The tool was able to discriminate between the two groups in both performances: experienced mean score =30.8±4.2 novice mean score =15.8☒.3, P<0.001. The total item score significantly correlated with the global score (rs=0.86, P0.80. The tool had a high internal consistency (Cronbach's alpha =0.94) and high inter-rater reliability (Cronbach's alpha =0.91). Nine novices and 8 experienced participants were included, generating 34 recorded performances and 136 expert assessments.

Contrasting groups' method was used to set a pass/fail standard. Performances were video-recorded and assessed by four expert raters using the new tool. Doctors with varying experience performed two consecutive procedures in a standardized, simulation-based setting using a newly developed thorax/lung silicone model. The tool was developed by five experts in respiratory medicine and medical education. Validity evidence for the assessment tool was gathered using the unified Messick framework. The aims of the study were to develop an assessment tool in local anaesthetic thoracoscopy (LAT), investigate validity evidence, and establish a pass/fail standard.

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