Pediatric Airway Management and Intubation Support Competency Assessment Tool

Background: Assessment tools for health professionals providing airway management and team support during airway events are essential to facilitate learning and document competence. We aimed to evaluate the validity of evidence of the Pediatric Airway Management and Intubation Support (PAMIS) tool for use in assessing the competency of respiratory therapists (RTs) assisting with pediatric intubation in a simulated environment. Methods: The PAMIS tool, developed based on task deconstruction, comprises 10 items assessing 3 core competency domains (manual ventilation, intubation preparation and assistance, and interprofessional team collaboration) and a global rating of performance. Novice and intermediate RT trainees and experienced registered RTs performed a simulated airway management scenario that was assessed independently by 2 live raters and 2 blinded video-based raters using the PAMIS tool. Fifteen videos were also re-evaluated by blinded raters 3 months later. Validity evidence for the tool was generated following Messick's validity framework, including evidence of content, response process, internal structure, and relations with other variables. Results: We analyzed assessments for 51 participants (15 novice, 21 intermediate, and 15 experienced participants) completed by 10 assessors. Internal consistency was acceptable (α = 0.75), with item-total correlations ranging from 0.17 to 0.74. Inter-rater reliability was high for both live (intraclass correlation coefficient [ICC] = 0.97) and video-based assessments (ICC = 0.85), with strong agreement between the 2 assessment modalities (ICC = 0.94). Test-retest reliability was excellent (ICC = 0.92). PAMIS scores differed significantly based on experience level (P < .001) and correlated highly with a global assessment of performance ratings (r = 0.89, P < .001). Both live and video-based ratings were perceived as user-friendly, with live assessments perceived as easier to use. Conclusions: The PAMIS tool demonstrated strong validity evidence for use as a formative assessment of competence for RTs providing pediatric airway management and intubation assistance within a simulated setting. This study presents a validated assessment tool designed to support competency-based RT education and practice.