Developing a competence-based core curriculum in biomedical laboratory science: a Delphi study

Optimization of the biochemical genetics laboratory rotation using a multidesign approach to curriculum

PURPOSE

A biochemical genetics laboratory rotation is required for multiple genetics training programs. Traditionally, this rotation has been observational with experience being dependent upon cases released and availability of laboratory director(s), resulting in inconsistent learning opportunities. This curriculum was created to standardize the learning experience.

METHODS

The revised rotation provides multiple teaching modalities including small group didactic sessions (flipped classroom model), case-based sessions, and hands-on laboratory experience. Trainees prepare a presentation (learning by teaching) and discuss the differential diagnosis, metabolic pathway, newborn screening, treatment, and molecular characteristics of the gene(s) implicated. Learner assessment is performed using pre- and post-tests, learner evaluations, and instructor feedback.

RESULTS

Pre- and post-test scores were significantly different (P < .001) for learners from all programs. Participants found the course to be effective, increased their learning, and allowed them to interact with metabolic testing results in helpful ways. Faculty appreciated the use of prerecorded lectures and additional time for in-depth teaching on interesting cases.

CONCLUSION

The revised rotation has been well received by trainees and faculty. Interaction of learners with the laboratory staff was optimized by ensuring all parties were prepared to teach and learn. Future directions include expanding the program to include remote learners from other centers.

Three year nursing PhD curricula content among schools participating in the future of nursing scholars program

BACKGROUND

The Robert Wood Johnson Foundation (RWJF) Future of Nursing Scholars program (FNS) supported 45 nursing schools to create or adapt their PhD curricula to facilitate students completing a PhD degree in 3-years.

PURPOSE

This analysis characterized the PhD program curricula of 45 schools. Differences in curricula were examined based on school characteristics.

METHODS

Data were collected from five cohorts of school FNS applications. Summaries of curricula are provided and differences in curricula between schools were examined.

FINDINGS

Most of the PhD programs (73.3%) were at very high research intensive universities. A median of 60 credit hours were needed to complete a 3-year PhD. Most programs (84.0%) required year-round enrollment, oftentimes inclusive of summers, and placed an emphasis on scholars pursuing additional coursework to meet the 3-year timeline.

DISCUSSION

Findings highlight common elements of 3-year PhD curricula that can be utilized to inform the development and educational needs of future nurse scientists.

Core competencies for a biomedical laboratory scientist - a Delphi study

BACKGROUND

After completing university education, biomedical laboratory scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, with the pace showing no signs of abatement. This rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study aimed to examine what was considered the necessary competencies needed to pursue a career as a biomedical laboratory scientist.

METHODS

A modified Delphi technique was used, with the panel of experts expressing their views in a series of three questionnaire. Consensus was defined as the point which 75 % or more of the panel participants agreed that a particular competency was necessary.

RESULTS

The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality.

CONCLUSIONS

We identified important competencies for biomedical laboratory scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all the competencies needed to work as professional biomedical laboratory scientists.

A Delphi consensus study for teaching "Basic Trauma Management" to third-year medical students

Background

The Basic-Trauma Management (BTM) course has been taught to third-year medical students in small groups for many years without substantial changes. With the introduction of a new curriculum for Swiss medical students, it was necessary to revise the BTM content and re-align it. Our aim was to identify core competencies for the revised BTM course.

Methods

We applied a three-round step-wise Delphi consensus. First, we asked open-ended questions on what were the most important competencies to be taught for BTM; the second round used Likert scales to ensure agreement on the competencies; and the final round reached out for consensus on these BTM competencies. Stakeholders were selected based on their long-standing experience in teaching BTM and in managing trauma patients.

Results

Consensus was found on 29 competencies out of an initial 130 proposals. “Human Factors”, which had not been taught previously, scored relatively high, at 22%. The sole specific trauma skill agreed upon was the use of tourniquets.

Conclusions

This is an example of curricular revision of a clinical skills course after the introduction of a regulatory framework for undergraduate medical education. The revised course curriculum tailors the concepts and skills in trauma that fulfill stakeholder needs, and are in agreement with the new Swiss learning outcomes.

Evaluation of immunohematology knowledge in hematology trainees

BACKGROUND

Canadian hematology trainees are expected to attain clinical knowledge in the subject of red blood cell and platelet antigen systems and the principles of transfusion medicine. However, the relative degree of expertise required in blood bank serology is not well defined.

STUDY DESIGN AND METHODS

A modified Delphi approach involving 10 Canadian hematology program directors was utilized to identify 12 relevant topics in immunohematology. A multiple-choice exam was developed and validated among hematology trainees from 13 hematology training programs across Canada. A Rasch analysis was used to determine fit of the examination before deploying the exam the following year to ascertain the level of knowledge in hematology trainees.

RESULTS

The exam was piloted with 62 hematology trainees. The reliability of the exam was 0.93 with a mean item fit score of 1.01. The exam was able to discriminate between training years and self-rated expertise with better performance attained by more advanced trainees (p < 0.01). No differences were seen between geographic regions. A modified version of the exam was deployed the following year to 85 trainees, with a mean score of 58.9% ± 15.3%. Trainees scored poorest on topics concerning antibody investigations and D variants.

CONCLUSION

A standardized exam for assessing hematology trainees on their expected expertise in transfusion immunohematology has been developed and can be used to assess the efficacy of educational resources provided in the subject. Trainees had a low overall mean score indicating additional educational initiatives are warranted.

Core principles of evolutionary medicine: A Delphi study

BACKGROUND AND OBJECTIVES

Evolutionary medicine is a rapidly growing field that uses the principles of evolutionary biology to better understand, prevent and treat disease, and that uses studies of disease to advance basic knowledge in evolutionary biology. Over-arching principles of evolutionary medicine have been described in publications, but our study is the first to systematically elicit core principles from a diverse panel of experts in evolutionary medicine. These principles should be useful to advance recent recommendations made by The Association of American Medical Colleges and the Howard Hughes Medical Institute to make evolutionary thinking a core competency for pre-medical education.

METHODOLOGY

The Delphi method was used to elicit and validate a list of core principles for evolutionary medicine. The study included four surveys administered in sequence to 56 expert panelists. The initial open-ended survey created a list of possible core principles; the three subsequent surveys winnowed the list and assessed the accuracy and importance of each principle.

RESULTS

Fourteen core principles elicited at least 80% of the panelists to agree or strongly agree that they were important core principles for evolutionary medicine. These principles over-lapped with concepts discussed in other articles discussing key concepts in evolutionary medicine.

CONCLUSIONS AND IMPLICATIONS

This set of core principles will be helpful for researchers and instructors in evolutionary medicine. We recommend that evolutionary medicine instructors use the list of core principles to construct learning goals. Evolutionary medicine is a young field, so this list of core principles will likely change as the field develops further.

An international survey and modified Delphi process revealed editors' perceptions, training needs, and ratings of competency-related statements for the development of core competencies for scientific editors of biomedical journals

Background: Scientific editors (i.e., those who make decisions on the content and policies of a journal) have a central role in the editorial process at biomedical journals. However, very little is known about the training needs of these editors or what competencies are required to perform effectively in this role. Methods: We conducted a survey of perceptions and training needs among scientific editors from major editorial organizations around the world, followed by a modified Delphi process in which we invited the same scientific editors to rate the importance of competency-related statements obtained from a previous scoping review. Results: A total of 148 participants completed the survey of perceptions and training needs. At least 80% of participants agreed on six of the 38 skill and expertise-related statements presented to them as being important or very important to their role as scientific editors. At least 80% agreed on three of the 38 statements as necessary skills they perceived themselves as possessing (well or very well).  The top five items on participants' list of top training needs were training in statistics, research methods, publication ethics, recruiting and dealing with peer reviewers, and indexing of journals. The three rounds of the Delphi were completed by 83, 83, and 73 participants, respectively, which ultimately produced a list of 23 "highly rated" competency-related statements and another 86 "included" items. Conclusion: Both the survey and the modified Delphi process will be critical for understanding knowledge and training gaps among scientific editors when designing curriculum around core competencies in the future.

Experience of Delphi technique in the process of establishing consensus on core competencies

Introduction:

The Department of Community Medicine and Family Medicine (CMFM) has been started as a new model for imparting the components of family medicine and delivering health-care services at primary and secondary levels in all six newly established All India Institute of Medical Sciences (AIIMS), but there is no competency-based curriculum for it. The paper aims to share the experience of Delphi method in the process of developing consensus on core competencies of the new model of CMFM in AIIMS for undergraduate medical students in India.

Methods:

The study adopted different approaches and methods, but Delphi was the most critical method used in this research. In Delphi, the experts were contacted by e-mail and their feedback on the same was analyzed.

Results:

Two rounds of Delphi were conducted in which 150 participants were contacted in Delphi-I but only 46 responded. In Delphi-II, 26 participants responded whose responses were finally considered for analysis. Three of the core competencies namely clinician, primary-care physician, and professionalism were agreed by all the participants, and the least agreement was observed in the competencies of epidemiologist and medical teacher. The experts having more experience were less consistent as responses were changed from agree to disagree in more than 15% of participants and 6% changed from disagree to agree.

Conclusion:

Within the given constraints, the final list of competencies and skills for the discipline of CMFM compiled after the Delphi process will provide a useful insight into the development of competency-based curriculum of the subject.

Design of a Genomics Curriculum: Competencies for Practicing Pathologists

CONTEXT

The field of genomics is rapidly impacting medical care across specialties. To help guide test utilization and interpretation, pathologists must be knowledgeable about genomic techniques and their clinical utility. The technology allowing timely generation of genomic data is relatively new to patient care and the clinical laboratory, and therefore, many currently practicing pathologists have been trained without any molecular or genomics exposure. Furthermore, the exposure that current and recent trainees receive in this field remains inconsistent.

OBJECTIVE

To assess pathologists' learning needs in genomics and to develop a curriculum to address these educational needs.

DESIGN

A working group formed by the College of American Pathologists developed an initial list of genomics competencies (knowledge and skills statements) that a practicing pathologist needs to be successful. Experts in genomics were then surveyed to rate the importance of each competency. These data were used to create a final list of prioritized competencies. A subset of the working group defined subtopics and tasks for each competency. Appropriate delivery methods for the educational material were also proposed.

RESULTS

A final list of 32 genomics competency statements was developed. A prioritized curriculum was created with designated subtopics and tasks associated with each competency.

CONCLUSIONS

We present a genomics curriculum designed as a first step toward providing practicing pathologists with the competencies needed to practice successfully.

A core competency model for Chinese baccalaureate nursing graduates: a descriptive correlational study in Beijing

BACKGROUND

A review of the literature showed that the core competencies needed by newly graduated Chinese nurses were not as of yet undocumented.

OBJECTIVE

To develop a psychometrically sound instrument for identifying and measuring the core competencies needed by Chinese nursing baccalaureate graduates.

DESIGN

Descriptive correlational and multicentre study.

SETTING

Seven major tertiary teaching hospitals and three major medical universities in Beijing.

PARTICIPANTS

790 subjects, including patients, nursing faculty members, doctors and nurses.

METHOD

A reliable and valid self-report instrument, consisting of 58 items, was developed using multiple methods. It was then distributed to 790 subjects to measure nursing competency in a broader Chinese context. The psychometric characteristics of reliability and validity were supported by descriptive and inferential analyses.

RESULTS

The final instrument consists of six dimensions with 47 items. The content validity index was 0.90. The overall scale reliability was 0.97 with dimensions range from 0.87 to 0.94. Six domains of core competencies were identified: professionalism; direct care; support and communication; application of professional knowledge; personal traits; and critical thinking and innovation.

CONCLUSION

The findings of this study provide valuable evidence for a psychometrically sound measurement tool, as well as for competency-based nursing curriculum reform.

The desired competence of the Swedish ambulance nurse according to the professionals - a Delphi study

Nursing is evolving into new fields of health care including ambulance care, where a branch of specialist nursing is growing. Various views exist on the desired competence for the ambulance nurse and valid guidelines are lacking in Sweden. To increase knowledge of the field, professionals were asked to describe what competences an ambulance nurse should possess. The aim of this study was therefore to elucidate the desired professional competence of the specialist ambulance nurse, according to the professionals. A modified Delphi technique was used, where a panel of professional experts expressed their views on the desired competence of the ambulance nurse. This study reports, at a high level of agreement among the panel experts, that the desired competence of the specialist ambulance nurse consist of forty-four separate competences creating ten areas of competences: execute leadership, generic abilities, interpersonal communication, institutional collaboration, pedagogic skills, possession of relevant knowledge, professional judgement, professional skills, research activities, and technical skills. The high level of agreement among the professionals as well as the large number of competences reflects the high demands placed on the ambulance nurse by the professionals themselves.

Twelve tips for implementing whole-task curricula: how to make it work

Whole-task models of learning and instructional design, such as problem-based learning, are nowadays very popular. Schools regularly encounter large problems when they implement whole-task curricula. The main aim of this article is to provide 12 tips that may help to make the implementation of a whole-task curriculum successful. Implementing whole-task curricula fails when the implementation is not well prepared. Requirements that must be met to make the implementation of whole task models into a success are described as twelve tips. The tips are organized in four clusters and refer to (1) the infrastructure, (2) the teachers, (3) the students, and (4) the management of the educational organization. Finally, the presented framework will be critically discussed and the importance of shared values and a change of culture is emphasized.

Development of a nursing practice based competency model for the Flemish master of nursing and obstetrics degree

The aim was to identify a set of competences for the Flemish academic Master of Nursing and Obstetrics degree that answer perceived needs in health care. The competency model was to demonstrate a degree of consensus among key nurses. The study was conducted in all Flemish hospitals registered to have 400 beds or more. Head nurses of surgery, geriatrics and intensive care units were eligible to participate, as well as one nurse from administration per hospital. A two round Delphi process allowed participants to comment on items identified in an analysis of existing international competency profiles of master level nurses and adapted to the Flemish context. Competences agreed to by 90% of the respondents were considered to have consensus. Fifteen out of 19 eligible hospitals were recruited in the study, 45 nurses participated in the Delphi panel. Consensus was reached on 31 competences that can be assigned to 5 nurse's roles: nursing expert, innovator, researcher, educator and manager. The resulting competency profile is in accordance with published profiles for similar programs. The reported study demonstrates a practical method to develop a consensus competency model for an academic master program based on the input of key individuals in mainstream nursing.

Identification of competencies for Malaysian occupational safety and health professionals

Competencies of occupational safety and health (OSH) professionals have become a concern due to the significance of safety management in the field of safety engineering. The purpose of this article is to identify competencies needed by OSH professionals. These competencies are required by professionals in administrating and enforcing legislations related to OSH in Malaysia. This study used Delphi technique in three rounds of data collection. The benefits of this research approach are the use of experts in gaining opinions without time and geographical restraints. The results show 25 generic competencies with combinations of cognitive, interpersonal and intrapersonal competencies and 33 functional or specific competencies including knowledge and skills needed by OSH professionals. Both generic and functional competencies are also divided into threshold and differentiating competencies that would be used to differentiate average and excellent performance of OSH professionals.

Meeting the curriculum needs for different career paths in Laboratory Medicine

There are a number of career paths in Laboratory Medicine and several clinical practice models for the discipline. This article summarizes the state of current training at the medical student and residency/post-graduate levels, emphasizing practice in the U.S., and the challenges of education in the discipline to meet the needs of diverse career paths. Data regarding effectiveness of current pedagogical approaches are discussed along with a brief review of evolving didactic methodologies. The recently published curriculum in Laboratory Medicine (Clinical Pathology) by the Academy of Clinical Laboratory Physicians and Scientists is reviewed, including its major emphases and the importance of competency assessment. Finally, the future of Laboratory Medicine and Pathology and the need to train for that future is expanded upon.