Engelke Monika, Grund Karl Ernst, Schilling Dieter, Beilenhoff Ulrike, Stebner Ferdinand, Kugler Christiane
Department of Nursing Science, University Witten/Herdecke, Witten, Germany.
Center of Medical Research, University Clinics Tübingen, Tübingen, Germany.
Visc Med. 2021 Jun;37(3):212-218. doi: 10.1159/000511350. Epub 2020 Nov 4.
The acquisition of sensorimotor skills, so-called "technical skills", plays an essential part in the professional and continuing educational training of medical and nursing staff. Facilities turn to simulator training to promote the safe and accurate performance of endoscopic examinations. Thus, this study aimed to develop and pilot-test a corresponding assessment instrument to monitor necessary sensorimotor or "technical" skills of the examiner for a safe percutaneous endoscopic gastrostomy (AS-PEG).
Instrument development and pilot validation involved four stages: identification of potential items and initial draft of the AS-PEG; expert panel with 11 experts (content validity index [CVI] calculated); empirical validation using a quasi-experimental intervention on simulators; revision of the pilot AS-PEG taking expert assessment, and empirical testing into consideration.
The initial instrument yielded 13 categories and 44 items describing the PEG procedure. Experts rated 30 out of 44 items (68%) extremely or very important for the safety of the puncture of the stomach. Initial item-CVIs ranged from 0.00 to 1.00; scale-CVI was 0.61. Twenty-four trainees (7 physicians, 17 nurses) participated in the pilot simulation study. On average, 8:25 min were required for PEG placement (min-max 5:59-13:38 min, SD = 1:43). The revised AS-PEG version was reduced to 14 items with a range of the item CVI from 0.8 to 1.0, and a scale-CVI of 0.90.
The AS-PEG instrument facilitates the evaluation of sensorimotor skills during percutaneous gastric puncture procedures within the context of PEG placement, across professions and without relating to the number of procedures previously performed. The instrument is economical and shows satisfying content validity.
获得感觉运动技能,即所谓的“技术技能”,在医护人员的专业和继续教育培训中起着至关重要的作用。医疗机构采用模拟培训来促进内镜检查的安全准确操作。因此,本研究旨在开发并进行相应评估工具的预试验,以监测检查者进行安全经皮内镜下胃造口术(AS-PEG)所需的感觉运动或“技术”技能。
工具开发和预试验验证包括四个阶段:确定潜在项目并初步起草AS-PEG;由11名专家组成的专家小组(计算内容效度指数[CVI]);使用模拟器进行准实验干预的实证验证;结合专家评估和实证测试对预试验版AS-PEG进行修订。
初始工具产生了13个类别和44个描述PEG操作的项目。专家们认为44个项目中的30个(68%)对胃穿刺的安全性极其或非常重要。初始项目CVI范围为0.00至1.00;量表CVI为0.61。24名学员(7名医生,17名护士)参与了预试验模拟研究。PEG放置平均需要8:25分钟(最小-最大5:59-13:38分钟,标准差=1:43)。修订后的AS-PEG版本减少到14个项目,项目CVI范围为0.8至1.0,量表CVI为0.90。
AS-PEG工具便于在PEG放置背景下评估经皮胃穿刺过程中的感觉运动技能,适用于不同专业,且与先前执行的操作数量无关。该工具经济实用,内容效度令人满意。