Development and pilot testing of an assessment tool for performance of anatomic lung resection Journal Article


Authors: Turner, S. R.; Lai, H.; Nasir, B. S.; Yasufuku, K.; Schieman, C.; Huang, J.; Bédard, E. L. R.
Contributors: Adusumilli; Bains; Bott; Downey; Isbell; Jones; Molena; Sihag
Article Title: Development and pilot testing of an assessment tool for performance of anatomic lung resection
Abstract: Background: To meet the need for competency assessment in thoracic surgery education, we developed and tested an instrument to assess trainees’ ability to perform anatomic lung resection for cancer. Methods: The Thoracic Competency Assessment Tool-Anatomic Resection for Lung Cancer (TCAT-ARC) was developed through a multistep process involving logical analysis, expert review, and simulation-based and clinical pilot testing. Validity evidence was gathered during a 6-month clinical study of trainees performing anatomic lung resections and assessments of practicing surgeons. Feedback was gathered via post-encounter questionnaires. Results: A 35-item instrument was developed and was tested in the clinical validation study. Seven trainees in 4 North American institutions participated and completed 64 anatomic lung resections. Reliability was high (α = 0.93). Interobserver reliability (k = 0.73) and correlation with an existing global competency scale (k = 0.68) were moderately high. Item analysis revealed the most difficult and discriminatory items, which matched well with a conceptual understanding of lung resection. Both trainees and assessors viewed the instrument as highly educationally effective and user-friendly. Practicing surgeons outperformed trainees. Conclusions: The TCAT-ARC demonstrated early evidence of validity and reliability in assessing performance of anatomic lung resection. The instrument may be most useful early in training and as a means for providing fine-grained formative feedback about which steps have been mastered and which still require improvement. The TCAT-ARC may be used in training programs to aid in the development of trainees’ competency and as a part of an aggregate assessment of trainees’ overall mastery of the procedure and readiness for independent practice. © 2020 The Society of Thoracic Surgeons
Keywords: conference paper; lung resection; lung cancer; validation study; questionnaire; pilot study; surgical training; professional competence; clinical assessment tool; interrater reliability; human; priority journal; thoracic surgeon; constructive feedback
Journal Title: Annals of Thoracic Surgery
Volume: 109
Issue: 6
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2020-06-01
Start Page: 1922
End Page: 1930
Language: English
DOI: 10.1016/j.athoracsur.2019.09.052
PUBMED: 31706874
PROVIDER: scopus
PMCID: PMC8919967
DOI/URL:
Notes: Conference Paper -- Export Date: 1 July 2020 -- Source: Scopus
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  1. James Huang
    214 Huang
  2. Matthew Bott
    135 Bott
  3. Robert J Downey
    254 Downey
  4. Manjit S Bains
    338 Bains
  5. David Randolph Jones
    417 Jones
  6. Daniela   Molena
    272 Molena
  7. James Michael Isbell
    127 Isbell
  8. Smita Sihag
    96 Sihag