Liu Kevin, Elmunzer B Joseph, Wani Sachin, Taft Tiffany, Walsh Catharine M, Arain Mustafa A, Berzin Tyler M, Buxbaum James, DiMaio Christopher, Fehmi Syed M Abbas, Gupta Neil, Jonnalagadda Sreenivasa, Kushnir Vladimir, Maple John T, Muthusamy Raman, Rastogi Amit, Shah Janak N, Chak Amitabh, Faulx Ashley, Forbes Nauzer, Keswani Rajesh N
Gastroenterology, Banner - University Medical Center Phoenix, Phoenix, United States.
Division of Gastroenterology, Medical University of South Carolina, Charleston, United States.
Endosc Int Open. 2024 Feb 28;12(2):E324-E331. doi: 10.1055/a-2161-1982. eCollection 2024 Feb.
The Bethesda ERCP Skill Assessment Tool (BESAT) is a video-based assessment tool of technical endoscopic retrograde cholangiopancreatography (ERCP) skill with previously established validity evidence. We aimed to assess the discriminative validity of the BESAT in differentiating ERCP skill levels. Twelve experienced ERCP practitioners from tertiary academic centers were asked to blindly rate 43 ERCP videos using the BESAT. ERCP videos consisted of native biliary cannulation and sphincterotomy and were recorded from 10 unique endoscopists of various ERCP experience (from advanced endoscopy fellow to > 10 years of ERCP experience). Inter-rater reliability, discriminative validity, and internal structure validity were subsequently assessed. The BESAT was found to reliably differentiate between endoscopists of varying levels of ERCP experience with experienced ERCPists scoring higher than novice ERCPists in 11 of 13 (85%) instrument items. Inter-rater reliability for BESAT items ranged from good to excellent (intraclass correlation range: 0.86 to 0.93). Internal structure validity was assessed with item-total correlations ranging from 0.53 to 0.83. Study findings demonstrate that the BESAT, a video-based ERCP skill assessment tool, has high inter-rater reliability and has discriminative validity in differentiating novice from expert ERCP skill. Further investigations are needed to determine the role of video-based assessment in improving trainee learning curves and patient outcomes.
贝塞斯达内镜逆行胰胆管造影术技能评估工具（BESAT）是一种基于视频的技术内镜逆行胰胆管造影术（ERCP）技能评估工具，具有先前确立的效度证据。我们旨在评估BESAT在区分ERCP技能水平方面的区分效度。来自三级学术中心的12名经验丰富的ERCP从业者被要求使用BESAT对43个ERCP视频进行盲评。ERCP视频包括原发性胆管插管和括约肌切开术，由10名具有不同ERCP经验（从高级内镜进修医生到有超过10年ERCP经验）的不同内镜医师录制。随后评估了评分者间信度、区分效度和内部结构效度。结果发现，BESAT能够可靠地区分不同ERCP经验水平的内镜医师，在13项工具项目中的11项（85%）中，经验丰富的ERCP医师得分高于新手ERCP医师。BESAT项目的评分者间信度从良好到优秀（组内相关系数范围：0.86至0.93）。内部结构效度通过项目与总分的相关性进行评估，范围为0.53至0.83。研究结果表明，基于视频的ERCP技能评估工具BESAT具有较高的评分者间信度，并且在区分新手和专家ERCP技能方面具有区分效度。需要进一步研究以确定基于视频的评估在改善学员学习曲线和患者预后方面的作用。
