Validation of a Curricular Map on Cardiac Implantable Electronic Devices (CIEDs) for Cardiac Anesthesia Trainees

Despite an increased exposure of cardiac anesthesia trainees to cardiac implantable electronic devices (CIEDs), there is a paucity of formal curricula on the subject. Herein, we present the validation of a CIED curricular map by a group of CIED experts and educators. The purpose of this stage of curriculum development is to determine whether experts in education regarding CIEDs consider: (a) the goals and objectives to be critical, (b) the degree to which the instructional materials align with specific objectives, (c) the degree to which the assessments reflect the objectives to which they have been aligned, and (d) the degree to which the assessments are adequately informed by the instructional materials for the aligned objectives.

The curriculum validation process involved the identification of a national panel of 15 experts in curricula relating to CIEDs. Each panelist received an online survey (Qualtrics), which presented the 17 major learning goals of the curriculum and the instructional objectives for each goal (5-15 objectives per goal). Respondents were asked to rate the importance of each instructional objective (not important, important, and essential), the fit of the objective to the learning goal (does not fit and aligns), and the clarity of the objective (unclear/ambiguous and clear). Respondents were also asked to propose additional objectives that would be needed to adequately represent the learning goal. A content validity ratio (CVR) is computed for each instructional objective based on the proportion of panelists who rate the objective as essential. A content validity index (CVI) is computed for each learning goal based on the sum of the CVRs for the objectives comprising a goal divided by the number of panelists. CVIs of greater than 0.72 across at least three raters are considered to provide sufficient evidence of the validity. Other variables (fit, clarity, and supplemental objectives) within the survey were used to discern and improve the quality of the objectives.

While all objectives were rated as important or essential by at least 80% of the 15 raters, several goals had fewer than 70% of their objectives rated as essential by 73% or more of the experts. Notably, six goals (3, 6, 8, 10, 12, and 13) had no objectives rated as essential by more than 73% of the experts. Although the overall CVR and CVI were lower than desired, there was significant agreement regarding the importance of the objectives for each goal. More than 80% of experts indicated that all objectives appropriately fit their respective goals.

CIED curriculum is well-received by national experts. Curricular refinements were made to meet the desired goals of agreement before finalizing the curriculum.