Pediatric Airway Assessment Tool (PAAT): A Rating Tool to Assess Resident Proficiency in Simulated Pediatric Airway Skills Performance
Robyn Wing,
Janette Baird,
Susan Duffy,
Linda Brown,
Frank Overly,
Mariann Nocera Kelley,
Chris Merritt
Affiliations
Robyn Wing
Assistant Professor, Departments of Emergency Medicine & Pediatrics, Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Director of Pediatric Simulation, Lifespan Medical Simulation Center
Janette Baird
Associate Professor, Department of Emergency Medicine and Injury Prevention Center, Alpert Medical School of Brown University
Susan Duffy
Professor, Departments of Emergency Medicine & Pediatrics, Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital
Linda Brown
Associate Professor, Departments of Emergency Medicine & Pediatrics, Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Vice Chair of Pediatric Emergency Medicine; Director of the Lifespan Medical Simulation Center
Frank Overly
Professor, Departments of Emergency Medicine & Pediatrics, Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Medical Director of Hasbro Emergency Department
Mariann Nocera Kelley
Assistant Professor, Departments of Pediatrics and Emergency Medicine/Traumatology, Division of Pediatric Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center; Director of Simulation Education, University of Connecticut School of Medicine
Chris Merritt
Associate Professor, Departments of Emergency Medicine & Pediatrics, Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Director, Brown Emergency Medicine Medical Education Research Fellowship
Introduction The Accreditation Council for Graduate Medical Education has identified the need for assessment of core skills for pediatric and emergency medicine residents, which includes pediatric airway management. Although there are standard courses for pediatric airway management, there is no validated tool to assess basic and advanced pediatric airway skills performance. Our objective was to develop a simulation-based tool for the formative assessment of resident pediatric airway skills performance that was concise, yet comprehensive, and to evaluate the evidence supporting the argument for the tool's validity. Methods We developed a pediatric airway assessment tool (PAAT) to assess six major domains of pediatric airway skills performance: basic airway maneuvers, airway adjuncts, bag-valve mask ventilation, advanced airway equipment preparation, direct laryngoscopy, and video laryngoscopy. This tool consisted of a 72-item pediatric airway skills assessment checklist to be used in simulation. We enrolled 12 subjects at four different training levels to participate. Assessment scores were rated by two independent expert raters. Results The interrater agreement was high, ranging from 0.92 (adult bagging rate) to 1 (basic airway maneuvers). There was a significant trend of increasing scores with increased training level. Discussion The PAAT demonstrated excellent interrater reliability and provided evidence of the construct's validity. Although further validation of this assessment tool is needed, these results suggest that the PAAT may eventually be useful for assessment of resident proficiency in pediatric airway skills performance.
