A competency-based test of bronchoscopic knowledge using the Essential Bronchoscopist: an initial concept study.

BACKGROUND AND OBJECTIVE Competency-based training and assessment are increasingly replacing the traditional structure- and process-based model of medical education. The web-based Essential Bronchoscopist (EB) is an open access, laddered, competency-based curriculum of question-answer sets pertaining to basic bronchoscopic knowledge, accessible in five languages. The purpose of this study was to use consensus to evaluate whether question-answer sets (items) from the EB could provide material from which to devise competency-based tests of bronchoscopic knowledge that could be used in countries with different health-care environments. METHODS Ten junior and five senior bronchoscopists in Argentina and the USA were asked to identify the material in each of the 186 items of the EB as either 'not necessary', 'necessary' or 'absolutely necessary' for inclusion in a competency-based test of bronchoscopic knowledge. The kappa statistic was used to analyse inter-rater agreement. RESULTS More than 80% of the 30 participants rated 150 of 186 items as necessary or absolutely necessary. Seventy items were rated as absolutely necessary by more than 50% of participants and as necessary or absolutely necessary by more than 90%. There was no statistically significant difference between items selected, based on level of training or environment of practice. CONCLUSION Consensus among junior and senior bronchoscopists from two culturally different health-care environments demonstrated that question-answer sets from the EB can be used to provide material for competency-based tests of bronchoscopic knowledge.