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Robbrecht M, Norga K, Van Winckel M, Valcke M, Embo M. Development of an integrated competency framework for postgraduate paediatric training: a Delphi study. Eur J Pediatr 2022; 181:637-646. [PMID: 34498171 PMCID: PMC8425852 DOI: 10.1007/s00431-021-04237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022]
Abstract
Competency-based education (CBE) has transformed medical training during the last decades. In Flanders (Belgium), multiple competency frameworks are being used concurrently guiding paediatric postgraduate CBE. This study aimed to merge these frameworks into an integrated competency framework for postgraduate paediatric training. In a first phase, these frameworks were scrutinized and merged into one using the Canadian Medical Education Directives for Specialists (CanMEDS) framework as a comprehensive basis. Thereafter, the resulting unified competency framework was validated using a Delphi study with three consecutive rounds. All competencies (n = 95) were scored as relevant in the first round, and twelve competencies were adjusted in the second round. After the third round, all competencies were validated for inclusion. Nevertheless, differences in the setting in which a paediatrician may work make it difficult to apply a general framework, as not all competencies are equally relevant, applicable, or suitable for evaluation in every clinical setting. These challenges call for a clear description of the competencies to guide curriculum planning, and to provide a fitting workplace context and learning opportunities.Conclusion: A competency framework for paediatric post-graduate training was developed by combining three existing frameworks, and was validated through a Delphi study. This competency framework can be used in setting the goals for workplace learning during paediatric training. What is Known: •Benefits of competency-based education and its underlying competency frameworks have been described in the literature. •A single and comprehensive competency framework can facilitate training, assessment, and certification. What is New: •Three existing frameworks were merged into one integrated framework for paediatric postgraduate education, which was then adjusted and approved by an expert panel. •Differences in the working environment might explain how relevant a competency is perceived.
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Affiliation(s)
- Marieke Robbrecht
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Koen Norga
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, Antwerp University, Universiteitsplein 1, 2610 Wilrijk, Belgium ,grid.411414.50000 0004 0626 3418Department of Paediatrics, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Myriam Van Winckel
- grid.5342.00000 0001 2069 7798Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium ,grid.410566.00000 0004 0626 3303Department of Paediatrics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - Martin Valcke
- grid.5342.00000 0001 2069 7798Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, 9000 Ghent, Belgium
| | - Mieke Embo
- grid.5342.00000 0001 2069 7798Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, 9000 Ghent, Belgium ,Expertise Network Health and Care, Artevelde University of Applied Sciences, Voetweg 66, 9000 Ghent, Belgium
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Viljoen CA, Millar RS, Manning K, Burch VC. Determining electrocardiography training priorities for medical students using a modified Delphi method. BMC MEDICAL EDUCATION 2020; 20:431. [PMID: 33198726 PMCID: PMC7670661 DOI: 10.1186/s12909-020-02354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/02/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND Although electrocardiography is considered a core learning outcome for medical students, there is currently little curricular guidance for undergraduate ECG training. Owing to the absence of expert consensus on undergraduate ECG teaching, curricular content is subject to individual opinion. The aim of this modified Delphi study was to establish expert consensus amongst content and context experts on an ECG curriculum for medical students. METHODS The Delphi technique, an established method of obtaining consensus, was used to develop an undergraduate ECG curriculum. Specialists involved in ECG teaching were invited to complete three rounds of online surveys. An undergraduate ECG curriculum was formulated from the topics of ECG instruction for which consensus (i.e. ≥75% agreement) was achieved. RESULTS The panellists (n = 131) had a wide range of expertise (42.8% Internal Medicine, 22.9% Cardiology, 16% Family Medicine, 13.7% Emergency Medicine and 4.6% Health Professions Education). Topics that reached consensus to be included in the undergraduate ECG curriculum were classified under technical aspects of performing ECGs, basic ECG analysis, recognition of the normal ECG and abnormal rhythms and waveforms and using electrocardiography as part of a clinical diagnosis. This study emphasises that ECG teaching should be framed within the clinical context. Course conveners should not overload students with complex and voluminous content, but rather focus on commonly encountered and life-threatening conditions, where accurate diagnosis impacts on patient outcome. A list of 23 "must know" ECG diagnoses is therefore proposed. CONCLUSION A multidisciplinary expert panel reached consensus on the ECG training priorities for medical students.
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Affiliation(s)
- Charle André Viljoen
- Division of Cardiology, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, 7925, South Africa.
- Department of Medicine, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, 7925, South Africa.
- Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Observatory, Cape Town, 7925, South Africa.
| | - Rob Scott Millar
- Division of Cardiology, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, 7925, South Africa
- Department of Medicine, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, 7925, South Africa
| | - Kathryn Manning
- Department of Medicine, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, 7925, South Africa
| | - Vanessa Celeste Burch
- Department of Medicine, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, 7925, South Africa
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Elledge ROC, McAleer S. Planning the content of a brief educational course in maxillofacial emergencies for staff in accident and emergency departments: a modified Delphi study. Br J Oral Maxillofac Surg 2014; 53:109-13. [PMID: 25453251 DOI: 10.1016/j.bjoms.2014.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 10/09/2014] [Indexed: 10/24/2022]
Abstract
It is well known that staff in accident and emergency (A&E) departments lack the knowledge and confidence needed to deal with maxillofacial emergencies, and that it is related to limited education at undergraduate and postgraduate levels. We therefore aimed to design a syllabus for a short course to educate staff about the most common emergencies. To find out which learning outcomes should be included and to reach a consensus, we did a 3-stage modified Delphi study of the opinions of members of the British Association of Oral and Maxillofacial Surgeons (BAOMS). Of a possible 890 members, 188 responded (21%) in the second round and 105 in the third (12%). Eighteen (37%) of the 49 proposed learning outcomes were rated very important and all of them were retained in the syllabus after the third round. Thirty (61%) items were retained with a consensus of 51% or above in the final round. The Delphi technique is a useful addition to the armamentarium of those involved in education, and has been used effectively in syllabus design. We achieved good consensus on the items to be included and the syllabus will be piloted locally.
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Affiliation(s)
- Ross O C Elledge
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Hawthorne Suite, Worcestershire Royal Hospital, Charles Hastings Way, Worcester WR5 1DD, Worcestershire, UK; Centre for Medical Education, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, Scotland, UK.
| | - Sean McAleer
- Centre for Medical Education, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, Scotland, UK
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Swamy M, Venkatachalam S, McLachlan J. A Delphi consensus study to identify current clinically most valuable orthopaedic anatomy components for teaching medical students. BMC MEDICAL EDUCATION 2014; 14:230. [PMID: 25342498 PMCID: PMC4287337 DOI: 10.1186/1472-6920-14-230] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 08/26/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Over recent years, wide ranging changes have occurred in undergraduate medical curricula with reduction of hours allocated for teaching anatomy. Anatomy forms the foundation of clinical practice. However, the challenge of acquiring sufficient anatomical knowledge in undergraduate medical education for safe and competent clinical practice remains. The purpose of this study is to identify clinically most valuable orthopaedic anatomy components that are relevant to current clinical practice in order to reinforce anatomy teaching. METHODS Modified Delphi technique with three rounds involving twenty currently practicing orthopaedic consultants and senior speciality orthopaedic registrars (StR, year six and above) was conducted. Anatomical components applied in corresponding clinical situations were generated from the opinions of this expert panel in the first round and the clinical importance of each of these components were rated with a four point Likert scale in the subsequent two rounds to generate consensus. Percentage agreement was utilised as outcome measure for components rated as considerably/very important with consensus of more than 94%. RESULTS Response rates were 90% for the first round and 100% for the next two rounds. After three Delphi rounds, thirty four anatomy components applied in general/ specific clinical conditions and clinical tests were identified as clinically most valuable following iteration. CONCLUSIONS The findings of this study provide clinicians opinions regarding the current required essential anatomical knowledge for a graduating medical student to apply during their orthopaedic clinical encounters. The information obtained can be utilised to encourage further development of clinical anatomy curriculum reflecting the evolving nature of health care.
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Affiliation(s)
- Meenakshi Swamy
- />School of Medicine, Pharmacy and Health, Holliday Building, Durham University, Queen’s Campus, University Boulevard, Stockton on Tees, TS17 6BH UK
| | - Santosh Venkatachalam
- />Department of Orthopaedics, Northumbria Healthcare, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH UK
| | - John McLachlan
- />School of Medicine, Pharmacy and Health, Holliday Building, Durham University, Queen’s Campus, University Boulevard, Stockton on Tees, TS17 6BH UK
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Lacasse M, Théorêt J, Tessier S, Arsenault L. Expectations of clinical teachers and faculty regarding development of the CanMEDS-Family Medicine competencies: Laval developmental benchmarks scale for family medicine residency training. TEACHING AND LEARNING IN MEDICINE 2014; 26:244-251. [PMID: 25010235 DOI: 10.1080/10401334.2014.914943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The CanMEDS-Family Medicine (CanMEDS-FM) framework defines the expected terminal enabling competencies (EC) for family medicine (FM) residency training in Canada. However, benchmarks throughout the 2-year program are not yet defined. PURPOSES This study aimed to identify expected time frames for achievement of the CanMEDS-FM competencies during FM residency training and create a developmental benchmarks scale for family medicine residency training. METHODS This 2011-2012 study followed a Delphi methodology. Selected faculty and clinical teachers identified, via questionnaire, the expected time of EC achievement from beginning of residency to one year in practice (0, 6, 12, […] 36 months). The 15-85th percentile intervals became the expected competency achievement interval. Content validity of the obtained benchmarks was assessed through a second Delphi round. RESULTS The 1st and 2nd rounds were completed by 33 and 27 respondents, respectively. A developmental benchmarks scale was designed after the 1st round to illustrate expectations regarding achievement of each EC. The 2nd round (content validation) led to minor adjustments (1.9±2.7 months) of intervals for 44 of the 92 competencies, the others remaining unchanged. CONCLUSIONS The Laval Developmental Benchmarks Scale for Family Medicine clarifies expectations regarding achievement of competencies throughout FM training. In a competency-based education system this now allows identification and management of outlying residents, both those excelling and needing remediation. Further research should focus on assessment of the scale reliability after pilot implementation in family medicine clinical teaching units at Laval University, and corroborate the established timeline in other sites.
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Affiliation(s)
- Miriam Lacasse
- a Department of Family Medicine and Emergency Medicine, Faculty of Medicine , Laval University , Québec City , Canada
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Pye J, Greenhalgh T. First aid kits for recreational dive boats, what should they contain? Travel Med Infect Dis 2010; 8:311-7. [PMID: 20971442 DOI: 10.1016/j.tmaid.2010.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Revised: 07/01/2010] [Accepted: 07/06/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Well-equipped first-aid kits are necessary but not always provided on recreational dive boats. We aimed to review the types of illness and injury likely to be encountered on such boats and inform a content list for such kits. METHOD We conducted a 3-round Delphi study by email using a volunteer panel of 18 experts drawn from diving, dive medicine and nursing. In round 1, panellists shared examples of illnesses and injuries they had come across personally. These scenarios were circulated along with findings from a literature review, including existing recommendations. In rounds 2 and 3, the list of kit for dive boats in different settings was iteratively refined through online discussion and feedback. MAIN FINDINGS Passengers and crew on recreational dive boats may encounter a range of medical problems from minor injuries to serious accidents and non-dive-related illnesses. Recommended kit varied depending on context and setting (e.g. distance from land, qualifications and experience of crew). Consensus was quickly reached on key first-aid items but experts' views on emergency medicines differed. CONCLUSIONS The study highlights the diversity of medical problems encountered on recreational dive boats. We offer preliminary guidance on the content of suitable first-aid kits and suggest areas for further research.
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Affiliation(s)
- Jacqueline Pye
- Travel Health and Medicine, University College London, UK.
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