The Face, Content, and Construct Validity Assessment of a Focused Assessment in Sonography for Trauma Simulator

Muzzafer Chaudery; James Clark; Derf Ap Dafydd; Joel Dunn; Duncan Bew; Mark H Wilson; Ara Darzi

doi:10.1016/j.jsurg.2015.04.003

The Face, Content, and Construct Validity Assessment of a Focused Assessment in Sonography for Trauma Simulator

J Surg Educ. 2015 Sep-Oct;72(5):1032-8. doi: 10.1016/j.jsurg.2015.04.003. Epub 2015 May 14.

Authors

Muzzafer Chaudery¹, James Clark², Derf Ap Dafydd³, Joel Dunn³, Duncan Bew⁴, Mark H Wilson², Ara Darzi²

Affiliations

¹ Department of Surgery and Cancer, Imperial College London, London, United Kingdom. Electronic address: muzzafer.chaudery10@imperial.ac.uk.
² Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
³ Department of Radiology, Imperial College Healthcare NHS Trust, London, United Kingdom.
⁴ Department of Trauma Surgery, Kings College Hospital NHS Foundation Trust, London, United Kingdom.

PMID: 25980827
DOI: 10.1016/j.jsurg.2015.04.003

Abstract

Objective: Hemorrhage identification in trauma care is a major priority. Focused assessment in sonography for trauma (FAST) offers a rapid, reliable means of detecting torso bleeding. The aims of this study were to conduct a face, content, and construct validity assessment of a FAST simulator and establish a rigorous assessment tool.

Design: Participants were requested to perform a FAST scan and state if any abnormality was found in each region. Metrics evaluated included time, errors, and missed targets. Accuracy of images obtained was assessed by 2 independent radiologists. Experts completed a face and content validity questionnaire at the end of the study.

Setting: The study took place in the simulation suite within the Academic Surgical Unit of the Department of Surgery and Cancer.

Participants: Novices had no prior experience with ultrasound, intermediates had less than 6 months experience with fewer than 50 FAST scans performed, and experts had more than 1 year of experience with greater than 100 FAST scans performed. There were 31 participants: 11 experts, 10 intermediates, and 10 novices.

Results: The face and content validity questionnaire scored high marks across all categories and achieved an overall median realism score of 8 ± 1.5 on a Likert scale. Experts performed the FAST scan faster with more accuracy and fewer errors than other cohorts (p < 0.001). Both the novices and intermediates were the slowest, least accurate, and either missed or made the most errors when scanning the lung bases and spleen.

Conclusions: This study has established the face, content, and construct validities of a FAST simulator, which could be used to accelerate training for novices. Additionally, it has demonstrated a rigorous method for FAST assessment, which has proven to be effective and in doing so addressed some of the criticisms leveled against it.

Keywords: Medical Knowledge; Practice-Based Learning and Improvement; education; hemorrhage identification; simulation; trauma; ultrasound.

MeSH terms

Clinical Competence*
Emergency Medicine / education
General Surgery / education
Hemorrhage / diagnostic imaging*
Humans
Phantoms, Imaging
Radiology / education
Simulation Training / methods*
Surveys and Questionnaires
Thoracic Injuries / diagnostic imaging*
Ultrasonography / methods*