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Development and Validation of a Shave Biopsy Training Checklist
Journal article   Open access   Peer reviewed

Development and Validation of a Shave Biopsy Training Checklist

Alicia Ludden-­Schlatter, Stephanie Bunt and Kate DuChene Hanrahan
Family medicine, Vol.57(4), pp.268-275
04/03/2025
DOI: 10.22454/FamMed.2025.615731
PMCID: PMC12147697
PMID: 40272869
url
https://doi.org/10.22454/FamMed.2025.615731View
Published (Version of record) Open Access

Abstract

Background and Objectives: Residencies train residents in procedures and assess their competency, but existing assessment tools have demonstrated poor reliability and have not been validated. Methods: This mixed-methods study validated a shave biopsy checklist with family medicine and dermatology faculty at two academic centers. In each phase of the study, teaching faculty scored a video-recorded simulated procedure using the checklist, and investigators assessed content validity, interrater reliability, and accuracy. Results: In focus groups of nine family medicine and dermatology faculty, 16 of 18 checklist items met or surpassed 80% interrater reliability. Overall checklist reliability was 74%. Focus group surveys initially revealed insufficient content validity. Lowest performing items were removed, and then the follow-up content validity index (0.76) surpassed the required threshold (0.62). Twenty-one of 70 family medicine faculty completed a final survey, which showed a content validity index of 0.63, surpassing the required threshold of 0.42. Twelve of 70 family medicine faculty viewed and scored a simulated video-recorded procedure. Overall interrater reliability was 91% (Cohen’s d=1.36). Fourteen of 16 checklist items demonstrated greater than or equal to 90% interrater reliability. Accuracy analysis revealed 67.9% correct responses in focus groups and 84.9% in final testing (simple t test, P<.001, Cohen’s d=1.4). Conclusions: This rigorously validated checklist demonstrates appropriate content validity, interrater reliability, and accuracy. Findings support use of this shave biopsy checklist as an objective mastery standard for medical education and as a tool for formative assessment of procedural competency.
ACGME competencies assessment of learner performance graduate medical education procedural training

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