Date of Award

12-23-2024

Degree Type

Thesis

Degree Name

Master of Health Professions Education

First Advisor

Dr Sana Saeed

Second Advisor

Dr Naveed Yousuf

Third Advisor

Dr Shazia Babar

Department

Community Health Sciences

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure that requires a professional to develop multiple competencies to ensure a patient’s safety. A structured and comprehensive assessment is required for the formative assessment of the competencies related to ERCP. However, no comprehensive assessment tool for assessing ERCP skills is widely available. This study aimed to develop and validate the content of an Objective Structured Assessment Tool for ERCP (OSAT- E).
Methods: This was an exploratory sequential design conducted at section of Gastroenterology, Aga Khan University hospital, Karachi Pakistan during October-November 2024. The study has 2 phases. During Phase 1 the Delphi method was used. A preliminary version OSAT-E (OSAT-E version 1) was developed based on a comprehensive literature review that consisted of 35 items with five subscales. Subscale I to assess the trainees’ pre-procedure knowledge and preparation skills. Subscale II to assess technical and procedural skills. Subscale III to assess the decision-making ability for selections of appropriate endoscopic therapy based on the identified pathology as per the standard of care. Subscale IV to assess the post-procedure management plan and report writing skills. Subscale V to assess non-clinical skills i.e. teamwork and leadership, professionalism and communication skills. The OSAT-E version 1 was shared with seven panelists in the first round of Delphi discussions. The consensus was set at 85%. Panelists rated the relevance, and comprehension of each item, provided feedback and suggestions. Based on expert consensus, the tool was revised (OSAT-E version 2) and shared as an online survey with 7 panelists to rate relevance, clarity, and comprehension of each item, providing feedback and suggestions. Based on expert’s consensus, OSAT-E was revised as final version. In phase 2, the content validity was assessed using the Content Validity Index (CVI), with relevance and importance scores calculated for each item.
Results: In Delphi round 1, 100% agreement was achieved for 26 items (74.3%), with 85.7% agreement for 6 items (17.1%). After revision, the second round included 34 items. In round 2, 100% agreement was obtained for 31 items (91.17%) regarding relevance, and 85.7% agreement was observed for 3 items (8.82%). Regarding clarity & comprehension the agreement of 100% was observed for 31 (91.17%) items and 85.7% for 3(8.82%) items. Hence, all 34 items were retained as they met the set criteria of consensus above 70%and OSAT-E concluded as final version (version 3). The final version (OSAT-E version 3), comprising of 34 items, met the predefined content validity criteria, with high agreement for both relevance and clarity.
Conclusion: The OSAT-E tool was successfully developed and demonstrated strong content validity through expert consensus. The newly constructed tool will provide a structured and comprehensive approach for assessing ERCP-related competencies. Future studies are required to assess the tool's reliability, predictive validity, and applicability in real-world clinical settings. < >

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