title: Development and Validation of a Bronchoscopy Competence Assessment Tool in a Clinical Setting.
abstract: BACKGROUND
  Flexible bronchoscopy is performed by clinicians representing multiple medical specialties in a variety of settings. Given the increasing importance of competency-based assessment in postgraduate training, it is important that this skill be assessed within a competency-based framework using a valid measurement tool.
  
  
  OBJECTIVE
  The purpose of this study was to design and validate a practical, competency-based bronchoscopy assessment tool that could be applied to trainees in a clinical setting.
  
  
  METHODS
  Focus groups of expert physicians were formed in Ottawa, Canada representing adult medical specialties routinely engaged in preparing trainees to perform flexible bronchoscopy (respiratory medicine, critical care, thoracic surgery and anesthesia). The focus groups were charged with identifying themes and items relevant to the assessment of competency in bronchoscopy. By an iterative process, a bronchoscopy assessment tool was developed, the Ontario Bronchoscopy Assessment Tool (OBAT). The tool was evaluated by first using it to assess learners in a pilot study, refining it based on the results, and then testing the OBAT again in a validation study.
  
  
  RESULTS
  The initial tool consisted of 19 items, organized into the following groups: preprocedure planning, sedation and monitoring, technical skill, diagnostic skill, and post-procedure planning. The tool demonstrated high reliability (0.91) and discriminated junior from senior trainees. Based on the results of the pilot, the tool was simplified to a 12-item scale with three subscales: preprocedure planning, technical skills, and post-procedure planning. In the validation study, the assessment tool remained highly reliable (0.92) and discriminated junior from senior trainees with an estimated eight assessments per trainee.
  
  
  CONCLUSIONS
  The OBAT demonstrates promise as a reliable tool to assess trainee competence for bronchoscopy in clinical settings.
authors: 1 Division of Respirology, Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada.
authors: Nha
authors: N
authors: Voduc
authors: 2 Department of Medicine, and.
authors: Nancy
authors: N
authors: Dudek
authors: 3 Department of Medicine, Queen's University, Kingston, Ontario, Canada.
authors: Christopher M
authors: CM
authors: Parker
authors: 2 Department of Medicine, and.
authors: Krishna B
authors: KB
authors: Sharma
authors: 4 Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada; and.
authors: Timothy J
authors: TJ
authors: Wood
mesh_terms: D001999:Bronchoscopy / Q000193:education*; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D017144:Focus Groups; D006801:Humans; D009864:Ontario; D010865:Pilot Projects; D015272:Pulmonary Medicine / Q000193:education*; D015203:Reproducibility of Results
keywords: assessment of clinical competence; bronchoscopy; workplace-based assessment