Consensus-Based Expert Development of Critical Items for Direct Observation of Point-of-Care Ultrasound Skills

基于共识的专家制定床旁超声技能直接观察关键项目

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Abstract

BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly used in a number of medical specialties. To support competency-based POCUS education, workplace-based assessments are essential. OBJECTIVE: We developed a consensus-based assessment tool for POCUS skills and determined which items are critical for competence. We then performed standards setting to set cut scores for the tool. METHODS: Using a modified Delphi technique, 25 experts voted on 32 items over 3 rounds between August and December 2016. Consensus was defined as agreement by at least 80% of the experts. Twelve experts then performed 3 rounds of a standards setting procedure in March 2017 to establish cut scores. RESULTS: Experts reached consensus for 31 items to include in the tool. Experts reached consensus that 16 of those items were critically important. A final cut score for the tool was established at 65.2% (SD 17.0%). Cut scores for critical items are significantly higher than those for noncritical items (76.5% ± SD 12.4% versus 53.1% ± SD 12.2%, P < .0001). CONCLUSIONS: We reached consensus on a 31-item workplace-based assessment tool for identifying competence in POCUS. Of those items, 16 were considered critically important. Their importance is further supported by higher cut scores compared with noncritical items.

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