Leander De Mol1, Amber Lievens, Najade De Pauw
1From the Department of Human Structure and Repair (L.D.M., A.L., N.D.P., I.V.H., L.D., W.W.), Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Gastrointestinal Surgery (H.V., W.W.), Ghent University Hospital, Ghent, Belgium; Department of Thoracic and Vascular Surgery (I.V.H., L.D.), Ghent University Hospital, Ghent, Belgium; Department of Basic and Applied Medical Sciences (P.V.d.V.), Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Emergency Medicine (P.V.d.V.), Ghent University Hospital, Ghent, Belgium; Faculty of Health and Medical Sciences, (L.K.) University of Copenhagen, Copenhagen, Denmark; and Copenhagen Academy for Medical Education and Simulation (CAMES) (L.K.), Copenhagen, Denmark.
The ACTION tool demonstrates strong validity for assessing chest tube insertion skills on a porcine model. This tool aids in training and evaluating procedural competence before patient care.
Area of Science:
- Medical Education
- Surgical Skills Assessment
- Procedural Simulation
Background:
- Validity evidence is crucial for assessment tools.
- The Assessment for Competence in Chest Tube Insertion (ACTION) tool assesses chest tube insertion (CTI) proficiency.
- The study aimed to gather validity evidence for the ACTION tool using a porcine rib model.
Purpose of the Study:
- To collect validity evidence for the ACTION tool on a porcine rib model.
- To evaluate the ACTION tool's rating scale and error checklist.
- To establish a pass/fail score for the ACTION tool.
Main Methods:
- A porcine hemithorax rib model was used as a simulator.
- Participants performed two chest tube insertions while being scored with the ACTION tool.
- Performances were assessed live and via video by blinded raters; generalizability analysis was conducted.
Main Results:
- High generalizability coefficients were found for both the rating scale (0.92) and error checklist (0.87).
- Novice participants scored significantly lower than experienced participants on the first chest tube insertion (P=0.042).
- A pass/fail score of 44/68 was established using the contrasting groups' method.
Conclusions:
- The ACTION tool's rating scale provides a solid basis for validity on a porcine rib model.
- The tool is suitable for both formative and summative assessment of procedural skills.
- It can be used to train and assess competence before patient contact.
