ArticleMedical education2015
Use of an error-focused checklist to identify incompetence in lumbar puncture performances.
Article in Medical education, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Improving Resident Comfort with Central Venous Catheter Supervision: Use of an Error Management Training Approach.Advances in medical education and practice · 2025Article
- Validation of an Educational Tool for Skin Abscess Incision and Drainage by Delphi and Angoff Methods.Journal of general internal medicine · 2023Article
- Using a novel virtual-reality simulator to assess performance in lumbar puncture: a validation study.BMC medical education · 2023Article
- Novel cricothyrotomy assessment tool for attending physicians: A multicenter study of an error avoidance checklist.AEM education and training · 2021Article
- Article
- Consensus-Based Expert Development of Critical Items for Direct Observation of Point-of-Care Ultrasound Skills.Journal of graduate medical education · 2020Article
- Picking the Right Tool for the Job: A Reliability Study of 4 Assessment Tools for Central Venous Catheter Insertion.Journal of graduate medical education · 2019Article
- Specific lumbar puncture training during clinical clerkship durably increases atraumatic needle use.PloS one · 2019Article
- Cut-scores revisited: feasibility of a new method for group standard setting.BMC medical education · 2018Article
- Development of performance and error metrics for ultrasound-guided axillary brachial plexus block.Advances in medical education and practice · 2017Article
- An experimental study on the impact of clinical interruptions on simulated trainee performances of central venous catheterization.Advances in simulation (London, England) · 2017Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextChecklists are commonly used in the assessment of procedural competence. However, on most checklists, high scores are often unable to rule out incompetence as the commission of a few serious procedural errors typically results in only a minimal reduction in performance score. We hypothesised that checklists constructed based on procedural errors may be better at identifying incompetence.
objectivesThis study sought to compare the efficacy of an error-focused checklist and a conventionally constructed checklist in identifying procedural incompetence.
methodsWe constructed a 15-item error-focused checklist for lumbar puncture (LP) based on input from 13 experts in four Canadian academic centres, using a modified Delphi approach, over three rounds of survey. Ratings of 18 video-recorded performances of LP on simulators using the error-focused tool were compared with ratings obtained using a published conventional 21-item checklist. Competence/incompetence decisions were based on global assessment. Diagnostic accuracy was estimated using the area under the curve (AUC) in receiver operating characteristic analyses.
resultsThe accuracy of the conventional checklist in identifying incompetence was low (AUC 0.11, 95% confidence interval [CI] 0.00-0.28) in comparison with that of the error-focused checklist (AUC 0.85, 95% CI 0.67-1.00). The internal consistency of the error-focused checklist was lower than that of the conventional checklist (α = 0.35 and α = 0.79, respectively). The inter-rater reliability of both tools was high (conventional checklist: intraclass correlation coefficient [ICC] 0.99, 95% CI 0.98-1.00; error-focused checklist: ICC 0.92, 95% CI 0.68-0.98).
conclusionsDespite higher internal consistency and inter-rater reliability, the conventional checklist was less accurate at identifying procedural incompetence. For assessments in which it is important to identify procedural incompetence, we recommend the use of an error-focused checklist.
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