Validation of an Educational Tool for Skin Abscess Incision and Drainage by Delphi and Angoff Methods

• Published in: Journal of general internal medicine : JGIM 2023-11, Vol.38 (14), p.3093-3098
• Main Authors: Mohanty, Sudipta, Mohanty, Aditya, Cool, Joséphine A., Fainstad, Brandon
• Format: Article
• Language: English
• Subjects: Abscess - surgery; Abscesses; Check lists; Checklist; Clinical Competence; Delphi method; Delphi Technique; Design standards; Drainage; Education; Educational Status; Emergency medical care; Emergency medical services; Errors; Humans; Internal Medicine; Medicine; Medicine & Public Health; Original Research; Skin; Surgical drains; Surveys and Questionnaires; Wound drainage
• ISSN: 0884-8734; 1525-1497; 1525-1497
• DOI: 10.1007/s11606-023-08205-4

Background Bedside incision and drainage (I&D) of skin abscesses is a common medical procedure performed in a variety of medical settings. Yet, there is a paucity of published validated educational tools to teach and assess competency for this procedure. Objective To validate an educational tool to teach and assess competency for bedside I&D of skin abscesses via the Delphi consensus and Angoff standard setting methods. Design Expert consensus on the importance of each procedural step in the educational tool was obtained using the Delphi method, consisting of four rounds of iterative revisions based on input from a panel of experts. The passing cut-off score for a proficient provider was determined using the modified dichotomous Angoff method. Participants All participants met the minimum criteria of active involvement in resident education and performance of at least 20 skin abscess I&D’s within the past 5 years. Participant specialties included general surgery, emergency medicine, and internal medicine. Main Measures The primary outcome was consensus on procedural steps and errors, defined as an interquartile range ≤ 2 on a 9-point Likert scale. A cut-off score was determined by the average across all respondents for the anticipated number of errors that would be committed by a provider with the level of proficiency defined in the survey. Qualitative input was incorporated into the educational tool. Key Results At the end of four rounds of review via the Delphi process, participants achieved consensus on 93% of items on the clinical checklist and 85% of errors on the assessment checklist. Via the modified dichotomous Angoff method, the determined passing cut-off for competency was 6 out of 22 errors. Conclusion An educational and evaluation tool for bedside I&D of skin abscesses was validated via the Delphi and Angoff methods.