Purpose: Technical proficiency in anesthesia has historically been determined subjectively. The purpose of this study was to establish the construct validity for the Imperial College Surgical Assessment Device (ICSAD), a measure of hand motion efficiency, as an objective assessment tool for technical skill performance, by examining its ability to distinguish between operators of different levels of experience performing a labour epidural. Concurrent validity for the ICSAD was investigated by comparison to a validated task specific checklist (CL) and global rating scale (GRS). Methods: A single blinded, prospective, controlled study design compared three groups of subjects: novice residents (<30 epidurals), experienced residents (>100 epidurals), and staff anesthesiologists (>500 epidurals). Performance was measured using the ICSAD (number of movements, path length, time) and scores from a CL and GRS graded by examiners blinded to the level of training. Data were analyzed by multivariate analysis of variance (MANOVA). Results: Twenty-nine subjects were recruited. Novice residents had longer path lengths compared to experienced residents (P = 0.031) and staff anesthesiologists (P = 0.0004), made more movements (P = 0.012) and took more time than staff (P = 0.009). Novice residents scored significantly worse on the GRS compared to experienced residents (P = 0.029) and staff (P = 0.01) and had significantly lower CL scores compared to staff (P = 0.003). Conclusions: Construct and concurrent validity for the ICSAD was established for a regional anesthesia technique by demonstrating that it can distinguish between operators of different levels of experience and by comparing it to the current standards of technical skill assessment. © 2009 Canadian Anesthesiologists' Society.
CITATION STYLE
Hayter, M. A., Friedman, Z., Bould, M. D., Hanlon, J. G., Katznelson, R., Borges, B., & Naik, V. N. (2009). Validation of the Imperial College Surgical Assessment Device (ICSAD) for labour epidural placement. Canadian Journal of Anesthesia, 56(6), 419–426. https://doi.org/10.1007/s12630-009-9090-1
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