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Measuring Residents' Competence in Chest Tube Insertion on Thiel-Embalmed Bodies: A Validity Study.

Leander De Mol1, Isabelle Van Herzeele, Patrick Van de Voorde

  • 1From the Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium (L.D.M., I.V.H., L.D., W.W.); Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium (I.V.H., L.D.); Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium (P.V.d.V.); Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium (P.V.d.V.); Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium (H.V., W.W.); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (L.K.); and Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen, Denmark (L.K.).

Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
|January 9, 2025
PubMed
Summary

This study validated the Assessment for Competence in Chest Tube InsertiON (ACTION) tool on Thiel-embalmed bodies. The rating scale shows good validity for simulation-based training, but the error checklist needs improvement for summative assessments.

Keywords:
Chest tube insertionsimulation-based medical educationvalidity argument

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Area of Science:

  • Medical Education
  • Surgical Simulation
  • Anatomical Models

Background:

  • Chest tube insertions (CTIs) have high complication rates, necessitating effective training.
  • Simulation-based training requires validated assessment tools for technical skills.
  • Thiel-embalmed bodies offer a realistic platform for CTI training.

Purpose of the Study:

  • To gather validity evidence for assessing CTI technical skills using the ACTION tool on Thiel-embalmed bodies.
  • To evaluate the reliability and validity of the ACTION tool's rating scale and error checklist.
  • To establish a pass/fail threshold for the ACTION tool.

Main Methods:

  • Participants (residents and staff) performed CTIs on Thiel-embalmed bodies.
  • The Assessment for Competence in Chest Tube InsertiON (ACTION) tool, including a rating scale and error checklist, was used for assessment.
  • Live and video-based assessments were conducted, with generalizability analysis for reliability.

Main Results:

  • The ACTION tool's rating scale demonstrated moderate generalizability (0.75).
  • Novices scored significantly lower on the rating scale than experienced participants (P=0.024).
  • The error checklist showed low generalizability (0.4) and no significant difference in errors between groups.

Conclusions:

  • The ACTION tool's rating scale is valid for assessing CTI skills on Thiel-embalmed bodies in simulation-based mastery learning.
  • The ACTION tool's error checklist lacks sufficient reliability and validity for summative assessment.
  • Further refinement of the error checklist is recommended.