Abstract
Contrast-enhanced ultrasound (CEUS) is an imaging modality applied in a broad field of medical specialties for diagnostic uses, guidance during biopsy procedures and ablation therapies and sonoporation therapy. Appropriate training and assessment of theoretical and practical competencies are recommended before practicing CEUS, but no validated assessment tools exist. This study was aimed at developing a theoretical multiple-choice question-based test for core CEUS competencies and gathering validity evidence for the test. An expert team developed the test via a Delphi process. The test was administered to medical doctors with varying CEUS experience, and the results were used to evaluate test items, internal-consistency reliability, ability to distinguish between different proficiency levels and to establish a pass/fail score. Validity evidence was gathered according to Messick's framework. The final test with 47 test items could distinguish between operators with and without CEUS experience with acceptable reliability. The pass/fail score led to considerable risk of false positives and negatives. The test may be used as an entry test before learning practical CEUS competencies but is not recommended for certification purposes because of the risk of false positives and negatives.
Highlights
Contrast-enhanced ultrasound Contrast-enhanced ultrasound (CEUS) is an imaging modality in which an ultrasound contrast agent (UCA) is Ultrasound in Medicine & BiologyVolume 00, Number 00, 2021 and pattern with high temporal and spatial resolution (Wilson et al 2020)
We aimed to recruit more than 10 participants from each study group, as this sample size can be considered as normally distributed in medical educational research (Bloch and Norman 2012)
In 1999, this framework of validity evidence was accepted as standard in the field of medical education; as such, our study provides a theoretical test developed in accordance with best practice in educational research (American Educational Research Association et al 1999)
Summary
Contrast-enhanced ultrasound Contrast-enhanced ultrasound (CEUS) is an imaging modality in which an ultrasound contrast agent (UCA) is Ultrasound in Medicine & BiologyVolume 00, Number 00, 2021 and pattern with high temporal and spatial resolution (Wilson et al 2020). UCAs are non-toxic and safe to use (Piscaglia and Bolondi 2006). International US societies provide guidelines and recommendations for the clinical practice of hepatic and non-hepatic CEUS, but recommendations regarding training and competence assessment are less well established (European Federation of Societies for Ultrasound in Medicine and Biology [EFSUMB] 2010; Sidhu et al 2018; Dietrich et al 2020). A useful model of the taxonomy of competencies is George Miller’s pyramid (Miller 1990). This model describes four different layers of competencies and how these may be assessed. The levels dealing with cognitive (theoretical) knowledge are prerequisites for learning practical skills, and can be assessed adequately by written tests, such as multiple-choice question (MCQ) tests (Downing and Yudkowsky 2009)
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