title: Establishing pass/fail criteria for bronchoscopy performance.
abstract: BACKGROUND
  Several tools have been created to assess competence in bronchoscopy. However, educational guidelines still use an arbitrary number of performed procedures to decide when basic competency is acquired.
  
  
  OBJECTIVE
  The purpose of this study was to define pass/fail scores for two bronchoscopy assessment tools, and investigate how these scores relate to physicians' experience regarding the number of bronchoscopy procedures performed.
  
  
  METHODS
  We studied two assessment tools and used two standard setting methods to create cut scores: the contrasting-groups method and the extended Angoff method. In the first we compared bronchoscopy performance scores of 14 novices with the scores of 14 experienced consultants to find the score that best discriminated between the two groups. In the second we asked an expert group of 7 experienced bronchoscopists to judge how a borderline trainee would perform on each item of the test.
  
  
  RESULTS
  Using the contrasting-groups method we found a standard that would fail all novices and pass all consultants. A clear pass related to prior experience of 75 procedures. The consequences of using the extended Angoff method were also acceptable: all trainees who had performed less than 50 bronchoscopies failed the test and all consultants passed. A clear pass related to 80 procedures.
  
  
  CONCLUSIONS
  Our proposed pass/fail scores for these two methods seem appropriate in terms of consequences. Prior experience with the performance of 75 and 80 bronchoscopies, respectively, seemed to ensure basic competency. In the future objective assessment tools could become an important aid in the certification of physicians performing bronchoscopies.
authors: Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark. lkonge@yahoo.dk
authors: Lars
authors: L
authors: Konge
authors: Paul
authors: P
authors: Clementsen
authors: Klaus Richter
authors: KR
authors: Larsen
authors: Henrik
authors: H
authors: Arendrup
authors: Christian
authors: C
authors: Buchwald
authors: Charlotte
authors: C
authors: Ringsted
mesh_terms: D001999:Bronchoscopy / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000592:standards*; D006801:Humans; D012016:Reference Values