Preparing for emergency: a valid, reliable assessment tool for emergency cricothyroidotomy skills.

Melchiors, Jacob; Todsen, Tobias; Nilsson, Philip; Wennervaldt, Kasper; Charabi, Birgitte; Bøttger, Morten; Konge, Lars; von Buchwald, Christian · Otolaryngol Head Neck Surg · 2015

basic_science · Level V

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Abstract

Emergency cricothyrodotomy (EC) is a lifesaving procedure. Evidence-based assessment of training effects and competency levels is relevant to all departments involved in emergency airway management. As most training uses low-fidelity models, the predictive value of good performance on such a model becomes relevant with regard to performance on a high-fidelity model (cadaver). This requires a valid assessment tool for EC performance. Psychometric study on low-fidelity models and human cadavers. University hospital. An assessment tool was created. Sixteen physicians (7 experienced surgeons and 9 novice physicians) performed an EC on a low-fidelity model and a cadaver. Two blinded raters assessed video recordings of performances using the assessment tool. We found a high interrater reliability, based on a Pearson's r (0.81), and good evidence for validity, based on successfully distinguishing the 2 groups, using an independent samples t test (P < .001). We found a good correlation between performance on a low-fidelity model and the cadaver with an R (2) = 0.78. The tool for assessing EC competence proved reliable and valid. Performance on a low-fidelity model measured this way is a good predictor of performance in a more lifelike situation.

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