TY - JOUR

T1 - Valid and reliable assessment of upper respiratory tract specimen collection skills during the COVID-19 pandemic

AU - Todsen, Tobias

AU - Bohr, Anne

AU - Hovgaard, Lisette Hvid

AU - Eið, Rebekka Consuelo

AU - Benfield, Thomas

AU - Svendsen, Morten B.S.

AU - Kirkby, Nikolai

AU - Konge, Lars

AU - von Buchwald, Christian

AU - Melchiors, Jacob

AU - Tolsgaard, Martin

N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021

Y1 - 2021

N2 - Proper specimen collection is the most important step to ensure accurate testing for the coronavirus disease 2019 (COVID-19) and other infectious diseases. Assessment of healthcare workers’ upper respiratory tract specimen collection skills is needed to ensure samples of high-quality clinical specimens for COVID-19 testing. This study explored the validity evidence for a theoretical MCQ-test and checklists developed for nasopharyngeal (NPS) and oropharyngeal (OPS) specimen collection skills assessment. We found good inter-item reliability (Cronbach’s alpha = 0.76) for the items of the MCQ-test and high inter-rater reliability using the checklist for the assessment of OPS and NPS skills on 0.86 and 0.87, respectively. The MCQ scores were significantly different between experts (mean 98%) and novices (mean 66%), p < 0.001, and a pass/fail score of 91% was established. We found a significant discrimination between checklist scores of experts (mean 95% score for OPS and 89% for NPS) and novices (mean 50% score for OPS and 36% for NPS), p < 0.001, and a pass/fail score was established of 76% for OPS and 61% for NPS. Further, the results also demonstrated that a group of non-healthcare educated workers can perform upper respiratory tract specimen collection comparably to experts after a short and focused simulation-based training session. This study, therefore, provides validity evidence for the use of a theoretical and practical test for upper respiratory specimens’ collection skills that can be used for competency-based training of the workers in the COVID-19 test centers.

AB - Proper specimen collection is the most important step to ensure accurate testing for the coronavirus disease 2019 (COVID-19) and other infectious diseases. Assessment of healthcare workers’ upper respiratory tract specimen collection skills is needed to ensure samples of high-quality clinical specimens for COVID-19 testing. This study explored the validity evidence for a theoretical MCQ-test and checklists developed for nasopharyngeal (NPS) and oropharyngeal (OPS) specimen collection skills assessment. We found good inter-item reliability (Cronbach’s alpha = 0.76) for the items of the MCQ-test and high inter-rater reliability using the checklist for the assessment of OPS and NPS skills on 0.86 and 0.87, respectively. The MCQ scores were significantly different between experts (mean 98%) and novices (mean 66%), p < 0.001, and a pass/fail score of 91% was established. We found a significant discrimination between checklist scores of experts (mean 95% score for OPS and 89% for NPS) and novices (mean 50% score for OPS and 36% for NPS), p < 0.001, and a pass/fail score was established of 76% for OPS and 61% for NPS. Further, the results also demonstrated that a group of non-healthcare educated workers can perform upper respiratory tract specimen collection comparably to experts after a short and focused simulation-based training session. This study, therefore, provides validity evidence for the use of a theoretical and practical test for upper respiratory specimens’ collection skills that can be used for competency-based training of the workers in the COVID-19 test centers.

KW - COVID-19 testing

KW - SARS-CoV-2 sample

KW - Skills assessment

KW - Upper respiratory tract specimens

KW - Validation

U2 - 10.3390/diagnostics11111987

DO - 10.3390/diagnostics11111987

M3 - Journal article

C2 - 34829333

AN - SCOPUS:85118824725

VL - 11

JO - Diagnostics

JF - Diagnostics

SN - 2075-4418

IS - 11

M1 - 1987

ER -