title: Development of RAD-Score: A Tool to Assess the Procedural Competence of Diagnostic Radiology Residents.
abstract: OBJECTIVE
  The purpose of this study is to develop a tool to assess the procedural competence of radiology trainees, with sources of evidence gathered from five categories to support the construct validity of tool: content, response process, internal structure, relations to other variables, and consequences.
  
  
  METHODS
  A pilot form for assessing procedural competence among radiology residents, known as the RAD-Score tool, was developed by evaluating published literature and using a modified Delphi procedure involving a group of local content experts. The pilot version of the tool was tested by seven radiology department faculty members who evaluated procedures performed by 25 residents at one institution between October 2014 and June 2015. Residents were evaluated while performing multiple procedures in both clinical and simulation settings. The main outcome measure was the percentage of residents who were considered ready to perform procedures independently, with testing conducted to determine differences between levels of training.
  
  
  RESULTS
  A total of 105 forms (for 52 procedures performed in a clinical setting and 53 procedures performed in a simulation setting) were collected for a variety of procedures (eight vascular or interventional, 42 body, 12 musculoskeletal, 23 chest, and 20 breast procedures). A statistically significant difference was noted in the percentage of trainees who were rated as being ready to perform a procedure independently (in postgraduate year [PGY] 2, 12% of residents; in PGY3, 61%; in PGY4, 85%; and in PGY5, 88%; p < 0.05); this difference persisted in the clinical and simulation settings. User feedback and psychometric analysis were used to create a final version of the form.
  
  
  CONCLUSIONS
  This prospective study describes the successful development of a tool for assessing the procedural competence of radiology trainees with high levels of construct validity in multiple domains. Implementation of the tool in the radiology residency curriculum is planned and can play an instrumental role in the transition to competency-based radiology training.
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Inga
authors.initials: I
authors.lastname: Isupov
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Matthew D F
authors.initials: MD
authors.lastname: McInnes
authors.affiliation: 2 Milestone Research and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, IL.
authors.forename: Stan J
authors.initials: SJ
authors.lastname: Hamstra
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Doherty
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Ashish
authors.initials: A
authors.lastname: Gupta
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Peddle
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Jibri
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Kawan
authors.initials: K
authors.lastname: Rakhra
authors.affiliation: 1 Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Rm c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Hibbert
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data*; D003952:Diagnostic Imaging; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007396:Internship and Residency / Q000706:statistics & numerical data*; D009864:Ontario; D010865:Pilot Projects; D011594:Psychometrics / Q000379:methods; D011871:Radiology / Q000193:education* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D000066477:Work Performance / Q000145:classification / Q000706:statistics & numerical data*
keywords: assessment; competence; education; procedure; resident