title: A valid and reliable assessment tool for remote simulation-based ultrasound-guided regional anesthesia.
abstract: OBJECTIVE
  The purpose of this study was to establish construct and concurrent validity and interrater reliability of an assessment tool for ultrasound-guided regional anesthesia (UGRA) performance on a high-fidelity simulation model.
  
  
  METHODS
  Twenty participants were evaluated using a Checklist and Global Rating Scale designed for assessing any UGRA block. The participants performed an ultrasound-guided supraclavicular brachial plexus block on both a patient and a simulator. Evaluations were completed in-person by an expert and remotely by a blinded expert using video recordings. Using previous number of blocks performed as an indication of expertise, participants were divided into Novice (n = 8) and Experienced (n = 12) groups. Construct validity was assessed through the tool's reliable on-site and remote discrimination of Novice and Experienced anesthetists. Concurrent validity was established by comparisons of patient versus simulator scoring. Finally, interrater reliability was determined by comparing the scores of on-site and off-site evaluators.
  
  
  RESULTS
  The Global Rating Scale was able to differentiate Novice from Experienced anesthetists both by on-site and remote assessment on a patient and simulation model. The Checklist was unable to discern the 2 groups on a simulation model remotely and was marginally significant with on-site scoring.
  
  
  CONCLUSIONS
  This is the first study to demonstrate the validity and reliability of a Global Rating Scale assessment tool for use in UGRA simulation training. Although the checklist may require further refinement, the Global Rating Scale can be used for remote and on-site assessment of UGRA skills.
authors.affiliation: From the *Department of Anesthesia and Pain Management, and †Temerty/Chang International Centre for Telesimulation and Innovation in Medical Education, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; and ‡Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Burckett-St Laurent
authors.forename: Ahtsham U
authors.initials: AU
authors.lastname: Niazi
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Cunningham
authors.forename: Melanie
authors.initials: M
authors.lastname: Jaeger
authors.forename: Sherif
authors.initials: S
authors.lastname: Abbas
authors.forename: Jason
authors.initials: J
authors.lastname: McVicar
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Chan
mesh_terms: D000776:Anesthesiology / Q000193:education*; D065527:Brachial Plexus Block; D057189:Checklist; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D015588:Observer Variation; D015203:Reproducibility of Results; D013647:Task Performance and Analysis; D018084:Ultrasonography, Interventional; D014741:Video Recording