Abstract
BackgroundTraditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia.MethodsThree groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity.ResultsThirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores.ConclusionsThis is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.
Highlights
Technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists
Subjects were categorized in three groups according to their level of experience: 10 novice, 10 intermediate and 10 attending anesthesiologists with obstetric or regional anesthesia fellowship and at least 5 years of experience in regional anesthesia
In order to standardize their level of knowledge, all participants reviewed a video on the technique of spinal anesthesia
Summary
Technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. It represents a real challenge to traditional methods of medical education [1,2,3] In this context, most of the technical proficiency in anesthesia is assessed using task-specific checklists or global rating scales applied during procedures performed in real patients. Most of the technical proficiency in anesthesia is assessed using task-specific checklists or global rating scales applied during procedures performed in real patients Some of these specific technical domains of performance remain underrepresented and the rates of failure and complications during training process are. The aim of this study was to determine the construct validity of the ICSAD as an assessment tool in spinal. We want to determine the concurrent validity of the ICSAD by correlating it with the scores of previously validated assessment tools [7, 11]
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