Duran1, Brian Dunkin2, Daryl Schulz1, Vid Fikfak2, Jean Bimuth1
1The Methodist DeBakey Heart & Vascular Center, Houston, TX; 2The Methodist Hospital Department of General Surgery, Houston, TX.
OBJECTIVES: There is growing interest in measuring trainee performance in the operating room to provide an objective means of assessing performance, which has led to the development and validation of standardized assessment tools for open and laparoscopic surgery. Our objective was to develop and validate a global assessment tool for endovascular performance.
METHODS: The global rating assessment device for endovascular skill, GRADES, measures 6 domains of performance graded on a 5-point Likert scale (Table 1). Vascular fellows were evaluated during endovascular procedures by 2 trained observers. Internal consistency was calculated using Cronbach α and inter-observer reliability assessed by intraclass correlation (ICC). Construct validity was evaluated by student's t-test, correlating scores with post graduate year (PGY) of training.
RESULTS: A total of 28 assessments were performed on a variety of venous and arterial endovascular procedures (including lower extremity and visceral angioplasty and stenting, endovascular aortic repair and central venous interventions). Total performance scores correlated with trainee experience (p=0.0008), and internal consistency was high (Cronbach's α=0.84). Good inter-observer correlation was demonstrated for the total score (r=0.83) and 5 of the 6 domains (Table 1).
CONCLUSIONS: This initial work confirms the validity of the grading tool for evaluating performance in endovascular procedures. The GRADES could serve as a valuable tool for objectively evaluating performance in both live simulated cases.
AUTHOR DISCLOSURES: J. Bismuth: Nothing to disclose; B. Dunkin: Nothing to disclose; C. Duran: Nothing to disclose; V. Fikfak: Nothing to disclose; D. Schulz: Nothing to disclose.
Posted April 2013