title: Endobronchial ultrasound skills and tasks assessment tool: assessing the validity evidence for a test of endobronchial ultrasound-guided transbronchial needle aspiration operator skill.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming standard of care for the sampling of mediastinal adenopathy. The need for a safe, effective, accurate procedure makes EBUS-TBNA ideal for mastery training and testing.
  
  
  OBJECTIVE
  The Endobronchial Ultrasound Skills and Tasks Assessment Tool (EBUS-STAT) was created as an objective competency-oriented assessment tool of EBUS-TBNA skills and knowledge. This study demonstrates the reliability and validity evidence of this tool.
  
  
  METHODS
  The EBUS-STAT objectively scores the EBUS-TBNA operator's skills, including atraumatic airway introduction and navigation, ultrasound image acquisition and optimization, identification of mediastinal nodal and vascular structures, EBUS-TBNA sampling, and recognition of EBUS/computed tomography images of mediastinal structures. It can be administered at the bedside or using combination of low- and high-fidelity simulation platforms. Two independent testers administered the EBUS-STAT to 24 operators at three levels of EBUS-TBNA experience (8 beginners, 8 intermediates, and 8 experienced) at three institutions; operators were also asked to self-assess their skills. Scores were analyzed for intertester reliability, correlation with prior EBUS-TBNA experience, and association with self-assessments.
  
  
  RESULTS
  Intertester reliability between testers was very high (r = 0.9991, P < 0.00005). Mean EBUS-STAT scores for beginner, intermediate, and experienced groups, respectively, were 31.1, 74.9, and 93.6 out of 100 (F(2,21) = 118.6, P < 0.0001). Groups were nonoverlapping: post hoc tests showed each group differed significantly from the others (P < 0.001). Self-assessments corresponded closely to actual EBUS-STAT scores (r(2) = 0.81, P < 0.001).
  
  
  CONCLUSIONS
  The EBUS-STAT can be used to reliably and objectively score and classify EBUS-TBNA operators from novice to expert. Its use to assess and document the acquisition of knowledge and skill is a step toward the goal of mastery training in EBUS-TBNA.
authors: Division of Pulmonary and Critical Care Medicine, University of California-Irvine, Orange, CA 92868, USA. mdavoudi@uci.edu
authors: Mohsen
authors: M
authors: Davoudi
authors: Henri G
authors: HG
authors: Colt
authors: Kathryn E
authors: KE
authors: Osann
authors: Carla R
authors: CR
authors: Lamb
authors: John J
authors: JJ
authors: Mullon
mesh_terms: D019985:Benchmarking; D001999:Bronchoscopy / Q000193:education*; D002983:Clinical Competence; D004521:Educational Measurement; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006801:Humans; D015999:Multivariate Analysis; D015588:Observer Variation; D012044:Regression Analysis; D015203:Reproducibility of Results; D012647:Self-Assessment; D014481:United States