SHM Converge Scientific Abstract ePoster Gallery-Development and Validation of an Assessment Tool to Determine Learner Comptency in the Performance of Bedside Paracentesis Using Real-Time Ultasound Guidance

Development and Validation of an Assessment Tool to Determine Learner Comptency in the Performance of Bedside Paracentesis Using Real-Time Ultasound Guidance

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This study developed and validated a structured assessment tool for learner competency in bedside paracentesis performed with real-time ultrasound guidance. The motivation was that traditional competency requirements, such as completing a minimum number of supervised procedures, may not adequately measure true skill, and few standardized tools exist for this procedure.<br /><br />Researchers created a Qualtrics-based survey using 10 simulated paracentesis videos that intentionally represented different skill levels. Experts evaluated five specific procedural factors: optimal ultrasound-guided site selection, stability of the ultrasound probe, probe orientation during needle advancement, needle visualization throughout the procedure, and catheter deployment technique. Each factor and overall performance were rated on a 5-point Likert scale, where 4 indicated readiness for unsupervised practice.<br /><br />The survey was distributed to content experts through a snowball sampling network. A total of 23 experts contributed 203 video ratings. Results showed that the tool could distinguish between low/unsafe performance and high/ready-for-independence performance, with substantial to almost perfect agreement across categories (kappa values 0.62–0.94). In the final proportional odds mixed-effects model, all five factors were significant predictors of overall competency ratings, meaning each element contributed meaningfully to expert judgments of performance.<br /><br />The authors concluded that standardized tools focusing on key procedural steps are needed to better assess and teach procedural competency. While the simulation-based assessment successfully identified high and low performers, further validation in real clinical settings is needed before widespread use.

Asset Subtitle

Erica Levine

Meta Tag

Author List Alec Duffy, Andrew P.J Olson, Erica Levine, Molly F. Wyman, Todd De for, Zachary Kaltenborn

Category Research

Concept Paracentesis

Concept Ultrasound Guidance

Concept Site Selection

Concept Needle Visualization

Concept Probe Stability

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Erica Levine

Track Education

Keywords

paracentesis

ultrasound guidance

competency assessment

simulation-based evaluation

procedural skill

learner assessment

bedside procedure

expert ratings

Likert scale

validation study

Paracentesis

Ultrasound Guidance

Site Selection

Needle Visualization

Probe Stability