Preparing for emergency: a valid, reliable assessment tool for emergency cricothyroidotomy skills.
OBJECTIVE
Emergency cricothyrodotomy (EC) is a lifesaving procedure. Evidence-based assessment of training effects and competency levels is relevant to all departments involved in emergency airway management. As most training uses low-fidelity models, the predictive value of good performance on such a model becomes relevant with regard to performance on a high-fidelity model (cadaver). This requires a valid assessment tool for EC performance.


METHODS
Psychometric study on low-fidelity models and human cadavers.


METHODS
University hospital.


METHODS
An assessment tool was created. Sixteen physicians (7 experienced surgeons and 9 novice physicians) performed an EC on a low-fidelity model and a cadaver. Two blinded raters assessed video recordings of performances using the assessment tool.


RESULTS
We found a high interrater reliability, based on a Pearson's r (0.81), and good evidence for validity, based on successfully distinguishing the 2 groups, using an independent samples t test (P < .001). We found a good correlation between performance on a low-fidelity model and the cadaver with an R (2) = 0.78.


CONCLUSIONS
The tool for assessing EC competence proved reliable and valid. Performance on a low-fidelity model measured this way is a good predictor of performance in a more lifelike situation.
Department of Otorhinolaryngology, Head and Neck Surgery, Centre of Head and Orthopedics, Rigshospitalet, University Hospital of Copenhagen, Denmark Jacob.melchiors@gmail.com.
Jacob
J
Melchiors
Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark Department of Surgery, Queen Ingrid's Hospital, Nuuk, Greenland.
Tobias
T
Todsen
Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark.
Philip
P
Nilsson
Department of Otorhinolaryngology, Head and Neck Surgery, Centre of Head and Orthopedics, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Kasper
K
Wennervaldt
Department of Otorhinolaryngology, Head and Neck Surgery, Centre of Head and Orthopedics, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Birgitte
B
Charabi
Department of Anesthesia, Centre of Head and Orthopedics, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Morten
M
Bøttger
Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark.
Lars
L
Konge
Department of Otorhinolaryngology, Head and Neck Surgery, Centre of Head and Orthopedics, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Christian
C
von Buchwald
D058109:Airway Management / Q000379:methods*; D002102:Cadaver; D002983:Clinical Competence; D003413:Cricoid Cartilage / Q000601:surgery*; D004630:Emergencies; D006785:Hospitals, University; D006801:Humans; D007318:Inservice Training; D008348:Manikins; D011594:Psychometrics; D015203:Reproducibility of Results; D014741:Video Recording
airway skills; assessment; cricothyroidotomy; objective surgical assessment tool; reliability; simulation; surgical education; surgical skills; validity