Validation of a new assessment tool for chest tube insertion on Thiel embalmed human cadavers: a feasibility study

INTRO: Thiel embalmed human cadavers are considered as high-fidelity simulator for several surgical procedures, including Chest Tube Insertion (CTI). In proficiency-based education, targeted feedback is essential in order to improve learners' technical skills. Assessments must be validated prior to their use. Validity can be established using Messick's framework, which collects evidence from five sources. The ACTION tool is a new assessment tool, and consists of a procedure-specific Rating Scale and an error checklist. It has been developed by a Delphi panel, which ensures content evidence. This study evaluates the feasibility of a validation study for the ACTION tool on Thiel embalmed human cadavers. METHODS: A convenience sample of three medical undergraduates and one PhD candidate was recruited. All provided informed consent and demographic information. Each participant was scored and recorded while performing a CTI. Each recording was later scored by three raters. Rater agreement was evaluated by calculating a two-way mixed effects, absolute agreement, single unit of measurement intraclass correlation coefficient (ICC) model. Internal consistency of the assessment was evaluated using Cronbach Alfa. Feasibility was evaluated using structured questions regarding recruitment and data outcomes. RESULTS: Recruitment capability and data collection procedures were evaluated as being feasible and suitable for the target study participants. All necessary resources are available and data analysis can be carried out. Preliminary results for the procedural steps indicate an ICC of 0.62, indicating moderate rater agreement, and a Cronbach Alfa of 0.94, indicating excellent internal consistency. For the errors, an ICC of 0.63, and a Cronbach Alfa of 0.68 was observed. CONCLUSION: Validation of the ACTION tool following Messick's framework is feasible. A rater training session can increase reliability. After validation, the assessment tool can be used to evaluate learners' proficiency in CTI on Thiel embalmed human cadavers, prior to patient contact. © FASEB.