Measuring competence: Validating a new Pelvic Assessment Tool (The PEAT Study)

Abstract

This article was migrated. The article was not marked as recommended. IntroductionMedical students are required by the General Medical Council to be proficient in performing a full female pelvic examination (FPE) prior to graduating as doctors. However, many UK medical schools do not conduct a formal summative assessment. Exploration of three electronic databases found no citations evaluating an assessment tool for pelvic examination. Methods The 'PEAT' was developed with an evidence-based literature search and consists of six domains, evaluating attitudes; inspection; bimanual palpation; adnexal examination; speculum; communication; and a global score using a 10cm visual analogue scale. 60 participants including final year medical students and junior doctors were divided into three groups of 20 according to their experience in performing gynaecological examination. Each participant performed a pelvic examination with a role player and pelvic model, which was video recorded. 20 Consultant assessors, who were blinded to the level of experience, used the PEAT for 15 video clips with a mix of participants from each group. Assessors also completed a questionnaire about the utility, relevance and face validity of the PEAT. The inter-assessor reliability of the PEAT was calculated using Cronbach's alpha. Statistical analysis was performed for continuous variables using the Student t-test.Results8/20 (40%) assessors returned their assessment packs. There was a significant increase in the mean score in the 'inspection' domain for novice compared with experienced students (p=0.02). A significant decrease was seen in the mean score for 'adnexal examination' for novice and experienced students compared with junior doctors (p=0.04;p=0.05 respectively). The mean assessor score for the ease of use and perceived effectiveness of PEAT was 7.4 (SD ±1.32) and 6.6 (SD ±1.19) on a 10cm VAS respectively. The PEAT had good or excellent internal consistency (α≥ 0.7) in 4/8 assessors (50%).ConclusionsThe PEAT appears to be easy to use and have face validity. However, further refinements are necessary for this PEAT to establish construct validity and improve reliability.