title: Development of a Tool to Assess Basic Competency in the Performance of Rigid Bronchoscopy.
abstract: BACKGROUND
  Rigid bronchoscopy is increasingly used by pulmonologists for the management of central airway disorders. However, an assessment tool to evaluate the competency of operators in the performance of this technique has not been developed. We created the Rigid Bronchoscopy Tool for Assessment of Skills and Competence (RIGID-TASC) to serve as an objective, competency-oriented assessment tool of basic rigid bronchoscopic skills, including rigid bronchoscopic intubation and central airway navigation.
  
  
  OBJECTIVE
  To assess whether RIGID-TASC scores accurately distinguish the basic rigid bronchoscopy skills of novice, intermediate, and expert operators, and to determine whether RIGID-TASC has adequate interrater reliability when used by different independent testers.
  
  
  METHODS
  At two academic medical centers in the United States, 30 physician volunteers were selected in three categories: 10 novices at rigid bronchoscopy (performed at least 50 flexible, but no rigid, bronchoscopies), 10 operators with intermediate experience (performed 5-20 rigid bronchoscopies), and 10 experts (performed ≥100 rigid bronchoscopies). Participants included pulmonary and critical care fellows, interventional pulmonology fellows, and faculty interventional pulmonologists. Each subject then performed rigid bronchoscopic intubation and navigation on a manikin, while being scored independently by two testers, using RIGID-TASC.
  
  
  RESULTS
  Mean scores for three categories (novice, intermediate, and expert) were 58.10 (±4.6 [SE]), 78.15 (±3.8), and 94.40 (±1.1), respectively. There was significant difference between novice and intermediate (20.05, 95% confidence interval [CI] = 7.77-32.33, P = 0.001), and intermediate and expert (16.25, 95% CI = 3.97-28.53, P = 0.008) operators. The interrater reliability (intraclass correlation coefficient) between the two testers was high (r = 0.95, 95% CI = 0.90-0.98).
  
  
  CONCLUSIONS
  RIGID-TASC showed evidence of construct validity and interrater reliability in this setting and group of subjects. It can be used to reliably and objectively score and classify operators from novice to expert in basic rigid bronchoscopic intubation and navigation.
authors.affiliation: 1 Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and.
authors.forename: Kamran
authors.initials: K
authors.lastname: Mahmood
authors.affiliation: 1 Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and.
authors.forename: Momen M
authors.initials: MM
authors.lastname: Wahidi
authors.affiliation: 2 Department of Medicine, Division of Hematology-Oncology, and.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Osann
authors.affiliation: 1 Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Coles
authors.affiliation: 1 Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Shofer
authors.affiliation: 1 Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Volker
authors.affiliation: 3 Division of Pulmonary and Critical Care Medicine, University of California Irvine, Orange, California.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Davoudi
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D001999:Bronchoscopy / Q000193:education*; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008348:Manikins; D010820:Physicians; D015272:Pulmonary Medicine / Q000592:standards*; D000072106:Pulmonologists / Q000193:education*; D015203:Reproducibility of Results; D014481:United States
keywords: bronchoscopy; competency-based education; pulmonary surgical procedures