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Assessing chest tube insertion skills using a porcine rib model : a validity study

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Abstract
Introduction Assessments require sufficient validity evidence before their use. The Assessment for Competence in Chest Tube Insertion (ACTION) tool evaluates proficiency in chest tube insertion (CTI), combining a rating scale and an error checklist. The aim of this study was to collect validity evidence for the ACTION tool on a porcine rib model according to the Messick framework. Methods A rib model, consisting of a porcine hemithorax that was placed in a wooden frame, was used as simulator. Participants were recruited from the departments of surgery, pulmonology, and emergency medicine. After familiarization with the rib model and the equipment, standardized instructions and clinical context were provided. They performed 2 CTIs while being scored with the ACTION tool. All performances were assessed live by 1 rater and by 3 blinded raters using video recordings. Generalizability-analysis was performed and mean scores and errors of both groups on the first performance were compared. A pass/fail score was established using the contrasting groups' method. Results Nine novice and 8 experienced participants completed the study. Generalizability coefficients where high for the rating scale (0.92) and the error checklist (0.87). In the first CTI, novices scored lower than the experienced group (38.1/68 vs. 47.1/68, P = 0.042), but no difference was observed on the error checklist. A pass/fail score of 44/68 was established. Conclusion A solid validity argument for the ACTION tool's rating scale on a porcine rib model is presented, allowing formative and summative assessment of procedural skills during training before patient contact.
Keywords
Modeling and Simulation, Education, Medicine (miscellaneous), Epidemiology

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MLA
De Mol, Leander, et al. “Assessing Chest Tube Insertion Skills Using a Porcine Rib Model : A Validity Study.” SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE, Ovid Technologies (Wolters Kluwer Health), 2024, doi:10.1097/sih.0000000000000750.
APA
De Mol, L., Lievens, A., De Pauw, N., Vanommeslaeghe, H., Van Herzeele, I., Van de Voorde, P., … Willaert, W. (2024). Assessing chest tube insertion skills using a porcine rib model : a validity study. SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE. https://doi.org/10.1097/sih.0000000000000750
Chicago author-date
De Mol, Leander, Amber Lievens, Najade De Pauw, Hanne Vanommeslaeghe, Isabelle Van Herzeele, Patrick Van de Voorde, Lars Konge, Liesbeth Desender, and Wouter Willaert. 2024. “Assessing Chest Tube Insertion Skills Using a Porcine Rib Model : A Validity Study.” SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE. https://doi.org/10.1097/sih.0000000000000750.
Chicago author-date (all authors)
De Mol, Leander, Amber Lievens, Najade De Pauw, Hanne Vanommeslaeghe, Isabelle Van Herzeele, Patrick Van de Voorde, Lars Konge, Liesbeth Desender, and Wouter Willaert. 2024. “Assessing Chest Tube Insertion Skills Using a Porcine Rib Model : A Validity Study.” SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE. doi:10.1097/sih.0000000000000750.
Vancouver
1.
De Mol L, Lievens A, De Pauw N, Vanommeslaeghe H, Van Herzeele I, Van de Voorde P, et al. Assessing chest tube insertion skills using a porcine rib model : a validity study. SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE. 2024;
IEEE
[1]
L. De Mol et al., “Assessing chest tube insertion skills using a porcine rib model : a validity study,” SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE, 2024.
@article{01HG84EXF5DGJD34Z17TGCM13J,
  abstract     = {{Introduction 
Assessments require sufficient validity evidence before their use. The Assessment for Competence in Chest Tube Insertion (ACTION) tool evaluates proficiency in chest tube insertion (CTI), combining a rating scale and an error checklist. The aim of this study was to collect validity evidence for the ACTION tool on a porcine rib model according to the Messick framework.

Methods 
A rib model, consisting of a porcine hemithorax that was placed in a wooden frame, was used as simulator. Participants were recruited from the departments of surgery, pulmonology, and emergency medicine. After familiarization with the rib model and the equipment, standardized instructions and clinical context were provided. They performed 2 CTIs while being scored with the ACTION tool. All performances were assessed live by 1 rater and by 3 blinded raters using video recordings. Generalizability-analysis was performed and mean scores and errors of both groups on the first performance were compared. A pass/fail score was established using the contrasting groups' method.

Results 
Nine novice and 8 experienced participants completed the study. Generalizability coefficients where high for the rating scale (0.92) and the error checklist (0.87). In the first CTI, novices scored lower than the experienced group (38.1/68 vs. 47.1/68, P = 0.042), but no difference was observed on the error checklist. A pass/fail score of 44/68 was established.

Conclusion 
A solid validity argument for the ACTION tool's rating scale on a porcine rib model is presented, allowing formative and summative assessment of procedural skills during training before patient contact.}},
  author       = {{De Mol, Leander and Lievens, Amber and De Pauw, Najade and Vanommeslaeghe, Hanne and Van Herzeele, Isabelle and Van de Voorde, Patrick and Konge, Lars and Desender, Liesbeth and Willaert, Wouter}},
  issn         = {{1559-2332}},
  journal      = {{SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE}},
  keywords     = {{Modeling and Simulation,Education,Medicine (miscellaneous),Epidemiology}},
  language     = {{eng}},
  pages        = {{7}},
  publisher    = {{Ovid Technologies (Wolters Kluwer Health)}},
  title        = {{Assessing chest tube insertion skills using a porcine rib model : a validity study}},
  url          = {{http://doi.org/10.1097/sih.0000000000000750}},
  year         = {{2024}},
}

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