Achieving Consensus on Leadership Competencies and Outcome Measures

2005 ◽  
Vol 28 (4) ◽  
pp. 428-446 ◽  
Author(s):  
Julie A. Mcdougal ◽  
C. Michael Brooks ◽  
Mark Albanese
Keyword(s):  
Outcome Measures ◽  
Leadership Training ◽  
Phase 1 ◽  
Nominal Group Technique ◽  
Leadership Competencies ◽  
Nominal Group ◽  
Evaluation Instrument ◽  
Modified Delphi ◽  
Formal Program ◽  
Modified Delphi Technique

Pediatric Pulmonary Centers (PPCs) are federally funded interdisciplinary leadership training programs aiming to improve the health of families and children. This article describes the process PPCs used to efficiently and effectively achieve consensus on leadership training competencies and outcome measures among a large and diverse group of health professionals. Phase 1 used a modified Delphi technique to develop an initial set of competencies and outcome measures. Phase 2 used the nominal group technique and modified focus group strategies to refine and prioritize the competencies and outcomes measures. Participants reported being highly satisfied with the process and outcomes. In Phase 3, a formal program evaluation instrument was implemented, designed to measure the competency and describe the career paths and leadership accomplishments of previous trainees. The consensus process adopted can serve as a model for academic and public health entities seeking to achieve consensus on program goals, strategies, methods, priorities, and outcomes.

scholarly journals The Standardization of Uveitis Nomenclature (SUN) Project

2013 ◽  
Vol 52 (03) ◽  
pp. 259-265 ◽  
Author(s):  
J. Thorne ◽  
D. Jabs ◽  
R. Belfort ◽  
A. Dick ◽  
S. Gangaputra ◽  
...  
Keyword(s):  
Working Group ◽  
Delphi Technique ◽  
Data Entry ◽  
Nominal Group ◽  
Web Based ◽  
Modified Delphi ◽  
Modified Delphi Technique ◽  
Majority Consensus ◽  
Based Medicine ◽  
Sun Project

SummaryBackground: Given the recent increased focus on evidence-based medicine, it is critical that diseases and syndromes have accurate and complete descriptions, including standardized and widely accepted terminologies. Standardizing these descriptions and terminologies is necessary to develop tools such as computerized data entry forms and classification criteria. This need is especially true for diseases that are relatively uncommon, such as uveitis.Objectives: To develop a standardized and internationally accepted terminology for the field of uveitis.Methods: The Standardization of Uveitis Nomenclature (SUN) Working Group (WG) is an international group of 79 uveitis experts from 18 countries and 62 clinical centers. Initial terminology was developed utilizing a “modified” green field approach, which was enhanced through web-based surveys and teleconferences via a “modified” Delphi technique. Terms were mapped provisionally into ontologic dimensions for each syndrome. The Working Group then met and utilized nominal group techniques as a formalized method of finalizing the mappings.Results: Mapping of terms into dimensions to describe 28 major uveitic diseases was confirmed using nominal group techniques (achieving super-majority consensus) for each of the diseases at a meeting of the entire WG.Conclusions: The SUN WG utilized an informatics-based approach to develop a stand ardized and internationally accepted terminology for the uveitides.

scholarly journals Supporting communication in semantic dementia: clinical consensus from expert practitioners

2015 ◽  
Vol 16 (3) ◽  
pp. 153-164 ◽  
Author(s):  
Jacqueline Kindell ◽  
Karen Sage ◽  
Madeline Cruice
Keyword(s):  
Nominal Group Technique ◽  
Research Literature ◽  
Dementia Care ◽  
Semantic Dementia ◽  
Nominal Group ◽  
Content Type ◽  
Modified Delphi ◽  
Client Group ◽  
Health And Social Care ◽  
The Uk

Purpose – The purpose of this paper is to gain consensus regarding the clinical priorities and tasks required in supporting communication needs in those living with semantic dementia and their families, by specialist speech and language therapists (SLTs), working in clinical practice within dementia care settings in the UK. Design/methodology/approach – A nominal group technique was used, followed by further exploration and refinement of issues using a modified Delphi technique with a group of six SLTs who specialised in dementia care and who had experience of working with individuals with semantic dementia and their families. Findings – The findings in the study demonstrate a broader scope of practice than is evident within the research literature with this client group. Therapists identified a range of psychosocial issues for both the person with semantic dementia and their family, in particular finding ways to support activity and participation in conversation and explore barriers and facilitators within the communication environment. Originality/value – This represents the first study to explore everyday practice in this rarer dementia and the information gathered here will be of use to a variety of health and social care professions interested in supporting those with semantic dementia and their families.

Research Priorities in Forensic Occupational Therapy

2003 ◽  
Vol 66 (2) ◽  
pp. 55-64 ◽  
Author(s):  
Edward A S Duncan ◽  
Karen Munro ◽  
Margaret M Nicol
Keyword(s):  
Occupational Therapy ◽  
Outcome Measures ◽  
Group Work ◽  
Nominal Group Technique ◽  
Research Priorities ◽  
Occupational Therapists ◽  
Assessment Tools ◽  
Nominal Group ◽  
Specific Research ◽  
Effective Group

National research priorities have been developed and published by the College of Occupational Therapists (Ilott and White 2001). Such an exercise, however, cannot provide the specific research priorities of a particular area of practice. A questionnaire survey was undertaken to ascertain the specific research priorities of forensic occupational therapists. The survey had three parts: determining research priorities, examining outcome measures and exploring the use of protocol-driven group work. Three specific research priorities were clearly defined by part one of the survey: the development of appropriate outcome measures, the development of rigorous and effective group-work programmes and the development of effective risk assessment tools. The nominal group technique was used in order to triangulate the data. The survey also examined the participants' use of outcome measures: a high number of the participants (62%, 44/71) stated that they used outcome measures in practice. The participants' responses to the third aspect of the survey, regarding the use of protocol-driven groups, were more varied. The majority of the groups reported by the participants were ‘home grown’, with little research base underpinning their implementation. The methodological weaknesses of undertaking such a survey are examined. The paper concludes that having identified clinicians' priorities in forensic occupational therapy research, the challenge is how best to gather robust evidence for practice.

scholarly journals Proposal for a definition for response to treatment, inactive disease and damage for JIA associated uveitis based on the validation of a uveitis related JIA outcome measures from the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC)

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ivan Foeldvari ◽  
Jens Klotsche ◽  
Gabriele Simonini ◽  
Clive Edelsten ◽  
Sheila T. Angeles-Han ◽  
...  
Keyword(s):  
Disease Activity ◽  
Outcome Measures ◽  
School Attendance ◽  
Nominal Group Technique ◽  
Initial Step ◽  
Nominal Group ◽  
Response To Treatment ◽  
Inactive Disease ◽  
Single Measure ◽  
Patient Reported

Abstract Background JIA-associated uveitis (JIAU) is a serious, sight-threatening disease with significant long-term complications and risk of blindness, even with improved contemporary treatments. The MIWGUC was set up in order to propose specific JIAU activity and response items and to validate their applicability for clinical outcome studies. Methods The group consists of 8 paediatric rheumatologists and 7 ophthalmologists. A consensus meeting took place on November 2015 in Barcelona (Spain) with the objective of validating the previously proposed measures. The validation process was based on the results of a prospective open, international, multi-centre, cohort study designed to validate the outcome measures proposed by the initial MIWGUC group meeting in 2012. The meeting used the same Delphi and nominal group technique as previously described in the first paper from the MIWGUC group (Arthritis Care Res 64:1365–72, 2012). Patients were included with a diagnosis of JIA, aged less than 18 years, and with active uveitis or an uveitis flare which required treatment with a disease-modifying anti-rheumatic drug. The proposed outcome measures for uveitis were collected by an ophthalmologist and for arthritis by a paediatric rheumatologist. Patient reported outcome measures were also measured. Results A total of 82 patients were enrolled into the validation cohort. Fifty four percent (n = 44) had persistent oligoarthritis followed by rheumatoid factor negative polyarthritis (n = 15, 18%). The mean uveitis disease duration was 3.3 years (SD 3.0). Bilateral eye involvement was reported in 65 (79.3%) patients. The main findings are that the most significant changes, from baseline to 6 months, are found in the AC activity measures of cells and flare. These measures correlate with the presence of pre-existing structural complications and this has implications for the reporting of trials using a single measure as a primary outcome. We also found that visual analogue scales of disease activity showed significant change when reported by the ophthalmologist, rheumatologist and families. The measures formed three relatively distinct groups. The first group of measures comprised uveitis activity, ocular damage and the ophthalmologists’ VAS. The second comprised patient reported outcomes including disruption to school attendance. The third group consisted of the rheumatologists’ VAS and the joint score. Conclusions We propose distinctive and clinically significant measures of disease activity, severity and damage for JIAU. This effort is the initial step for developing a comprehensive outcome measures for JIAU, which incorporates the perspectives of rheumatologists, ophthalmologists, patients and families.

scholarly journals Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills

2017 ◽  
Vol 9 (2) ◽  
pp. 209-214 ◽  
Author(s):  
Debra Pugh ◽  
Rodrigo B. Cavalcanti ◽  
Samantha Halman ◽  
Irene W. Y. Ma ◽  
Maria Mylopoulos ◽  
...  
Keyword(s):  
Nominal Group Technique ◽  
Nominal Group ◽  
Professional Activity ◽  
Future Research ◽  
Procedural Skills ◽  
Professional Activities ◽  
Competency Based Education ◽  
Modified Delphi ◽  
Competency Based ◽  
Essential Skills

ABSTRACT Background The entrustable professional activity (EPA) framework has been identified as a useful approach to assessment in competency-based education. To apply an EPA framework for assessment, essential skills necessary for entrustment to occur must first be identified. Objective Using an EPA framework, our study sought to (1) define the essential skills required for entrustment for 7 bedside procedures expected of graduates of Canadian internal medicine (IM) residency programs, and (2) develop rubrics for the assessment of these procedural skills. Methods An initial list of essential skills was defined for each procedural EPA by focus groups of experts at 4 academic centers using the nominal group technique. These lists were subsequently vetted by representatives from all Canadian IM training programs through a web-based survey. Consensus (more than 80% agreement) about inclusion of each item was sought using a modified Delphi exercise. Qualitative survey data were analyzed using a framework approach to inform final assessment rubrics for each procedure. Results Initial lists of essential skills for procedural EPAs ranged from 10 to 24 items. A total of 111 experts completed the national survey. After 2 iterations, consensus was reached on all items. Following qualitative analysis, final rubrics were created, which included 6 to 10 items per procedure. Conclusions These EPA-based assessment rubrics represent a national consensus by Canadian IM clinician educators. They provide a practical guide for the assessment of procedural skills in a competency-based education model, and a robust foundation for future research on their implementation and evaluation.

scholarly journals Outcome measures in post-stroke arm rehabilitation trials: do existing measures capture outcomes that are important to stroke survivors, carers, and clinicians?

2019 ◽  
Vol 33 (4) ◽  
pp. 737-749 ◽  
Author(s):  
Julie Duncan Millar ◽  
Frederike van Wijck ◽  
Alex Pollock ◽  
Myzoon Ali
Keyword(s):  
Outcome Measures ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Post Stroke ◽  
Arm Rehabilitation ◽  
Modified Ashworth Scale ◽  
Research Outcome ◽  
Ashworth Scale

Objective: We sought to (1) identify the outcome measures currently used across stroke arm rehabilitation randomized trials, (2) identify and compare outcomes important to stroke survivors, carers and clinicians and (3) describe where existing research outcome measures capture outcomes that matter the most to stroke survivors, carers and clinicians and where there may be discrepancies. Methods: First, we systematically identified and extracted data on outcome measures used in trials within a Cochrane overview of arm rehabilitation interventions. Second, we conducted 16 focus groups with stroke survivors, carers and clinicians using nominal group technique, supplemented with eight semi-structured interviews, to identify these stakeholders’ most important outcomes following post-stroke arm impairment. Finally, we described the constructs of each outcome measure and indicated where stakeholders’ important outcomes were captured by each measure. Results: We extracted 144 outcome measures from 243 post-stroke arm rehabilitation trials. The Fugl-Meyer Assessment Upper Extremity section (used in 79/243 trials; 33%), Action Research Arm Test (56/243; 23%), and modified Ashworth Scale (53/243; 22%) were most frequently used. Stroke survivors ( n = 43), carers ( n = 10) and clinicians ( n = 58) identified 66 unique, important outcomes related to arm impairment following stroke. Between one and three outcomes considered important by the stakeholders were captured by the three most commonly used assessments in research. Conclusion: Post-stroke arm rehabilitation research would benefit from a reduction in the number of outcome measures currently used, and better alignment between what is measured and what is important to stroke survivors, carers and clinicians.

scholarly journals Identifying the Priority Topics for the Assessment of Competence in Care of the Elderly

2018 ◽  
Vol 21 (1) ◽  
pp. 6-13
Author(s):  
Lesley A. Charles ◽  
Chris C. Frank ◽  
Tim Allen ◽  
Tatjana Lozanovska ◽  
Marcel Arcand ◽  
...  
Keyword(s):  
Family Physicians ◽  
The Elderly ◽  
National Standards ◽  
Nominal Group ◽  
Face To Face ◽  
Modified Delphi ◽  
Senior Population ◽  
Modified Delphi Technique ◽  
Added Competence ◽  
Assessment Of Competence

BackgroundWith Canada’s senior population increasing, there is greater demand for family physicians with enhanced skills in Care of the Elderly (COE). The College of Family Physicians Canada (CFPC) has introduced Certificates of Added Competence (CACs), one being in COE. Our objective is to summarize the process used to determine the Priority Topics for the assessment of competence in COE.MethodsA modified Delphi technique was used, with online surveys and face-to-face meetings. The Working Group (WG) of six physicians acted as the nominal group, and a larger group of randomly selected practitioners from across Canada acted as the Validation Group (VG). The WG, and then the VG, completed electronic write-in surveys that asked them to identify the Priority Topics. Responses were compiled, coded, and tabulated to identify the topics and to calculate the frequencies of their selection. The WG used face-to-face meetings and iterative discussion to decide on the final topic names.ResultsThe correlation between the initial Priority Topic list identified by the VG and that identified by the WG is 0.6793. The final list has 18 Priority Topics.ConclusionDefining the required competencies is a first step to establishing national standards in COE.

scholarly journals Preferred Reporting Items for Overviews of Reviews (PRIOR): a protocol for development of a reporting guideline for overviews of reviews of healthcare interventions

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Michelle Pollock ◽  
Ricardo M. Fernandes ◽  
Dawid Pieper ◽  
Andrea C. Tricco ◽  
Michelle Gates ◽  
...  
Keyword(s):  
Online Survey ◽  
Nominal Group Technique ◽  
Reporting Guideline ◽  
Reporting Guidelines ◽  
Nominal Group ◽  
Modified Delphi ◽  
Relevant Evidence ◽  
Delphi Exercise ◽  
Healthcare Interventions ◽  
High Level

Abstract Background Overviews of reviews (i.e., overviews) compile information from multiple systematic reviews to provide a single synthesis of relevant evidence for healthcare decision-making. Despite their increasing popularity, there are currently no systematically developed reporting guidelines for overviews. This is problematic because the reporting of published overviews varies considerably and is often substandard. Our objective is to use explicit, systematic, and transparent methods to develop an evidence-based and agreement-based reporting guideline for overviews of reviews of healthcare interventions (PRIOR, Preferred Reporting Items for Overviews of Reviews). Methods We will develop the PRIOR reporting guideline in four stages, using established methods for developing reporting guidelines in health research. First, we will establish an international and multidisciplinary expert advisory board that will oversee the conduct of the project and provide methodological support. Second, we will use the results of comprehensive literature reviews to develop a list of prospective checklist items for the reporting guideline. Third, we will use a modified Delphi exercise to achieve a high level of expert agreement on the list of items to be included in the PRIOR reporting guideline. We will identify and recruit a group of up to 100 international experts who will provide input into the guideline in three Delphi rounds: the first two rounds will occur via online survey, and the third round will occur during a smaller (8 to 10 participants) in-person meeting that will use a nominal group technique. Fourth, we will produce and publish the PRIOR reporting guideline. Discussion A systematically developed reporting guideline for overviews could help to improve the accuracy, completeness, and transparency of overviews. This, in turn, could help maximize the value and impact of overviews by allowing more efficient interpretation and use of their research findings.

scholarly journals P125: Introduction of extracorporeal cardiopulmonary resuscitation (ECPR) into emergency care: a feasibility study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S101-S101
Author(s):  
D. Rollo ◽  
P. Atkinson ◽  
J. Fraser ◽  
J. Mekwan ◽  
J. P. French ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Phase 1 ◽  
Hospital Setting ◽  
Regional Hospital ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Modified Delphi ◽  
Phase Study ◽  
Number Of Patients ◽  
Modified Delphi Technique ◽  
Poor Outcomes

Introduction: Traditionally, out of hospital cardiac arrests (CA) have poor outcomes. Incorporation of extracorporeal cardiopulmonary resuscitation (ECPR) is being used increasingly to supplement ACLS to provide better outcomes for patients. Current literature suggests potentially improved outcomes, including neurological function. We assessed the feasibility of introduction of ECPR to a regional hospital using a 4-phase study. We report phase-1, an estimation of the number of potential candidates for ECPR in our setting. Methods: Following development and agreement on local criteria for selection of patients for ECPR using a modified Delphi Technique, inclusion and exclusion criteria were applied retrospectively, to a database comprising 4 years of emergency department (ED) cardiac arrests (n=395). This provided estimates of the number of patients who would have qualified for EMS transport for ECPR and initiation of ECPR in the ED. Results: Application of criteria would result in 20.0% (95% CI 16.2-24.3%) of CA being transported to the ED for ECPR (mean 18.5 patients per year). In the ED 4.6% (95% CI 2.83-7.26%) would be eligible to receive ECPR (4.3 patients per year). Incorporating downtime criteria, 3.0% (95% CI 1.6-5.3%) qualify. After considering local in-house cardiac catheterization hours 9.4% (95% CI 6.8-12.9%) and 5.4% (95% CI 3.5-8.2%), without and with EMS rhythm assumptions respectively, would be eligible for transport. For placement on pump, 3.0% (95% CI 1.6-5.3%) and 2.4% (95% CI 1.2-4.6%), without and with use of total downtime respectively, were eligible. Conclusion: If historical patterns of CA were to continue, we believe that an ECPR program may be feasible in our regional hospital setting, with a small number of selected cardiac arrest patients meeting eligibility for transportation and initiation of ECPR. These numbers suggest that an ECPR program would not be resource intensive, yet would be sufficiently busy to maintain adequate team competency.

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