Department of Anaesthesia, Critical Care and Pain, University College London Hospitals, London, UK.
Resuscitation. 2013 Jun;84(6):831-6. doi: 10.1016/j.resuscitation.2012.11.013. Epub 2012 Dec 7.
To develop and test the feasibility, reliability, and validity of a practical toolkit for the assessment and feedback of skills required to manage paediatric emergencies in critical care settings.
The Imperial Paediatric Emergency Training Toolkit (IPETT) was developed based on current evidence-base and expert input. IPETT assesses both technical and non-technical skills. The technical component covers skills in the areas of clinical assessment, airway and breathing, cardiovascular, and drugs. The non-technical component is based on the validated NOTECHS tool and covers communication and interaction, cooperation and team skills, leadership and managerial skills, and decision-making. The reliability (internal consistency), content validity (inter-correlations between different skills) and concurrent validity (correlations between global technical and non-technical scores) of IPETT were prospectively evaluated in 45 simulated paediatric crises carried out in a PICU with anaesthetic and paediatric trainees (N=52). Non-parametric analyses were carried out. Significance was set at P<0.05.
Cronbach alpha reliability coefficients were overall acceptable for the technical (alpha range=0.638-0.810) and good for the non-technical (alpha range=0.701-0.899) component of IPETT. The median inter-skill correlation was rho=0.564 and rho=0.549 for the technical and non-technical components, respectively. These indicate good content validity, as the skills were inter-related but not redundant. We also demonstrate a correlation between the global technical and non-technical scores (rho=0.471) - all Ps<0.05 during the assessments.
IPETT offers a psychometrically viable and feasible to use tool in the context of paediatric emergencies training. This study shows that assessment of technical and non-technical skills in combination may offer a more clinically relevant model for training in paediatric emergencies. Further validation should aim to demonstrate skill retention over time and skill transfer from simulation-based training to real emergencies.
开发和测试一种实用工具包，用于评估和反馈在重症监护环境中处理儿科急症所需的技能，以评估其可行性、可靠性和有效性。
根据现有循证医学证据和专家意见，开发了 Imperial Paediatric Emergency Training Toolkit（IPETT）。IPETT 评估技术和非技术技能。技术部分涵盖临床评估、气道和呼吸、心血管和药物等领域的技能。非技术部分基于经过验证的 NOTECHS 工具，涵盖沟通和互动、合作和团队技能、领导力和管理技能以及决策制定。在重症监护病房（PICU）进行的 45 例模拟儿科危象中，前瞻性评估了麻醉和儿科学员（N=52）的 IPETT 的可靠性（内部一致性）、内容有效性（不同技能之间的相关性）和同时有效性（全球技术和非技术评分之间的相关性）。进行了非参数分析。P<0.05 为差异有统计学意义。
IPETT 技术部分的 Cronbach α 可靠性系数总体上可接受（范围=0.638-0.810），非技术部分良好（范围=0.701-0.899）。技术和非技术部分的中位数技能相关性分别为 rho=0.564 和 rho=0.549，表明内容有效性良好，因为这些技能是相互关联但不重复的。我们还在评估过程中证明了全球技术和非技术评分之间的相关性（rho=0.471），所有 P<0.05。
IPETT 在儿科急症培训背景下提供了一种具有心理测量学可行性和实用性的工具。本研究表明，综合评估技术和非技术技能可能为儿科急症培训提供更具临床相关性的模型。进一步的验证应旨在证明随着时间的推移保留技能和从模拟训练到真实紧急情况的技能转移。
