Bick Julian S, Wanderer Jonathan P, Myler Conrad S, Shaw Andrew D, McEvoy Matthew D
From the Department of Anesthesiology (J.S.B., J.P.W., C.S.M., A.D.S., M.D.M.) and Departments of Anesthesiology and Biomedical Informatics (J.P.W.), Vanderbilt University Medical Center, Nashville, Tennessee.
Anesthesiology. 2017 Apr;126(4):718-728. doi: 10.1097/ALN.0000000000001538.
Credible methods for assessing competency in basic perioperative transesophageal echocardiography examinations have not been reported. The authors' objective was to demonstrate the collection of real-world basic perioperative transesophageal examination performance data and establish passing scores for each component of the basic perioperative transesophageal examination, as well as a global passing score for clinical performance of the basic perioperative transesophageal examination using the Angoff method.
National Board of Echocardiography (Raleigh, North Carolina) advanced perioperative transesophageal echocardiography-certified anesthesiologists (n = 7) served as subject matter experts for two Angoff standard-setting sessions. The first session was held before data analysis, and the second session for calibration of passing scores was held 9 months later. The performance of 12 anesthesiology residents was assessed via the new passing score grading system.
The first standard-setting procedure resulted in a global passing score of 63 ± 13% on a basic perioperative transesophageal examination. The global passing score from the second standard-setting session was 73 ± 9%. Three hundred seventy-one basic perioperative transesophageal examinations from 12 anesthesiology residents were included in the analysis and used to guide the second standard-setting session. All residents scored higher than the global passing score from both standard-setting sessions.
To the authors' knowledge, this is the first demonstration that the collection of real-world anesthesia resident basic perioperative transesophageal examination clinical performance data is possible and that automated grading for competency assessment is feasible. The authors' findings demonstrate at least minimal basic perioperative transesophageal examination clinical competency of the 12 residents.
尚未有关于评估围手术期基础经食管超声心动图检查能力的可靠方法的报道。作者的目的是展示围手术期基础经食管检查实际操作数据的收集情况，并使用安格夫法确定围手术期基础经食管检查各组成部分的及格分数，以及围手术期基础经食管检查临床操作的整体及格分数。
美国超声心动图委员会（北卡罗来纳州罗利市）认证的围手术期高级经食管超声心动图麻醉医师（n = 7）担任两次安格夫标准设定会议的主题专家。第一次会议在数据分析之前举行，第二次用于校准及格分数的会议在9个月后举行。通过新的及格分数分级系统评估了12名麻醉住院医师的操作情况。
第一次标准设定程序得出围手术期基础经食管检查的整体及格分数为63±13%。第二次标准设定会议的整体及格分数为73±9%。分析纳入了12名麻醉住院医师的371次围手术期基础经食管检查，并用于指导第二次标准设定会议。所有住院医师的得分均高于两次标准设定会议的整体及格分数。
据作者所知，这是首次证明收集麻醉住院医师围手术期基础经食管检查实际临床操作数据是可行的，并且自动评分用于能力评估是可行的。作者的研究结果表明这12名住院医师至少具备围手术期基础经食管检查的最低临床能力。
