open access
Development and validation of a performance assessment checklist for insertion of an intra-uterine device (IUD)
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Affiliations- Department of General Practice, Faculty of Medicine, University of Poitiers, France
- Department of Gynecology and Obstetrics, University Hospital, Poitiers, France
- ABS Lab, Simulation Laboratory, Faculty of Medicine, Poitiers, France
- Department of GI Surgery, University Hospital, Poitiers, France
- Emergency Department and EMS, University Hospital of Amiens, Amiens, France
- MUSE (Emergency Medicine, Simulation and Education in Emergency Medicine) Unit Research, University Hospital of Amiens, France
- Pediatric Emergency Department, University Hospital, Poitiers, France
open access
Abstract
Objectives: The World Health Organization (WHO) supports increasing the availability and acceptability of long-acting reversible contraception including intra-uterine device (IUD), but its insertion includes certain risks (uterine perforation). The objective was to develop and validate an IUD insertion performance assessment checklist.
Material and methods: This prospective study took place in hospitals and simulation center of the Poitou-Charentes region, France. The checklist content reached consensus among 10 experts solicited by a Delphi method. A modified gynecologic mannequin Zoe (Gaumard®) was used for simulations. Psychometric testing included 30 multi-professional participants for internal consistency and reliability between two independent observers, and 27 residents for assessment of score evolution over time and reliability. Cronbach alpha (CA) and intraclass coefficient (ICC) were used. Progression of performance was carried out using ANOVA for repeated measures. The data collected were used to plot receiver operating characteristic (ROC) curves for the score values and the area under the curve (AUC) was determined.
Results: The checklist included 27 items (2 sections, total score = 27). Psychometric testing showed CA = 0.79, ICC = 0.99, and good clinical relevance. The checklist is discriminative, showing a significant increase in performance scores when the simulations were repeated (F = 77.6, p < 0.0001). ROC curve [AUC: 0.792 (95% CI: 0.71–0.89); p < 0.0001] revealed the best score cutoff predictive of 100% sensitivity, i.e., true positive rate or success rate. Performance score was highly correlated to success rate. The cut-off score guaranteeing successful IUD insertion was 22/27.
Conclusions: This coherent and reproducible checklist for IUD insertion provide an objective assessment of the procedure during SBT, with the aim of obtaining a score ≥ 22/27.
Abstract
Objectives: The World Health Organization (WHO) supports increasing the availability and acceptability of long-acting reversible contraception including intra-uterine device (IUD), but its insertion includes certain risks (uterine perforation). The objective was to develop and validate an IUD insertion performance assessment checklist.
Material and methods: This prospective study took place in hospitals and simulation center of the Poitou-Charentes region, France. The checklist content reached consensus among 10 experts solicited by a Delphi method. A modified gynecologic mannequin Zoe (Gaumard®) was used for simulations. Psychometric testing included 30 multi-professional participants for internal consistency and reliability between two independent observers, and 27 residents for assessment of score evolution over time and reliability. Cronbach alpha (CA) and intraclass coefficient (ICC) were used. Progression of performance was carried out using ANOVA for repeated measures. The data collected were used to plot receiver operating characteristic (ROC) curves for the score values and the area under the curve (AUC) was determined.
Results: The checklist included 27 items (2 sections, total score = 27). Psychometric testing showed CA = 0.79, ICC = 0.99, and good clinical relevance. The checklist is discriminative, showing a significant increase in performance scores when the simulations were repeated (F = 77.6, p < 0.0001). ROC curve [AUC: 0.792 (95% CI: 0.71–0.89); p < 0.0001] revealed the best score cutoff predictive of 100% sensitivity, i.e., true positive rate or success rate. Performance score was highly correlated to success rate. The cut-off score guaranteeing successful IUD insertion was 22/27.
Conclusions: This coherent and reproducible checklist for IUD insertion provide an objective assessment of the procedure during SBT, with the aim of obtaining a score ≥ 22/27.
Keywords
IUD; contraception; assessment checklist; performance; uterine perforation; simulation-based education
About this articleTitle
Development and validation of a performance assessment checklist for insertion of an intra-uterine device (IUD)
Journal
Issue
Article type
Research paper
Pages
874-882
Published online
2023-04-04
Page views
316
Article views/downloads
305
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(11):874-882.
Keywords
IUD
contraception
assessment checklist
performance
uterine perforation
simulation-based education
Authors
Stephanie Mignot
Anne-Charlotte Berthome
Marion Andre
Cyril Breque
Jean-Pierre Richer
Daniel Ghazali
Denis Oriot
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