Validation of the Imperial College Surgical Assessment Device (ICSAD) for labour epidural placement Validation du dispositif d'evaluation chirurgicale du Imperial College (ICSAD) pour le positionnement de la peridurale pour le travail obstetrical

Purpose Technical proficiency in anesthesia has historically been determined subjectively. The purpose of this study was to establish the construct validity for the Imperial College Surgical Assessment Device (ICSAD), a measure of hand motion efficiency, as an objective assessment tool for technical skill performance, by examining its ability to distinguish between operators of different levels of experience performing a labour epidural. Concurrent validity for the ICSAD was investigated by comparison to a validated task specific checklist (CL) and global rating scale (GRS). Methods A single blinded, prospective, controlled study design compared three groups of subjects: novice residents (\30 epidurals), experienced residents ([100 epidurals), and staff anesthesiologists ([500 epidurals). Performance was measured using the ICSAD (number of movements, path length, time) and scores from a CL and GRS graded by examiners blinded to the level of training. Data were analyzed by multivariate analysis of variance (MANOVA).