Design and Validation of a Clinical Teaching Performance Checklist in Anesthesia Education: A Kane-Based Approach

Clinical teaching is essential in high-risk disciplines such as anesthesia. MSc students in Anesthesia Education require validated tools to assess their instructional performance during clinical internships. This study aimed to design and validate a clinical teaching performance checklist for MSc students in Anesthesia Education using Kane's argument-based validation framework.

This descriptive-analytical, cross-sectional, single-center study was conducted at Iran University of Medical Sciences (2023-2025) with 11 fourth-semester MSc students. The checklist was developed using curriculum objectives, Entrustable Professional Activities (EPAs), focus groups, and a two-round Delphi process with 10 experts. Face and content validity (Impact Score, CVR, CVI), reliability (Cronbach's alpha, ICC across two settings), and extrapolation evidence (Spearman correlation with global ratings) were evaluated.

Seven EPAs yielded a 20-item checklist. Content validity was acceptable (CVI≥0.79 for most items; two retained via expert consensus). The instrument showed high internal consistency (Cronbach's α=0.88) and excellent inter-rater reliability (ICC≥0.98). Extrapolation inference was supported by a strong correlation with faculty global ratings (r_s=0.81). Faculty and students reported high satisfaction with the tool.

This study offers promising preliminary evidence supporting the feasibility, validity, and reliability of the EPA-based checklist for clinical teaching assessment. Integrating Kane's framework with EPAs provides a structured approach for formative evaluation; however, broader confirmation through larger, multicenter studies is required prior to widespread implementation.