Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review.

Background and study aims Competent endoscopic ultrasound (EUS) performance requires a combination of technical, cognitive, and non-technical skills. Direct observation assessment tools can be employed to enhance learning and ascertain clinical competence; however, there is a need to systematically evaluate validity evidence supporting their use. We aimed to evaluate the validity evidence of competency assessment tools for EUS and examine their educational utility. Methods We systematically searched five databases and gray literature for studies investigating EUS competency assessment tools from inception to May 2023. Data on validity evidence across five domains (content, response process, internal structure, relations to other variables, and consequences) were extracted and graded (maximum score 15). We evaluated educational utility using the Accreditation Council for Graduate Medical Education framework and methodological quality using the Medical Education Research Quality Instrument (MERSQI). Results From 2081 records, we identified five EUS assessment tools from 10 studies. All tools are formative assessments intended to guide learning, with four employed in clinical settings. Validity evidence scores ranged from 3 to 12. The EUS and ERCP Skills Assessment Tool (TEESAT), Global Assessment of Performance and Skills in EUS (GAPS-EUS), and the EUS Assessment Tool (EUSAT) had the strongest validity evidence with scores of 12, 10, and 10, respectively. Overall educational utility was high given ease of tool use. MERSQI scores ranged from 9.5 to 12 (maximum score 13.5). Conclusions The TEESAT, GAPS-EUS, and EUSAT demonstrate strong validity evidence for formative assessment of EUS and are easily implemented in educational settings to monitor progress and support learning.
Competing Interests: Conflict of Interest N. Forbes does not have any current conflicts of interest but in the last 3 years was a consultant for AstraZeneca, a consultant and speaker for Boston Scientific, and a consultant and speaker for Pentax Medical. He received research funding from Pentax Medical. J. D. Mosko has been a consultant and speaker for Boston Scientific, ERBE, Fuji, Medtronic, Pendopharm, and Steris. He received research funding from Boston Scientific and ERBE. S. C. Grover has been a speaker for Abbvie, a stockholder and employee of Volo Healthcare, on the advisory board for Amgen, BioJAMP, Pfizer, and Sanofi, and has received education support from Fresenius Kabi, BioJAMP, Celltrion, Takeda, and Pfizer. A. Ceccacci, H. Hothi, R. Khan, N. Gimpaya, B. Chan, P. D. James, D. J. Low, E. Yeung, and C. M. Walsh do not have any conflicts of interest to indicate.
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