Top

Published in:

01-06-2021 | Ultrasound | Radiological Education

Evaluation of competence in ultrasound-guided procedures—a generic assessment tool developed through the Delphi method

Authors: Niklas Kahr Rasmussen, Leizl Joy Nayahangan, Jonathan Carlsen, Olle Ekberg, Knut Brabrand, Elisabeth Albrecht-Beste, Michael Bachmann Nielsen, Lars Konge

Published in: European Radiology | Issue 6/2021

Abstract

Objectives

To develop a generic and objective tool for assessing competence in percutaneous ultrasound-guided procedures.

Methods

Interventional ultrasound experts from the Nordic countries were invited to participate in a three-round Delphi process. A steering committee was formed to manage the process. In round 1, the experts were asked to suggest all aspects to consider when assessing competence in US-guided procedures. Suggestions were analyzed and condensed into assessment items. In round 2, the expert panel rated these items on a 1–5 scale and suggested new items. Items with a mean rating of ≤ 3.5 were excluded. In round 3, the expert panel rated the list items and suggested changes to the items.

Results

Twenty-five experts were invited, and response rates in the three rounds were 68% (17 out of 25), 100% (17 out of 17), and 100% (17 out of 17). The three-round Delphi process resulted in a 12-item assessment tool, using a five-point rating scale. The final assessment tool evaluates pre-procedural planning, US technique, procedural technique, patient safety, communication, and teamwork.

Conclusions

Expert consensus was achieved on a generic tool for assessment of competence in percutaneous ultrasound-guided procedures—the Interventional Ultrasound Skills Evaluation (IUSE). This is the initial step in ensuring a valid and reliable method for assessment of interventional US skill.

Key Points

• Through a Delphi process, expert consensus was achieved on the content of an assessment tool for percutaneous ultrasound-guided procedures—the Interventional Ultrasound Skills Evaluation (IUSE) tool.

• The IUSE tool is comprehensive and covers pre-procedural planning, US technique, procedural technique, patient safety, communication, and teamwork.

• This is an important step in ensuring valid and reliable assessment of interventional US skills.

Nazeer SR, Dewbre H, Miller AH (2005) Ultrasound-assisted paracentesis performed by emergency physicians vs the traditional technique: a prospective, randomized study. Am J Emerg Med 23:363–367 Philadelphia. http://dx.doi.org.ep.fjernadgang.kb.dk/10.1016/j.ajem.2004.11.001CrossRef

Gordon CE, Feller-Kopman D, Balk EM, Smetana GW (2010) Pneumothorax following thoracentesis: a systematic review and meta-analysis. Arch Intern Med 170:332–339. https://doi.org/10.1001/archinternmed.2009.548CrossRefPubMed

Mercaldi CJ, Lanes SF (2013) Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis. Chest 143:532–538. https://doi.org/10.1378/chest.12-0447CrossRefPubMed

Radiologi. https://www.sst.dk/da/uddannelse/speciallaeger/maalbeskrivelser/radiologi. Accessed 30 Jul 2018

ESR European Training Curriculum Level I-II (2018).pdf. In: European Society of Radiology. https://www.myesr.org/media/2838. Accessed 13 Oct 2019

Nayahangan LJ, Nielsen KR, Albrecht-Beste E et al (2018) Determining procedures for simulation-based training in radiology: a nationwide needs assessment. Eur Radiol 28:2319–2327. https://doi.org/10.1007/s00330-017-5244-7CrossRefPubMed

Duncan DR, Morgenthaler TI, Ryu JH, Daniels CE (2009) Reducing iatrogenic risk in thoracentesis: establishing best practice via experiential training in a zero-risk environment. Chest 135:1315–1320. https://doi.org/10.1378/chest.08-1227CrossRefPubMed

Education and Practical Standards Committee, European Federation of Societies for Ultrasound in Medicine and Biology (2006) Minimum training recommendations for the practice of medical ultrasound. Ultraschall Med 27:79–105. https://doi.org/10.1055/s-2006-933605CrossRef

Hertzberg BS, Kliewer MA, Bowie JD et al (2000) Physician training requirements in sonography. AJR Am J Roentgenol 174:1221–1227. https://doi.org/10.2214/ajr.174.5.1741221

10.

Kahr Rasmussen N, Andersen TT, Carlsen J et al (2019) Simulation-based training of ultrasound-guided procedures in radiology - a systematic review. Ultraschall Med. https://doi.org/10.1055/a-0896-2714

11.

Stefanidis D, Korndorffer JR Jr, Markley S, Sierra R, Scott DJ (2006) Proficiency maintenance: impact of ongoing simulator training on laparoscopic skill retention. J Am Coll Surg 202:599–603. https://doi.org/10.1016/j.jamcollsurg.2005.12.018

12.

Stefanidis D, Korndorffer JR Jr, Sierra R, Touchard C, Dunne JB, Scott DJ (2005) Skill retention following proficiency-based laparoscopic simulator training. Surgery 138:165–170. https://doi.org/10.1016/j.surg.2005.06.002

13.

Van Der Vleuten CP (1996) The assessment of professional competence: developments, research and practical implications. Adv Health Sci Educ Theory Pract 1:41–67. https://doi.org/10.1007/BF00596229CrossRef

14.

Holmboe ES, Sherbino J, Long DM, Swing SR, Frank JR (2010) The role of assessment in competency-based medical education. Med Teach 32:676–682. https://doi.org/10.3109/0142159X.2010.500704

15.

Tolsgaard MG, Todsen T, Sorensen JL et al (2013) International multispecialty consensus on how to evaluate ultrasound competence: a Delphi consensus survey. PLoS One 8:e57687. https://doi.org/10.1371/journal.pone.0057687CrossRefPubMedPubMedCentral

16.

Tolsgaard MG, Ringsted C, Dreisler E et al (2014) Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology. Ultrasound Obstet Gynecol 43:437–443. https://doi.org/10.1002/uog.13198CrossRefPubMed

17.

Hsu C-C, Sandford B (2019) The Delphi technique: making sense of consensus. Pract Assess Res Eval 12:1–8. https://doi.org/10.7275/pdz9-th90CrossRef

18.

Hasson F, Keeney S, McKenna H (2000) Research guidelines for the Delphi survey technique. J Adv Nurs 32:1008–1015. https://doi.org/10.1046/j.1365-2648.2000.t01-1-01567.xCrossRefPubMed

19.

Lorentzen T, Nolsøe CP, Ewertsen C et al (2015) EFSUMB guidelines on Interventional Ultrasound (INVUS), part I – general aspects (long version). Ultraschall Med 36:E1–E14. https://doi.org/10.1055/s-0035-1553593CrossRefPubMed

20.

Gordon M, Darbyshire D, Baker P (2012) Non-technical skills training to enhance patient safety: a systematic review. Med Educ 46:1042–1054. https://doi.org/10.1111/j.1365-2923.2012.04343.xCrossRefPubMed

21.

Yudkowsky R, Park YS, Downing SM (2019) Assessment in health professions education, 2nd edn. Routledge, New YorkCrossRef

22.

Hodges B, Regehr G, McNaughton N, Tiberius R, Hanson M (1999) OSCE checklists do not capture increasing levels of expertise. Acad Med 74:1129–1134. https://doi.org/10.1097/00001888-199910000-00017

23.

Cook DA, Hatala R (2016) Validation of educational assessments: a primer for simulation and beyond. Adv Simul (Lond) 1:31. https://doi.org/10.1186/s41077-016-0033-yCrossRef

24.

Streiner DL, Norman GR, Cairney J (2015) Health measurement scales: a practical guide to their development and use. Oxford University Press

25.

Strøm M, Lönn L, Bech B, Konge L, EVARATE Delphi Panel (2017) Assessment of competence in EVAR procedures: a novel rating scale developed by the Delphi technique. Eur J Vasc Endovasc Surg 54:34–41. https://doi.org/10.1016/j.ejvs.2017.04.001

26.

Jensen K, Petersen RH, Hansen HJ, Walker W, Pedersen JH, Konge K (2018) A novel assessment tool for evaluating competence in video-assisted thoracoscopic surgery lobectomy. Surg Endosc 32:4173–4182. https://doi.org/10.1007/s00464-018-6162-8

27.

Østergaard ML, Rue Nielsen K, Albrecht-Beste E, Ersbøll AK, Konge L, Nielsen MB (2019) Simulator training improves ultrasound scanning performance on patients: a randomized controlled trial. Eur Radiol 29:3210–3218. https://doi.org/10.1007/s00330-018-5923-z

28.

Dalkey NC (1969) The Delphi method: an experimental study of group opinion. https://www.rand.org/pubs/research_memoranda/RM5888.html. Accessed 10 Feb 2020

29.

Nayahangan LJ, Stefanidis D, Kern DE, Konge L (2018) How to identify and prioritize procedures suitable for simulation-based training: experiences from general needs assessments using a modified Delphi method and a needs assessment formula. Med Teach 40:676–683. https://doi.org/10.1080/0142159X.2018.1472756CrossRefPubMed

30.

Rosenkrantz AB, Wang W, Hughes DR, Duszak R (2017) Generalist versus subspecialist characteristics of the U.S. Radiologist Workforce. Radiology 286:929–937. https://doi.org/10.1148/radiol.2017171684CrossRefPubMed

31.

Borgersen NJ, Naur TMH, Sørensen SMD et al (2018) Gathering validity evidence for surgical simulation: a systematic review. Ann Surg 267:1063–1068. https://doi.org/10.1097/SLA.0000000000002652CrossRefPubMed

Title: Evaluation of competence in ultrasound-guided procedures—a generic assessment tool developed through the Delphi method
Authors: Niklas Kahr Rasmussen
Leizl Joy Nayahangan
Jonathan Carlsen
Olle Ekberg
Knut Brabrand
Elisabeth Albrecht-Beste
Michael Bachmann Nielsen
Lars Konge
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Ultrasound
Ultrasound
Published in: European Radiology / Issue 6/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07280-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of competence in ultrasound-guided procedures—a generic assessment tool developed through the Delphi method

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 6/2021

Teaching brain imaging through a drawing method may improve learning in medical students

A multifaceted approach to quality in the MRI-directed biopsy pathway for prostate cancer diagnosis

Intrahepatic cholangiocarcinoma: MRI texture signature as predictive biomarkers of immunophenotyping and survival

Deep learning with convolutional neural network in the assessment of breast cancer molecular subtypes based on US images: a multicenter retrospective study

Predictors of pneumothorax and chest drainage after percutaneous CT-guided lung biopsy: A prospective study

Correction to: The practice of emergency radiology throughout Europe: a survey from the European Society of Emergency Radiology on volume, staffing, equipment, and scheduling