NDLI: Comparison of a dichotomous versus trichotomous checklist for neonatal intubation

Content Provider	Springer Nature : BioMed Central
Author	Johnston, Lindsay Sawyer, Taylor Nishisaki, Akira Whitfill, Travis Ades, Anne French, Heather Glass, Kristen Dadiz, Rita Bruno, Christie Levit, Orly Auerbach , Marc
Abstract	Background To compare validity evidence for dichotomous and trichotomous versions of a neonatal intubation (NI) procedural skills checklist. Methods NI skills checklists were developed utilizing an existing framework. Experts were trained on scoring using dichotomous and trichotomous checklists, and rated recordings of 23 providers performing simulated NI. Videolaryngoscope recordings of glottic exposure were evaluated using Cormack-Lehane (CL) and Percent of Glottic Opening scales. Internal consistency and reliability of both checklists were analyzed, and correlations between checklist scores, airway visualization, entrustable professional activities (EPA), and global skills assessment (GSA) were calculated. Results During rater training, raters gave significantly higher scores on better provider performance in standardized videos (both p < 0.001). When utilized to evaluate study participants’ simulated NI attempts, both dichotomous and trichotomous checklist scores demonstrated very good internal consistency (Cronbach’s alpha 0.868 and 0.840, respectively). Inter-rater reliability was higher for dichotomous than trichotomous checklists [Fleiss kappa of 0.642 and 0.576, respectively (p < 0.001)]. Sum checklist scores were significantly different among providers in different disciplines (p < 0.001, dichotomous and trichotomous). Sum dichotomous checklist scores correlated more strongly than trichotomous scores with GSA and CL grades. Sum dichotomous and trichotomous checklist scores correlated similarly well with EPA. Conclusions Neither dichotomous or trichotomous checklist was superior in discriminating provider NI skill when compared to GSA, EPA, or airway visualization assessment. Sum scores from dichotomous checklists may provide sufficient information to assess procedural competence, but trichotomous checklists may permit more granular feedback to learners and educators. The checklist selected may vary with assessment needs.
Related Links	https://bmcmededuc.biomedcentral.com/counter/pdf/10.1186/s12909-022-03700-4.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14726920
DOI	10.1186/s12909-022-03700-4
Journal	BMC Medical Education
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2022-08-26
Access Restriction	Open
Subject Keyword	Medical Education Theory of Medicine Bioethics Neonatal intubation Dichotomous checklist Trichotomous checklist Global skills assessment Entrustable professional activities assessment Theory of Medicine/Bioethics
Content Type	Text
Resource Type	Article
Subject	Education Medicine
Journal Impact Factor	2.7/2023
5-Year Journal Impact Factor	3.4/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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