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Pulmonary Procedures |

Development of a Tool to Assess Competency in Basic Rigid Bronchoscopy Skills

Kamran Mahmood, MPH; Kathryn Osann; Momen Wahidi, MBA; Scott Shofer, PhD; Kathleen Coles; Ellen Volker; Mohsen Davoudi
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Duke University Medical Center, Durham, NC


Chest. 2014;146(4_MeetingAbstracts):746A. doi:10.1378/chest.1992155
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Abstract

SESSION TITLE: Bronchoscopy and Interventional Procedures

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Monday, October 27, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Rigid bronchoscopy has seen a recent resurgence in popularity for management of central airways disorders. An increasing number of interventional pulmonary fellowship programs are offering rigid bronchoscopy training. However, to date an assessment tool to evaluate an operator’s rigid bronchoscopy skills has not been developed. The RIGID-TASC (Rigid-Bronchoscopy Tool for Assessment of Skills and Competence) was created as an objective, competency-oriented assessment tool of basic rigid bronchoscopic skills, including rigid bronchoscopic intubation and navigation of the central airways. The objective of this study was to test the hypotheses that [1] RIGID-TASC scores will accurately distinguish the basic rigid bronchoscopy skills of novice, intermediate, and expert operators, and [2] the RIGID-TASC has high inter-rater reliability, with reproducible results when used by different independent testers.

METHODS: Thirty volunteer subjects at two academic institutions, were selected in three categories: 10 novices (performed at least 50 flexible but no rigid bronchoscopies), 10 intermediates (performed 5-20 rigid bronchoscopies) and 10 experts (performed more than 100 rigid bronchoscopies). Novices were given a 10 minute instruction on the basic technique before testing. Each subject then performed rigid bronchoscopic intubation and central airway navigation on a manikin, while being scored by two independent testers, using the 100-point RIGID-TASC.

RESULTS: Mean scores for the three categories (novice, intermediate and expert) were 58.10 (SE=4.6), 78.15 (SE=3.8) and 94.40 (SE=1.1) respectively. There was significant difference between novice and intermediate (20.05, 95%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 inter-rater reliability (Cronbach’s alpha) between the two testers was r=0.976.

CONCLUSIONS: The RIGID-TASC showed evidence of construct validity and inter-rater 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.

CLINICAL IMPLICATIONS: RIGID-TASC can be used to assess the basic competence of rigid bronchoscopy trainees, plotting the learning curve corresponding to the acquisition of this important skill.

DISCLOSURE: The following authors have nothing to disclose: Kamran Mahmood, Kathryn Osann, Momen Wahidi, Scott Shofer, Kathleen Coles, Ellen Volker, Mohsen Davoudi

No Product/Research Disclosure Information


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