Development of an assessment tool for ultrasound-guided regional anaesthesia image interpretation.

INTRODUCTION 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. METHODS 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. RESULTS 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. DISCUSSION 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.