TY - JOUR

T1 - Assessment of EVAR Competence

T2 - Validity of a Novel Rating Scale (EVARATE) in a Simulated Setting

AU - Strøm, Michael

AU - Lönn, Lars

AU - Konge, Lars

AU - Schroeder, Torben V.

AU - Lindgren, Hans

AU - Nyheim, Thomas

AU - Venermo, Maarit

AU - Bech, Bo

PY - 2018

Y1 - 2018

N2 - Objectives: The aims of this study were to investigate the validity evidence for a novel procedure specific assessment tool of competence in endovascular aortic repair (EVAR) and to establish a pass/fail level for the assessment. Methods: Computed tomography angiography data of a 55 mm in diameter infrarenal aortic aneurysm was implemented into an endovascular simulator. Twenty-three physicians with varying EVAR experiences were video-recorded when performing a standard EVAR procedure on the simulator. Two experienced EVAR operators assessed the participants using the novel rating scale, “EndoVascular Aortic Repair Assessment of Technical Expertise” (EVARATE). Validity was studied according to the framework endorsed by the American Educational Research Association. Results: The EVARATE scale had a high internal consistency (Cronbach's alpha =.90). The inter-rater reliability was acceptable (Intraclass Correlation Coefficient =.68, p =.005). Specific EVAR experience correlated significantly with the EVARATE score (Spearman's rho =.62, p =.002), but general endovascular experience did not. Consequence analysis showed that the EVARATE assessment could distinguish novices from intermediates (p <.01) and from experts (p <.001). A pass/fail score was determined using the contrasting groups' method. Conclusion: This paper presents the initial validity evidence for a novel procedure specific assessment tool, EVARATE, for operator competence in endovascular aortic repair investigated in a simulated setting. The assessment tool can be used to provide structured formative feedback to trainees.

AB - Objectives: The aims of this study were to investigate the validity evidence for a novel procedure specific assessment tool of competence in endovascular aortic repair (EVAR) and to establish a pass/fail level for the assessment. Methods: Computed tomography angiography data of a 55 mm in diameter infrarenal aortic aneurysm was implemented into an endovascular simulator. Twenty-three physicians with varying EVAR experiences were video-recorded when performing a standard EVAR procedure on the simulator. Two experienced EVAR operators assessed the participants using the novel rating scale, “EndoVascular Aortic Repair Assessment of Technical Expertise” (EVARATE). Validity was studied according to the framework endorsed by the American Educational Research Association. Results: The EVARATE scale had a high internal consistency (Cronbach's alpha =.90). The inter-rater reliability was acceptable (Intraclass Correlation Coefficient =.68, p =.005). Specific EVAR experience correlated significantly with the EVARATE score (Spearman's rho =.62, p =.002), but general endovascular experience did not. Consequence analysis showed that the EVARATE assessment could distinguish novices from intermediates (p <.01) and from experts (p <.001). A pass/fail score was determined using the contrasting groups' method. Conclusion: This paper presents the initial validity evidence for a novel procedure specific assessment tool, EVARATE, for operator competence in endovascular aortic repair investigated in a simulated setting. The assessment tool can be used to provide structured formative feedback to trainees.

KW - Abdominal aortic aneurysm

KW - Educational assessment

KW - Endovascular

KW - EVAR

KW - Simulation

KW - Training

U2 - 10.1016/j.ejvs.2018.02.035

DO - 10.1016/j.ejvs.2018.02.035

M3 - Journal article

C2 - 29628288

AN - SCOPUS:85044953873

VL - 56

SP - 137

EP - 144

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 1

ER -