Video-Based Tool for Assessment of Airway Management With Flexible Laryngeal Mask in Clinical Practice-A Protocol for a Study Gathering Validity Evidence.

Abstract

BACKGROUND: Flexible laryngeal mask airway (fLMA) devices are widely used in head, neck, and oral surgery, but insertion can be technically challenging, and inadequate placement may compromise ventilation. Competency-based training requires trustworthy assessment instruments with validity evidence; however, no assessment tool with solid validity evidence currently exists for fLMA airway management. METHODS: This is a prospective, patient-based, rater-blinded validation study. The study will be conducted at multiple tertiary hospitals in China: the Eye & ENT Hospital of Fudan University (Shanghai), Huzhou Central Hospital (Zhejiang Province), and Luoyang Central Hospital (Henan Province). Thirty physicians (15 novices and 15 experts) will each perform fLMA airway management in two adult patients with predicted normal airways. Procedures will be video-recorded and independently assessed by two blinded raters using a structured Global Rating Scale. Validity evidence will be gathered according to Messick's framework, including content, response process, internal structure, relations to other variables, and consequences of testing. A pass/fail standard will be established using the contrasting groups' standard-setting method. RESULTS: The study will provide validity evidence for a video-based assessment tool for fLMA airway management in clinical practice. Reliability, discrimination between experience levels, and the consequences of pass/fail decisions will be evaluated. CONCLUSION: This study addresses an important gap in airway management education by developing and validating an assessment tool with a credible pass/fail score for fLMA management. The tool may support structured training, competency-based assessment, and mastery learning programs in airway management.