Reliability of the Leicester Clinical procedure Assessment Tool LCAT, a tool to support holistic gen

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Reliability of the Leicester Clinical procedure
Assessment Tool (LCAT), a tool to support
holistic generic assessment of clinical procedure
skills

• RK McKinley, J Strand, L Schuwirth
• T Gray, T Alun-Jones, H Miller

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Background

• Assessment
• Repertoire of competence
• Micro-certification
• Changing roles
• Skills extension
• Skills cascade
• Volume
• Implications for assessment

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Instrument specification

• Generic
• Holistic
• Multi-professional
• Multi-level
• Multi-modal
• Enable high quality assessment
• reliable, valid, acceptable, feasible,
  educational impact
• Nationally accredited

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Methods

• Multi stage
• Systematic review
• Qualitative development
• National validation
• Psychometrics
• Implementation

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Stage 1 Systematic review

• LCAT v1.7

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Stage 2 Qualitative

• Focus groups
• Observed assessments, debrief interviews
• Trial hi-fi OSCE
• LCAT v2.5

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Stage 3 Delphi

• National sampling frame
• Recruitment
• Questionnaire
• Definition of consensus
• Agreement
• Categories All gt95
• Components All gt89
• LCAT v3.0

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LCAT v3.0

• Category
• Communication and working with the patient
• Safety
• Infection Prevention
• Procedural Competence
• Team working

• Components
• 9
• 7
• 6
• 12
• 4

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Stage 4 Psychometrics

• Hi-fi OSCE
• 8 stations (2X3 tracks)
• Prosthetics simulator
• Venepuncture, venous cannulation, IV drugs, ABG,
  ?? urinary catheterisation, skin suture, ECG
• Prep station
• 15 minutes 5 feedback

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Stage 4 Psychometrics

• Analysis
• Used data from 1 assessor per station
• Assessors not systematically assigned to stations
• Variable group of assessors
• Unbalanced design

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Stage 4 Psychometrics

• Analysis
• P (candidate)
• S (stations)
• A(PS) assessors within candidates x stations
• PS,e interaction candidates and stations error

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Stage 4 Psychometrics

• 46 candidates
• 50 assessors
• 19 medical
• 27 nurses
• 1 midwife
• 3 HCA

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Stage 4 Psychometrics

• Results variance

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Stage 4 Psychometrics

• Results D analysis

0.76
0.79
0.79
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Summary

• Generic
• Holistic
• Multi-professional
• Multi-level
• Multi-modal
• Enable high quality assessment
• reliable, valid, acceptable, feasible,
  educational impact
• Nationally accredited

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Summary

• Generic
• Holistic
• Multi-professional
• Multi-level
• Multi-modal
• Quality
• reliable, valid, acceptable, feasible,
  educational impact
• Nationally accredited

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Acknowledgements

• Analysis
• Ron Hoogenboom, Cees van der Vleuten and Arno
  Muijtjens
• Colleagues
• Linda Ward, Clinical Librarian UHL
• University Hospitals of Leicester
• Eastern Leicester PCT
• Students and staff
• University of Leicester
• De Montfort University
• Funding
• Nation Health Service University
• Leicestershire, Northamptonshire and Rutland WDC

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