Validation of an Assessment Tool for Field Endotracheal Intubation

Danielle Hart; Joseph Clinton; Shilo Anders; Troy Reihsen; Mary Ann McNeil; Gregory Rule; Robert Sweet

doi:10.7205/MILMED-D-15-00570

Validation of an Assessment Tool for Field Endotracheal Intubation

Mil Med. 2016 Nov;181(11):e1484-e1490. doi: 10.7205/MILMED-D-15-00570.

Authors

Danielle Hart¹, Joseph Clinton¹, Shilo Anders², Troy Reihsen³, Mary Ann McNeil⁴, Gregory Rule⁵, Robert Sweet⁶

Affiliations

¹ Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415.
² Department of Anesthesiology and Biomedical Informatics, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232.
³ SimPORTAL, University of Minnesota Medical Center, 500 Harvard Street, Minneapolis, MN 55455.
⁴ Department of Emergency Medicine, University of Minnesota Medical School, 420 Delaware Street SE, Minneapolis, MN 55455.
⁵ Applied Research Associates, Inc., 950 Isom Road Suite 102, San Antonio, TX 78216.
⁶ Department of Urologic Surgery and SimPORTAL, University of Minnesota Medical Center, 500 Harvard Street, Minneapolis, MN 55455.

PMID: 27849480
DOI: 10.7205/MILMED-D-15-00570

Abstract

Objectives: Endotracheal intubation (ETI) is an important skill for all emergency providers; our ability to train and assess our learners is integral to providing optimal patient care. The primary aim of this study was to assess the inter-rater reliability (IRR) and discriminant validity of a novel field ETI assessment tool using a checklist-derived performance score (PS) and critical failure (CF) rate.

Methods: Forty-three participants (18 paramedic students, 11 paramedics, and 14 emergency physicians [EPs]) performed ETI during a simulated trauma scenario on a pseudo-ventilated cadaver. Each participant was assessed by two experienced raters. IRR was calculated using the intraclass correlation coefficient. Regarding discriminant validity, a Kruskal-Wallis test was used to analyze PSs and a χ² test was used for CFs. Mean global rating scale (GRS) scores were compared using an analysis of variance.

Results: The ETI assessment tool had excellent IRR, with an intraclass correlation coefficient of 0.94. There was a significant difference in PSs, CFs, and GRSs (p < 0.05) between cohorts.

Conclusion: The novel field ETI assessment tool has excellent reliability among trained raters and discriminates between experienced ETI providers (EPs) and less experienced ETI performers using PSs, CFs, and GRSs on a fresh cadaveric model.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Airway Management / methods
Airway Management / standards
Checklist / methods
Checklist / standards*
Clinical Competence / standards
Clinical Competence / statistics & numerical data
Cohort Studies
Educational Measurement / methods
Educational Measurement / standards*
Female
Health Personnel / standards
Health Personnel / statistics & numerical data
Humans
Intubation, Intratracheal / methods
Intubation, Intratracheal / standards*
Intubation, Intratracheal / statistics & numerical data
Male
Prospective Studies
Reproducibility of Results
Teaching / classification
Teaching / statistics & numerical data
Validation Studies as Topic