Haddad Sam J, Murali Mayur, Ko Shun W S, Narayanan Madan, Bowness James S, Merjavy Peter, Turbitt Lloyd, Macfarlane Alan J R, Pawa Amit, Bellew Boyne
Imperial College Healthcare NHS Trust, London, UK.
London Deanery, London, UK.
Anaesthesia. 2025 Jul 31. doi: 10.1111/anae.16724.
The success of ultrasound-guided regional anaesthesia depends on the acquisition and interpretation of optimal ultrasound images. This study aimed to develop an assessment tool to evaluate proficiency in interpreting ultrasound images for regional anaesthesia.
This study involved domain and item generation; preliminary testing; and content validity evaluation by an expert panel review. Questions were generated by the study group and pilot testing was conducted with UK-based anaesthesia consultants and resident doctors. Face validity was tested by thematic analysis of participant feedback questionnaires, discriminative ability using Rasch modelling of item response and internal reliability using Cronbach's α method.
A 57-item pilot test was completed by 43 participants across clinical experiences from stage 1 training to consultant. Median (IQR [range]) completion time was 55 (41-64 [29-94]) min and fatigue point was question 49 of 57 (37-57 [15-57]). Rasch analysis led to the exclusion of seven items and content validity evaluation resulted in the removal of a further six items, resulting in a 44-item question set. The test showed good face validity, with a Cronbach's α of 0.92, indicating high internal reliability.
This study produced a 44-item assessment tool to assess the proficiency of ultrasound image interpretation in regional anaesthesia for a range of upper limb, lower limb and truncal blocks, with proven face validity, internal reliability and content validity. Further testing with a larger sample is planned to verify reliability and validity, with the hope that this may be an asset for regional anaesthesia training and assessment.
超声引导下区域麻醉的成功取决于获取和解读最佳超声图像。本研究旨在开发一种评估工具，以评估区域麻醉超声图像解读的熟练程度。
本研究包括领域和项目生成；初步测试；以及通过专家小组审查进行内容效度评估。问题由研究小组提出，并对英国的麻醉顾问和住院医生进行了预测试。通过对参与者反馈问卷的主题分析来测试表面效度，使用项目反应的拉施模型来测试区分能力，使用克朗巴赫α方法来测试内部信度。
43名参与者完成了一项包含57个项目的预测试，他们的临床经验涵盖从1级培训到顾问阶段。中位数（四分位间距[范围]）完成时间为55（41 - 64[29 - 94]）分钟，疲劳点出现在第49题（共57题，37 - 57[15 - 57]）。拉施分析导致7个项目被排除，内容效度评估又导致另外6个项目被删除，最终形成了一个包含44个项目的问题集。该测试显示出良好的表面效度，克朗巴赫α系数为0.92，表明内部信度较高。
本研究产生了一种包含44个项目的评估工具，用于评估上肢、下肢和躯干阻滞等一系列区域麻醉中超声图像解读的熟练程度，已证实具有表面效度、内部信度和内容效度。计划用更大的样本进行进一步测试，以验证信度和效度，希望这可能成为区域麻醉培训和评估的一项有用工具。
