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Oper Neurosurg (Hagerstown). 2017 Feb 1;13(1):60-68. doi: 10.1227/NEU.0000000000001158.

Validity Evidence for the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT).

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Centre for Image Guided Innovation and Therapeutic Intervention (CIGITI), The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Neuro-surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Neurosurgery, University Medical Center Groningen, Groningen, the Netherlands.
Division of Clinical Neurological Scien-ces, Western University, London, Ontario, Canada.
SickKids Learning Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
The Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada.
Department of Pediatric Neurosurgery, Santobono-Pausilipon Pediatric Hospital, Naples, Italy.



Growing demand for transparent and standardized methods for evaluating surgical competence prompted the construction of the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT).


To provide validity evidence of the NEVAT by reporting on the tool's internal structure and its relationship with surgical expertise during simulation-based training.


The NEVAT was used to assess performance of trainees and faculty at an international neuroendoscopy workshop. All participants performed an endoscopic third ventriculostomy (ETV) on a synthetic simulator. Participants were simultaneously scored by 2 raters using the NEVAT procedural checklist and global rating scale (GRS). Evidence of internal structure was collected by calculating interrater reliability and internal consistency of raters' scores. Evidence of relationships with other variables was collected by comparing the ETV performance of experts, experienced trainees, and novices using Jonckheere's test (evidence of construct validity).


Thirteen experts, 11 experienced trainees, and 10 novices participated. The interrater reliability by the intraclass correlation coefficient for the checklist and GRS was 0.82 and 0.94, respectively. Internal consistency (Cronbach's α) for the checklist and the GRS was 0.74 and 0.97, respectively. Median scores with interquartile range on the checklist and GRS for novices, experienced trainees, and experts were 0.69 (0.58-0.86), 0.85 (0.63-0.89), and 0.85 (0.81-0.91) and 3.1 (2.5-3.8), 3.7 (2.2-4.3) and 4.6 (4.4-4.9), respectively. Jonckheere's test showed that the median checklist and GRS score increased with performer expertise ( P = .04 and .002, respectively).


This study provides validity evidence for the NEVAT to support its use as a standardized method of evaluating neuroendoscopic competence during simulation-based training.


Educational measurement; Medical education; NEVAT; Neuroendoscopy; Performance assessment; Reliability and validity; Ventriculostomy

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