Competency-Based Assessment Tool for Pediatric Esophagoscopy: International Modified Delphi Consensus

Erynne A Faucett; Nikolaus E Wolter; Karthik Balakrishnan; Stacey L Ishman; Deepak Mehta; Sanjay Parikh; Lily H P Nguyen; Diego Preciado; Michael J Rutter; Jeremy D Prager; Glenn E Green; Seth M Pransky; Ravi Elluru; Murad Husein; Soham Roy; Kaalan E Johnson; Jacob Friedberg; Romaine F Johnson; Nancy M Bauman; Charles M Myer 4th; Ellen S Deutsch; Eric A Gantwerker; J Paul Willging; Catherine K Hart; Robert H Chun; Derek J Lam; Jonathan B Ida; John J Manoukian; David R White; Douglas R Sidell; Christopher T Wootten; Andrew F Inglis; Craig S Derkay; George Zalzal; David W Molter; Jeffrey P Ludemann; Sukgi Choi; Scott Schraff; Charles M Myer 3rd; Robin T Cotton; Shyan Vijayasekaran; Carlton J Zdanski; Hamdy El-Hakim; Udayan K Shah; Marlene A Soma; Marshall E Smith; Dana M Thompson; Luv Ram Javia; Karen B Zur; Steven E Sobol; Christopher J Hartnick; Reza Rahbar; Jean-Philippe Vaccani; Benjamin Hartley; Sam J Daniel; Ian N Jacobs; Gresham T Richter; Alessandro de Alarcon; Matthew A Bromwich; Evan J Propst

doi:10.1002/lary.29126

Competency-Based Assessment Tool for Pediatric Esophagoscopy: International Modified Delphi Consensus

Laryngoscope. 2021 May;131(5):1168-1174. doi: 10.1002/lary.29126. Epub 2020 Oct 9.

Authors

Erynne A Faucett^{1

2}, Nikolaus E Wolter³, Karthik Balakrishnan⁴, Stacey L Ishman⁵, Deepak Mehta⁶, Sanjay Parikh⁷, Lily H P Nguyen⁸, Diego Preciado⁹, Michael J Rutter⁵, Jeremy D Prager¹⁰, Glenn E Green¹¹, Seth M Pransky¹², Ravi Elluru¹³, Murad Husein¹⁴, Soham Roy¹⁵, Kaalan E Johnson⁷, Jacob Friedberg³, Romaine F Johnson¹⁶, Nancy M Bauman⁹, Charles M Myer 4th⁵, Ellen S Deutsch^{17

18}, Eric A Gantwerker¹⁹, J Paul Willging⁵, Catherine K Hart⁵, Robert H Chun²⁰, Derek J Lam²¹, Jonathan B Ida²², John J Manoukian⁸, David R White²³, Douglas R Sidell⁴, Christopher T Wootten²⁴, Andrew F Inglis⁷, Craig S Derkay²⁵, George Zalzal⁹, David W Molter²⁶, Jeffrey P Ludemann²⁷, Sukgi Choi²⁸, Scott Schraff²⁹, Charles M Myer 3rd⁵, Robin T Cotton⁵, Shyan Vijayasekaran³⁰, Carlton J Zdanski³¹, Hamdy El-Hakim³², Udayan K Shah³³, Marlene A Soma³⁴, Marshall E Smith³⁵, Dana M Thompson²², Luv Ram Javia³⁶, Karen B Zur³⁶, Steven E Sobol³⁶, Christopher J Hartnick³⁷, Reza Rahbar²⁸, Jean-Philippe Vaccani³⁸, Benjamin Hartley³⁹, Sam J Daniel⁸, Ian N Jacobs³⁶, Gresham T Richter⁴⁰, Alessandro de Alarcon⁵, Matthew A Bromwich³⁸, Evan J Propst³

Affiliations

¹ Division of Otolaryngology, Head and Neck Surgery, Phoenix Children's Hospital, Department of Child Health, University of Arizona, Tucson, Arizona, U.S.A.
² College of Medicine, Department of Otolaryngology, Mayo College of Medicine and Science, Phoenix, Arizona, U.S.A.
³ Department of Otolaryngology - Head and Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Canada.
⁴ Department of Otolaryngology, Head and Neck Surgery, Stanford University, Lucile Salter Packard Children's Hospital, Palo Alto, California, U.S.A.
⁵ Department of Otolaryngology - Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center Cincinnati, Cincinnati, Ohio, U.S.A.
⁶ Department of Pediatric Otolaryngology, Texas Children's Hospital, Houston, Texas, U.S.A.
⁷ Division of Otolaryngology - Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.
⁸ Department of Otolaryngology - Head and Neck Surgery, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
⁹ Department of Otolaryngology, Children's National Health System, Division of Otolaryngology, George Washington University Washington, Washington, District of Columbia, U.S.A.
¹⁰ Department of Pediatric Otolaryngology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, U.S.A.
¹¹ Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Mott Children's Hospital, Ann Arbor, Michigan, U.S.A.
¹² Division of Pediatric Otolaryngology, Rady Children's Hospital San Diego, San Diego, California, U.S.A.
¹³ Division of Otolaryngology, Dayton Children's Hospital, Dayton, Ohio, U.S.A.
¹⁴ Department of Otolaryngology - Head and Neck Surgery, Victoria Hospital, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
¹⁵ Department of Otorhinolaryngology, University of Texas at Houston McGovern Medical School, Houston, Texas, U.S.A.
¹⁶ Department of Otolaryngology - Head and Neck Surgery, Division of Pediatric Otolaryngology University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
¹⁷ Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.
¹⁸ Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A.
¹⁹ Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, U.S.A.
²⁰ Department of Otolaryngology, Children's Hospital of Wisconsin-Milwaukee Campus, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
²¹ Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Pediatric Otolaryngology, Doernbecher Children's Hospital, Portland, Oregon, U.S.A.
²² Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, U.S.A.
²³ Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
²⁴ Division of Otolaryngology, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee, U.S.A.
²⁵ Department of Otolaryngology - Head and Neck Surgery Children's Hospital of the King's Daughters, Eastern Virginia Medical School, Norfolk, Virginia, U.S.A.
²⁶ Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, U.S.A.
²⁷ Pediatric Otolaryngology, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
²⁸ Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A.
²⁹ Arizona Otolaryngology Consultants, Phoenix, Arizona, U.S.A.
³⁰ Department of Otolaryngology, Head and Neck Surgery, Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia.
³¹ Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
³² Division of Pediatric Surgery and Otolaryngology - Head and Neck Surgery, Departments of Surgery and Pediatrics, The Stollery Children's Hospital, University of Alberta Hospital, Edmonton, Alberta, Canada.
³³ Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, U.S.A.
³⁴ Department of Paediatric Otolaryngology, Sydney Children's Hospital, Randwick, New South Wales, Australia.
³⁵ Division of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A.
³⁶ Division of Otolaryngology, The Children's Hospital of Philadelphia, Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A.
³⁷ Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, Boston, Massachusetts, U.S.A.
³⁸ Division of Otolaryngology, Department of Surgery, CHEO, University of Ottawa, Ottawa, Ontario, Canada.
³⁹ Department of Otolaryngology, Great Ormond Street Hospital, London, United Kingdom.
⁴⁰ Division of Pediatric Otolaryngology, Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.

PMID: 33034397
DOI: 10.1002/lary.29126

Abstract

Objectives/hypothesis: Create a competency-based assessment tool for pediatric esophagoscopy with foreign body removal.

Study design: Blinded modified Delphi consensus process.

Setting: Tertiary care center.

Methods: A list of 25 potential items was sent via the Research Electronic Data Capture database to 66 expert surgeons who perform pediatric esophagoscopy. In the first round, items were rated as "keep" or "remove" and comments were incorporated. In the second round, experts rated the importance of each item on a seven-point Likert scale. Consensus was determined with a goal of 7 to 25 final items.

Results: The response rate was 38/64 (59.4%) in the first round and returned questionnaires were 100% complete. Experts wanted to "keep" all items and 172 comments were incorporated. Twenty-four task-specific and 7 previously-validated global rating items were distributed in the second round, and the response rate was 53/64 (82.8%) with questionnaires returned 97.5% complete. Of the task-specific items, 9 reached consensus, 7 were near consensus, and 8 did not achieve consensus. For global rating items that were previously validated, 6 reached consensus and 1 was near consensus.

Conclusions: It is possible to reach consensus about the important steps involved in rigid esophagoscopy with foreign body removal using a modified Delphi consensus technique. These items can now be considered when evaluating trainees during this procedure. This tool may allow trainees to focus on important steps of the procedure and help training programs standardize how trainees are evaluated.

Level of evidence: 5. Laryngoscope, 131:1168-1174, 2021.

Keywords: Delphi; Esophagoscopy; OSAT; assessment; education; objective structured assessment of technical skills.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Clinical Competence / standards*
Consensus*
Delphi Technique
Esophagoscopes
Esophagoscopy / education*
Esophagoscopy / instrumentation
Esophagus / diagnostic imaging
Esophagus / surgery
Foreign Bodies / diagnosis
Foreign Bodies / surgery
Humans
Internship and Residency / standards*
Surgeons / education
Surgeons / standards*
Surgeons / statistics & numerical data
Surveys and Questionnaires / statistics & numerical data