scholarly journals Development of entrustable professional activities for residents rotating nephrology department in a Japanese university hospital: a Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047923
Author(s):  
Akihito Tanaka ◽  
Takeshi Kondo ◽  
Yuka Urushibara-Miyachi ◽  
Shoichi Maruyama ◽  
Hiroshi Nishigori
Keyword(s):  
Delphi Method ◽  
Delphi Study ◽  
Evaluation Criteria ◽  
University Hospital ◽  
Entrustable Professional Activities ◽  
Affiliate Hospital ◽  
Japanese University ◽  
Professional Activities ◽  
Modified Delphi ◽  
Initial List

ObjectivesTraining strategies regarding entrustable professional activities (EPAs) vary from country to country; one such strategy is for residents. However, there are no reports of EPAs developed for residents who rotate to the nephrology departments. We aimed to construct such EPAs, which could be generalised to other institutions.DesignPurposive design and a modified Delphi method to build consensus.SettingThe department of nephrology in a university hospital in Aichi Prefecture, Japan.ParticipantsBased on the attainment goals used in our department, an initial list was developed within the research group. The expert panel included 25 nephrologists from our affiliate hospital. Responses were based on a 5-point method and agreement was reached if both (A) and (B) were met: (A) mean≥4 with a SD <1; (B) more than 75% of respondents rated the item 4 or more. With agreement, the item was left for the next round. This round was repeated.ResultsAn initial list of 11 items was developed; after three Delphi rounds and revisions, eight items remained that were then established as the final EPAs. These items can serve as a list of goals to be reached by residents who rotate to the department of nephrology. The results indicated that most of the experts believed residents should be able to perform tasks deemed necessary or urgent for all physicians, such as those that deal with hyperkalaemia and heart failure.ConclusionsThe concept of EPAs enabled us to develop goals and evaluation criteria for residents’ training in nephrology. This study can serve as a springboard for future discussions and contribute to the development of resident education in nephrology.

Development of a List of Competencies and Entrustable Professional Activities for Resident Physicians During Death Pronouncement: A Modified Delphi Study

2021 ◽  
Author(s):  
Takaomi Kessoku ◽  
Yu Uneno ◽  
Yuka Urushibara-Miyach ◽  
Kiyofumi Oya ◽  
Akihiko Kusakabe ◽  
...  
Keyword(s):  
Delphi Study ◽  
Evaluation Method ◽  
Entrustable Professional Activities ◽  
Snowball Sampling ◽  
Professional Activities ◽  
Modified Delphi ◽  
Resident Physicians ◽  
External Evaluators ◽  
Item List ◽  
General Wards

Abstract Purpose: Appropriate delivery of death pronouncements potentially affects bereaved families’ wellbeing positively. Younger physicians need to learn death pronouncement skills; currently, the competencies and entrustable professional activities (EPAs) in death pronouncement practice have not been clarified.Therefore, this study aimed to develop a list of competencies and EPAs necessary for death pronouncement practice, which resident physicians need to acquire by the end of their residency training (postgraduate year 2).Methods: An anonymous modified Delphi study was conducted with a panel of 31 experts. The experts were invited online from general wards in hospitals with resident physicians across Japan to participate in the study using the purposive and snowball sampling method. A non-anonymous web conference was held with three additional external evaluators to finalize the item list. The consensus criterion was defined as a mean response of at least 4 points on a 5-point Likert scale for each competency and EPA item and a rating of 4 or 5 points by at least 80% of the participants.Results: Consensus was achieved, with consistently high levels of agreement across panel members, on 11 competencies and 9 EPA items. Additionally, a correspondence matrix table between competencies and EPAs was developed.Conclusions: This study clarified the standardized educational outcomes for knowledge, skills, and attitudes in death pronouncement practice and the level of physicians who can perform this practice independently, serving as a blueprint to aid the development of an educational model and evaluation method for clinical educational institutions and developers of medical school curriculums.

scholarly journals Development of entrustable professional activities for paediatric intensive care fellows: A national modified Delphi study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248565
Author(s):  
Marije P. Hennus ◽  
Anneliese Nusmeier ◽  
Gwen G. M. van Heesch ◽  
Maaike A. Riedijk ◽  
Nikki J. Schoenmaker ◽  
...  
Keyword(s):  
Delphi Study ◽  
Task Force ◽  
Assessment System ◽  
Entrustable Professional Activities ◽  
Specialty Training ◽  
Professional Activities ◽  
Modified Delphi ◽  
Delphi Round ◽  
Learner Assessment ◽  
High Degree

Entrustable professional activities (EPAs), as a focus of learner assessment, are supported by validity evidence. An EPA is a unit of professional practice requiring proficiency in multiple competencies simultaneously, that can be entrusted to a sufficiently competent learner. Taken collectively, a set of EPAs define and inform the curriculum of a specialty training. The goal of this study was to develop a set of EPAs for Dutch PICU fellows. A multistage methodology was employed incorporating sequential input from task force members, a medical education expert, PICU fellowship program directors, and PICU physicians and fellows via a modified three-round Delphi study. In the first modified Delphi round, experts rated indispensability and clarity of preliminary EPAs. In the subsequent rounds, aggregated scores for each EPA and group comments were provided. In round two, respondents rated indispensability and clarity of revised EPAs. Round three was used to gain explicit confirmation of suitability to implement these EPAs. Based on median ratings and content validity index (CVI) analysis for indispensability in the first two rounds, all nine preliminary EPAs covered activities that were deemed essential to the clinical practice of PICU physicians. Based on median ratings and CVI analysis for clarity however, four EPAs needed revision. With an agreement percentage of 93–100% for all individual EPAs as well as the set as a whole, a high degree of consensus among experts was reached in the third round. The resulting nine PICU EPAs provide a succinct overview of the core tasks of Dutch PICU physicians. These EPAs were created as an essential first step towards developing an assessment system for PICU fellows, grounded in core professional activities. The robust methodology used, may have broad applicability for other (sub)specialty training programs aiming to develop specialty specific EPAs.

scholarly journals Expert Consensus on Clinical Application of Lateral Lumbar Interbody Fusion: Results From a Modified Delphi Study

2021 ◽  
pp. 219256822110126
Author(s):  
Yong Hai ◽  
Jingwei Liu ◽  
Yuzeng Liu ◽  
Tie Liu ◽  
Xinuo Zhang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Delphi Method ◽  
Delphi Study ◽  
Interbody Fusion ◽  
Expert Consensus ◽  
Lumbar Spine Surgery ◽  
Study Group ◽  
Lumbar Interbody Fusion ◽  
Modified Delphi ◽  
Chinese Study

Study Design: Modified Delphi study. Objective: The objective of this study was to establish expert consensus on the application of lateral lumbar interbody fusion (LLIF) by using the modified Delphi study. Methods: From June 2019 to March 2020, Members of the Chinese Study Group for Lateral Lumbar Spine Surgery were selected to collect expert feedback using the modified Delphi method where 65 spine surgeons from all over China agreed to participate. Four rounds were performed: 1 face-to-face meeting and 3 subsequent survey rounds. The consensus was achieved with ≥a 70.0% agreement for each question. The recommendation of grade A was defined as ≥90.0% of the agreement for each question. The recommendation of grade B was defined as 80.0-89.9% of the agreement for each question. The recommendation of grade C was defined as 70.0-79.9% of the agreement for each question. Results: A total of 65 experts formed a panelist group, and the number of questionnaires collected was 63, 59, and 62 in the 3 rounds. In total, 5 sections, 71 questions, and 382 items achieved consensus after the Delphi rounds including summary; preoperative evaluation; application at the lumbar spinal stenosis, lumbar disc herniation, lumbar spondylolisthesis, adult degenerative scoliosis, postoperative adjacent segmental degeneration, and revision surgery; complications; and postoperative follow-up evaluation of LLIF. Conclusion: The modified Delphi method was utilized to ascertain an expert consensus from the Chinese Study Group for Lateral Lumbar Spine Surgery to inform clinical decision-making in the application of LLIF. The salient grade A recommendations of the survey are enumerated.

scholarly journals Improving Risk Assessment for Transporting Dangerous Goods through European Road Tunnels: A Delphi Study

Systems ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 80
Author(s):  
Marianna Kalogeraki ◽  
Fani Antoniou
Keyword(s):  
Risk Assessment ◽  
Delphi Method ◽  
Delphi Study ◽  
Emergency Services ◽  
Lessons Learned ◽  
Quantitative Risk Assessment ◽  
Modified Delphi ◽  
Dangerous Goods ◽  
Road Tunnels ◽  
Open Road

Managing the transportation of dangerous goods (DG) through road tunnels is of great importance since it is associated with a serious risk of accidents. The consequences of an accident involving DG, especially in the closed tunnel environment, might be more significant and even more catastrophic compared to the same accident occurring on an open road. This article presents the Greek experience regarding the application of quantitative risk assessment (QRA) methods for the transportation of DG through Greek road tunnels. The modified Delphi method, with the participation of nine experts, is employed to investigate the obstacles to successfully conforming with the mandatory European Union regulatory framework that applies to transport operations within the Trans-European road network. Recommendations are made to improve the applied QRA approach, to facilitate the cooperation between tunnel managers and emergency services, to communicate lessons learned and to enhance the training of risk assessors.

scholarly journals Standardization of Syndrome Differentiation Defined by Traditional Chinese Medicine in Operative Breast Cancer: A Modified Delphi Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Qianqian Guo ◽  
Qianjun Chen
Keyword(s):  
Breast Cancer ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Delphi Method ◽  
Delphi Study ◽  
Literature Search ◽  
Syndrome Differentiation ◽  
Response Ratio ◽  
Modified Delphi ◽  
E Mail

Objective. The aim of this study was to establish the standardization of syndrome differentiation of operative breast cancer treated with Traditional Chinese Medicine (TCM) by the modified Delphi method.Method. A literature search for standardization of syndrome differentiation of operative breast cancer was conducted and eligible articles were identified in indexed databases from 1982 to 2013. We carried out two rounds of investigation between March and October 2013 and organized 20 experts who focused on TCM or integrative medicine in breast cancer research. Experts’ judgments were collectedviaposted questionnaires or e-mail. A final evaluation was carried out after the end of both rounds.Result. The response ratio of the 1st round investigation reached 100%, and two experts were excluded due to the uncompleted questionnaire. The 2nd round investigation was completed by 18 experts in the 1st round panel board. In both rounds, the experts agreed that the stage of breast cancer defined by TCM could be divided into the perioperation period, the perichemotherapy period, the periradiotherapy period, and the consolidation period.Conclusion. We identified the feasibility and reasonability to establish the standardization of syndrome differentiation of operative breast cancer. According to the suggestions from experts in our Delphi study, we preliminarily established the TCM standard of syndrome differentiation based on different treatment stages of operative breast cancer.

scholarly journals Determining electrocardiography training priorities for medical students using a modified Delphi method

2020 ◽  
Author(s):  
Charle Andre Viljoen ◽  
Rob Scott Millar ◽  
Kathryn Manning ◽  
Vanessa Celeste Burch
Keyword(s):  
Medical Students ◽  
Delphi Method ◽  
Delphi Study ◽  
Delphi Technique ◽  
Expert Panel ◽  
Expert Consensus ◽  
Modified Delphi ◽  
Wide Range ◽  
Life Threatening ◽  
Curriculum Specialists

Abstract BackgroundAlthough 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.MethodsThe 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. ResultsThe 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.ConclusionA multidisciplinary expert panel reached consensus on the ECG training priorities for medical students.

scholarly journals Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative

CJEM ◽  
2013 ◽  
Vol 15 (01) ◽  
pp. 24-33 ◽  
Author(s):  
Rick Penciner ◽  
Robert A. Woods ◽  
Jill McEwen ◽  
Richard Lee ◽  
Trevor Langhan ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Delphi Method ◽  
Expert Panel ◽  
Core Competencies ◽  
Competency Framework ◽  
Modified Delphi Method ◽  
The Core ◽  
Modified Delphi ◽  
Physician Competency ◽  
Initial List

ABSTRACTObjectives:There is no consensus on what constitutes the core competencies for emergency medicine (EM) clerkship rotations in Canada. Existing EM curricula have been developed through informal consensus and often focus on EM content to be known at the end of training rather than what is an appropriate focus for a time-limited rotation in EM. We sought to define the core competencies for EM clerkship in Canada through consensus among an expert panel of Canadian EM educators.Methods:We used a modified Delphi method and the CanMEDS 2005 Physician Competency Framework to develop a consensus among expert EM educators from across Canada.Results:Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). A complete list of competencies is provided.Conclusion:This study established a national consensus defining the core competencies for EM clerkship in Canada.

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