title: The Face, Content, and Construct Validity Assessment of a Focused Assessment in Sonography for Trauma Simulator.
abstract: OBJECTIVE
  Hemorrhage identification in trauma care is a major priority. Focused assessment in sonography for trauma (FAST) offers a rapid, reliable means of detecting torso bleeding. The aims of this study were to conduct a face, content, and construct validity assessment of a FAST simulator and establish a rigorous assessment tool.
  
  
  METHODS
  Participants were requested to perform a FAST scan and state if any abnormality was found in each region. Metrics evaluated included time, errors, and missed targets. Accuracy of images obtained was assessed by 2 independent radiologists. Experts completed a face and content validity questionnaire at the end of the study.
  
  
  METHODS
  The study took place in the simulation suite within the Academic Surgical Unit of the Department of Surgery and Cancer.
  
  
  METHODS
  Novices had no prior experience with ultrasound, intermediates had less than 6 months experience with fewer than 50 FAST scans performed, and experts had more than 1 year of experience with greater than 100 FAST scans performed. There were 31 participants: 11 experts, 10 intermediates, and 10 novices.
  
  
  RESULTS
  The face and content validity questionnaire scored high marks across all categories and achieved an overall median realism score of 8 ± 1.5 on a Likert scale. Experts performed the FAST scan faster with more accuracy and fewer errors than other cohorts (p < 0.001). Both the novices and intermediates were the slowest, least accurate, and either missed or made the most errors when scanning the lung bases and spleen.
  
  
  CONCLUSIONS
  This study has established the face, content, and construct validities of a FAST simulator, which could be used to accelerate training for novices. Additionally, it has demonstrated a rigorous method for FAST assessment, which has proven to be effective and in doing so addressed some of the criticisms leveled against it.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom. Electronic address: muzzafer.chaudery10@imperial.ac.uk.
authors.forename: Muzzafer
authors.initials: M
authors.lastname: Chaudery
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Clark
authors.affiliation: Department of Radiology, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Derf Ap
authors.initials: DA
authors.lastname: Dafydd
authors.affiliation: Department of Radiology, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Joel
authors.initials: J
authors.lastname: Dunn
authors.affiliation: Department of Trauma Surgery, Kings College Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Duncan
authors.initials: D
authors.lastname: Bew
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Wilson
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D002983:Clinical Competence; D004635:Emergency Medicine / Q000193:education; D013502:General Surgery / Q000193:education; D006470:Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D019047:Phantoms, Imaging; D011871:Radiology / Q000193:education; D000066908:Simulation Training / Q000379:methods*; D011795:Surveys and Questionnaires; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*
keywords: Medical Knowledge; Practice-Based Learning and Improvement; education; hemorrhage identification; simulation; trauma; ultrasound