Assessing Resident Diagnostic Skills Using a Modified Bronchiolitis Score

Abstract Objective: The purpose of this study is to evaluate resident’s assessment of respiratory distress compared to attending’s assessment in the academic setting. Results: We evaluated resident’s assessment of respiratory distress in children through inter-rater reliability of a bronchiolitis severity assessment tool among pediatric attendings and pediatric residents. Inter-rater reliability (IRR) was assessed using a one-way random, average measures intra-class correlation (ICC) to evaluate the degree of consistency and magnitude of disagreement between inter-raters. Value of >0.6 was considered substantial for kappa and good internal consistency for ICC. Twenty patients were evaluated. Analysis showed fair agreement for the presence of retractions (K=0.31), auscultation (K=0.33), and total score (K=0.3). The RR (ICC=0.97), peripheral saturation (ICC=1.0), auscultation (ICC=0.77), and total score (ICC=0.84) were scored similarly across both raters, indicating excellent IRR. The identification of retractions had the least level of agreement.