title: Analyses of inter-rater reliability between professionals, medical students and trained school children as assessors of basic life support skills.
abstract: BACKGROUND
  Training of lay-rescuers is essential to improve survival-rates after cardiac arrest. Multiple campaigns emphasise the importance of basic life support (BLS) training for school children. Trainings require a valid assessment to give feedback to school children and to compare the outcomes of different training formats. Considering these requirements, we developed an assessment of BLS skills using MiniAnne and tested the inter-rater reliability between professionals, medical students and trained school children as assessors.
  
  
  METHODS
  Fifteen professional assessors, 10 medical students and 111-trained school children (peers) assessed 1087 school children at the end of a CPR-training event using the new assessment format. Analyses of inter-rater reliability (intraclass correlation coefficient; ICC) were performed.
  
  
  RESULTS
  Overall inter-rater reliability of the summative assessment was high (ICC = 0.84, 95 %-CI: 0.84 to 0.86, n = 889). The number of comparisons between peer-peer assessors (n = 303), peer-professional assessors (n = 339), and peer-student assessors (n = 191) was adequate to demonstrate high inter-rater reliability between peer- and professional-assessors (ICC: 0.76), peer- and student-assessors (ICC: 0.88) and peer- and other peer-assessors (ICC: 0.91). Systematic variation in rating of specific items was observed for three items between professional- and peer-assessors.
  
  
  CONCLUSIONS
  Using this assessment and integrating peers and medical students as assessors gives the opportunity to assess hands-on skills of school children with high reliability.
authors.affiliation: Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. st.beck@uke.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Beck
authors.affiliation: The Medical Faculty of the University Hamburg, Martinistr. 52, 20246, Hamburg, Germany.
authors.forename: Bjarne
authors.initials: B
authors.lastname: Ruhnke
authors.affiliation: Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Issleib
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Daubmann
authors.affiliation: Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Harendza
authors.affiliation: Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Zöllner
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education*; D002648:Child; D002983:Clinical Competence; D004521:Educational Measurement; D005858:Germany; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D008020:Life Support Care / Q000592:standards*; D008348:Manikins; D015588:Observer Variation; D010379:Peer Group; D010820:Physicians; D015203:Reproducibility of Results; D013334:Students; D013337:Students, Medical
keywords: Assessment; Basic life support; Inter-rater reliability; Peer assessors; Resuscitation