title: Reliability of the direct observation of procedural skills assessment tool for ultrasound-guided regional anaesthesia.
abstract: The Direct Observation of Procedural Skills (DOPS) form is used as a workplace-based assessment tool in the current Australian and New Zealand College of Anaesthetists curriculum. The objective of this study was to evaluate the reliability of DOPS when used to score trainees performing ultrasound-guided regional anaesthesia. Reliability of an assessment tool is defined as the reproducibility of scores given by different assessors viewing the same trainee. Forty-nine anaesthetists were recruited to score two scripted videos of trainees performing a popliteal sciatic nerve block and an axillary brachial plexus block. Reliability, as measured by intraclass correlation coefficients, was -0.01 to 0.43 for the individual items in DOPS, and 0.15 for the 'Overall Performance for this Procedure' item. Assessors demonstrated consistency of scoring within DOPS, with significant correlation of sum of individual item scores with the 'Overall Performance for this Procedure' item (r=0.78 to 0.80, P<0.001), and with yes versus no responses to the 'Was the procedure completed satisfactorily?' item (W=24, P=0.0004, Video 1, and W=65, P=0.003, Video 2). While DOPS demonstrated a good degree of internal consistency in this setting, inter-rater reliability did not reach levels generally recommended for formative assessment tools. Feasibility of the form could be improved by removing the 'Was the procedure completed satisfactorily?' item without loss of information.
authors.affiliation: Department of Anaesthesia, Liverpool Hospital, Liverpool, New South Wales.
authors.forename: A
authors.initials: A
authors.lastname: Chuan
authors.affiliation: Anaesthesia Registrar, Liverpool Hospital, Sydney, NSW.
authors.forename: S
authors.initials: S
authors.lastname: Thillainathan
authors.affiliation: Department of Statistics, Macquarie University, Sydney.
authors.forename: P L
authors.initials: PL
authors.lastname: Graham
authors.affiliation: Faculty of Health and Medicine, Newcastle University, Newcastle, NSW.
authors.forename: B
authors.initials: B
authors.lastname: Jolly
authors.affiliation: St Vincent's Hospital, Melbourne, Victoria.
authors.forename: D M
authors.initials: DM
authors.lastname: Wong
authors.affiliation: Wollongong Hospital, Honorary Clinical Associate Professor, Graduate School of Medicine, University of Wollongong, NSW.
authors.forename: N
authors.initials: N
authors.lastname: Smith
authors.affiliation: Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria.
authors.forename: M J
authors.initials: MJ
authors.lastname: Barrington
mesh_terms: D000765:Anesthesia, Conduction; D002983:Clinical Competence; D006801:Humans; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional
keywords: anaesthesia; curriculum; educational measurement; medical education; medical nerve block; reproducibility of results; workplace