Assessment of laypersons' paediatric basic life support and foreign body airway obstruction management skills: a validity study

TY - JOUR

T1 - Assessment of laypersons' paediatric basic life support and foreign body airway obstruction management skills

T2 - a validity study

AU - Hasselager, Asbjørn

AU - Østergaard, Doris

AU - Kristensen, Tim

AU - Sønderskov, Claus

AU - Bohnstedt, Cathrine

AU - Lauritsen, Torsten L B

AU - Konge, Lars

AU - Tolsgaard, Martin G

PY - 2018/9/6

Y1 - 2018/9/6

N2 - Background: Standardised courses for laypeople in Paediatric Basic Life Support (PBLS) and Foreign Body Airway Obstruction Management (FBAOM) teach essential skills for the initiation of resuscitation by bystanders. Performance assessments are necessary to ensure that skills are acquired. We aimed to examine the validity of developed performance assessments and to determine credible pass/fail standards. Methods: Validity evidence was gathered in a standardised simulated setting by testing participants with three different levels of PBLS/FBAOM experience: untrained laypersons, trained laypersons, and lifeguards. Two blinded raters assessed participants' performance. The reliability of test scores was analysed using generalizability theory, scores were compared across the three groups, and pass/fail-standards were established. Results: A total of 33 participants were included. More than two raters and two cases were necessary for PBLS to achieve a reliability coefficient above 0.80, which is considered the minimally acceptable level for high-stakes certification. For FBAOM, two tests or three raters were needed. Assessment scores differed across the three groups for PBLS skills, as well as for FBAOM skills (p<0.001). Pass levels of 74% and 55% of the maximum score for PBLS and FBAOM, respectively, were identified as the levels that best discriminated between competent and non-competent laypersons. Conclusions: Laypersons' PBLS and FBAOM skills can be assessed in a reliable and valid way in a standardised simulated setting. However, multiple raters and scenario tests are needed to ensure sufficient reliability, which raises questions regarding the feasibility of performing certification tests for laypersons who participate in short paediatric resuscitation courses.

AB - Background: Standardised courses for laypeople in Paediatric Basic Life Support (PBLS) and Foreign Body Airway Obstruction Management (FBAOM) teach essential skills for the initiation of resuscitation by bystanders. Performance assessments are necessary to ensure that skills are acquired. We aimed to examine the validity of developed performance assessments and to determine credible pass/fail standards. Methods: Validity evidence was gathered in a standardised simulated setting by testing participants with three different levels of PBLS/FBAOM experience: untrained laypersons, trained laypersons, and lifeguards. Two blinded raters assessed participants' performance. The reliability of test scores was analysed using generalizability theory, scores were compared across the three groups, and pass/fail-standards were established. Results: A total of 33 participants were included. More than two raters and two cases were necessary for PBLS to achieve a reliability coefficient above 0.80, which is considered the minimally acceptable level for high-stakes certification. For FBAOM, two tests or three raters were needed. Assessment scores differed across the three groups for PBLS skills, as well as for FBAOM skills (p<0.001). Pass levels of 74% and 55% of the maximum score for PBLS and FBAOM, respectively, were identified as the levels that best discriminated between competent and non-competent laypersons. Conclusions: Laypersons' PBLS and FBAOM skills can be assessed in a reliable and valid way in a standardised simulated setting. However, multiple raters and scenario tests are needed to ensure sufficient reliability, which raises questions regarding the feasibility of performing certification tests for laypersons who participate in short paediatric resuscitation courses.

KW - Adult

KW - Airway Obstruction/therapy

KW - Cardiopulmonary Resuscitation/standards

KW - Certification

KW - Child

KW - Child, Preschool

KW - Female

KW - First Aid/standards

KW - Foreign Bodies

KW - Helping Behavior

KW - Humans

KW - Male

KW - Middle Aged

KW - Reproducibility of Results

KW - Simulation Training

U2 - 10.1186/s13049-018-0544-8

DO - 10.1186/s13049-018-0544-8

M3 - Journal article

C2 - 30189887

SN - 1757-7241

VL - 26

JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

M1 - 73

ER -