scholarly journals Defining fitness for purpose in South African anaesthesiologists using a Delphi technique to assess the CanMEDS framework

2019 ◽  
pp. 7-16 ◽  
Author(s):  
N Kalafatis ◽  
T Sommerville ◽  
PD Gopalan
Keyword(s):  
South African ◽  
Context Awareness ◽  
Delphi Technique ◽  
Primary Outcome ◽  
Response Rate ◽  
Expert Panel ◽  
Descriptive Study ◽  
Fitness For Purpose ◽  
Medical Expert ◽  
Health Advocate

Background: Training of South African anaesthesiologists is based on the Canadian Medical Education Directives for Specialists (CanMEDS). However, the applicability of CanMEDS in this context has not been assessed. An expert panel participated in a Delphi process to create an appropriate expanded list of CanMEDS competencies that may be used in the future to assess fitness for purpose of local graduates. Methods: This descriptive study comprised a representative panel of 16 experts surveyed electronically over three rounds to assess the importance of the existing CanMEDS roles and enabling competencies and suggested additions deemed applicable locally. The primary outcome was the creation of a list of competencies applicable to South Africa. Results: There was a 100% response rate for all three rounds. Based on the existing seven CanMEDS meta-competencies (Medical Expert, Collaborator, Communicator, Leader, Scholar, Professional and Health Advocate), respondents scored the importance of 89 enabling competencies and 19 additional competencies. Seven CanMEDS enabling competencies did not achieve consensus and were excluded. Nineteen new enabling competencies and two new meta-competencies (Humaneness, Context Awareness) achieved consensus and were added. Median ratings of importance of meta-competencies showed highest scores for Medical Expert and Collaborator and lowest scores for Health Advocate. Weighting of meta-competencies revealed highest scores for Medical Expert and Professional with all others equally weighted. Conclusion: This study has formulated an adapted CanMEDS list of enabling competencies with the addition of the two new metacompetencies of Context Awareness and Humaneness for use in South African anaesthesiology. This provides a means with which future graduates may be assessed for fitness for purpose.

scholarly journals Are South African anaesthesiologists fit for purpose? A comparison of opinions of graduates, teachers and examiners

2020 ◽  
pp. 272-278
Author(s):  
N Kalafatis ◽  
TE Sommerville ◽  
PD Gopalan
Keyword(s):  
South African ◽  
Context Awareness ◽  
Independent Practice ◽  
Medical Expert ◽  
Self Assessment ◽  
University Departments ◽  
National University ◽  
Health Advocate ◽  
Fit For Purpose ◽  
The Impact

Background: Anaesthesiologists must be assessed as and deemed fit for purpose (FFP) to function independently as specialists prior to their embarking on independent practice. Opinions of various stakeholders are useful in determining whether graduating specialists are prepared for practice, some of which include teachers, examiners and the graduates themselves. Methods: This descriptive quantitative study comprised recent graduates and anaesthesiology teachers and examiners from all eight national university departments of anaesthesiology. Each participant scored the preparedness of graduates’ competences deemed appropriate by national experts via an electronic survey. Nine specialist role meta-competences (medical expert, communicator, collaborator, leader, health advocate, scholar, professional, context awareness, humaneness) with their accompanying 101 component enabling competences were assessed. Participants used a 4-point Likert scale to score preparedness for each meta- and enabling competence (1– completely unprepared; 2 – somewhat prepared; 3 – prepared; 4 – completely prepared). Scores of 1 and 2 were considered as unprepared and 3 and 4 as prepared. Scores of graduates, teachers and examiners were compared. After individual group comparisons, the scores of combined teachers and examiners (seniors) were compared with those of graduates. Results: Response rates for graduates, teachers and examiners were 85%, 68% and 96% respectively. Graduates felt prepared for 7/9 roles (medical expert, collaborator, communicator, professional, scholar, context awareness and humaneness) and unprepared for the roles of health advocate and leader. Teachers’ and examiners’ scores were similar, perceiving graduates as prepared for 4/9 roles (medical expert, collaborator, context awareness and humaneness) and unprepared for the majority of their roles (communicator, scholar, professional, leader and health advocate). Leader and health advocate roles were unanimously perceived as unprepared by all three groups. Statistically significant disparate scores were evident between seniors and graduates for the roles of communicator, scholar and professional, with graduates assessing themselves as more prepared compared to the opinions of seniors. Conclusion: According to South African national anaesthesiology teachers and examiners, local graduates may not be fit for purpose, despite the contrasting perceptions of graduates. Graduates’ self-assessment may be less objective than that of experienced opinions, necessitating the need for longitudinal assessments to establish the impact of experience on subsequent graduate perceptions.

Using the Delphi technique to achieve consensus on bereavement care in palliative care in Europe: An EAPC White Paper

2021 ◽  
pp. 026921632110430
Author(s):  
Orla Keegan ◽  
Irene Murphy ◽  
Inger Benkel ◽  
Joaquim T Limonero ◽  
Marilyn Relf ◽  
...  
Keyword(s):  
Palliative Care ◽  
Delphi Study ◽  
Delphi Technique ◽  
Response Rate ◽  
Expert Panel ◽  
Task Force ◽  
Research Literature ◽  
Bereavement Support ◽  
Six Dimensions ◽  
Bereavement Care

Background: The WHO definition of palliative care includes bereavement support as integral to palliative care, yet a previous survey of bereavement support in palliative care in Europe has shown a range of service responses to loss. A rigorous approach to agreeing and implementing a palliative care bereavement framework was required. Aim: The aim of this study was to develop consensus on best-practice recommendations for bereavement care principles, structures, processes and delivery based on current practice and evidence. Design: In accordance with Guidance on Conducting and Reporting Delphi Studies, a consensus-building five-round Delphi technique was performed. A scoping review of research literature informed drafting of 54 statements by the EAPC Bereavement Task Force. Evaluation of the statements was performed by an expert panel using a 5-point Likert scale. ⩾80% agreement were defined as essential items and 75%–79% agreement were defined as desirable items. Items with a consensus rating <75% were revised during the process. Setting/participants: The Delphi study was carried out by an expert panel among membership organisations of the European Association for Palliative Care. Results: In total, 376 email requests to complete Delphi questionnaire were distributed with a response rate of 23% ( n = 87) and a follow-up response-rate of 79% ( n = 69). Of the initial 54 statements in six dimensions, 52 statements were endorsed with 26 essential statements and 26 desirable statements. Conclusions: The six dimensions and 52 statements agreed through this Delphi study clarify a coherent direction for development of bereavement services in palliative care in Europe.

scholarly journals Efficacy and safety of Si-Jun-Zi-Tang-based therapies for functional (non-ulcer) dyspepsia: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yaping Wang ◽  
Bin Liu ◽  
Xiuqiong Fu ◽  
Tiejun Tong ◽  
Zhiling Yu
Keyword(s):  
Relapse Rate ◽  
Large Scale ◽  
Primary Outcome ◽  
Response Rate ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Efficacy And Safety ◽  
History Of ◽  
Non Ulcer Dyspepsia

Abstract Background The traditional Chinese medicine formula Si-Jun-Zi-Tang (SJZT) has a long history of application in the treatment of functional dyspepsia (non-ulcer dyspepsia, FD)-like symptoms. SJZT-based therapies have been claimed to be beneficial in managing FD. This study aimed to assess the efficacy and safety of SJZT-based therapies in treating FD by meta-analysis. Methods Systematic searches for RCTs were conducted in seven databases (up to February 2019) without language restrictions. Data were analyzed using Cochrane RevMan software version 5.3.0 and Stata software version 13.1, and reported as relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CIs). The primary outcome was response rate and the secondary outcomes were gastric emptying, quality of life, adverse effects and relapse rate. The quality of evidence was evaluated according to criteria from the Cochrane risk of bias. Results A total of 341 potentially relevant publications were identified, and 12 RCTs were eligible for inclusion. For the response rate, there was a statically significant benefit in favor of SJZT-based therapies (RR = 1.23; 95% CI 1.17 to 1.30). However, the benefit was limited to modified SJZT (MSJZT). The relapse rate of FD patients received SJZT-based therapies was lower than that of patients who received conventional medicines (OR = 0.23; 95% CI 0.10 to 0.51). No SJZT-based therapies-related adverse effect was reported. Conclusion SJZT-based prescriptions may be effective in treating FD and no serious side-effects were identified, but the effect on response rate appeared to be limited to MSJZT. The results should be interpreted with caution as all the included studies were considered at a high risk of bias. Standardized, large-scale and strictly designed RCTs are needed to further validate the benefits of SJZT-based therapies for FD management. Trial registration Systematic review registration: [PROSPERO registration: CRD42019139136].

The Management of Febrile Infants by Primary-Care Pediatricians in Utah: Comparison With Published Practice Guidelines

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 623-627 ◽  
Author(s):  
Paul C. Young
Keyword(s):  
Primary Care ◽  
Practice Guidelines ◽  
Laboratory Tests ◽  
Blood Count ◽  
Response Rate ◽  
Expert Panel ◽  
Complete Blood Count ◽  
Age Groups ◽  
Design Case ◽  
Primary Care Pediatricians

Objective. To determine primary-care pediatricians' management of febrile infants and compare them with published practice guidelines. Design. Case scenarios were sent to 194 primary-care pediatricians in Utah, describing three febrile infants, ages 21 days, 60 days, and 20 months, corresponding to the three age groups: 0 to 28 days; 29 to 90 days, and 91 days to 36 months for which the guidelines suggest different strategies. Results. Ninety-four pediatricians responded (response rate, 48%). Compliance with the guidelines was 39% for the 21 day old, 9.6% for the 60 day old, and 75% for the 20 month old. No respondent followed the guidelines for all three infants. Performance of tests to determine if an infant was low risk varied from 3%, for a stool white cell examination in a febrile 2 month old with diarrhea, to 75% for a complete blood count in a 20 month old with a temperature of 40°C. Compliance did not differ between private and academic practitioners. Those in practice less than 5 years (n = 22) were more likely than those with more experience to follow the guidelines for the 21 day old but not the other two infants. Conclusion. Primary-care pediatricians in Utah manage febrile infants with fewer laboratory tests and less hospitalization than recent practice guidelines developed by an expert panel of academic specialists suggest.

Telehealth Music Therapy Services in the United States With Older Adults: A Descriptive Study

2022 ◽  
Author(s):  
Lindsey Wilhelm ◽  
Kyle Wilhelm
Keyword(s):  
United States ◽  
Older Adults ◽  
Music Therapy ◽  
Response Rate ◽  
Descriptive Study ◽  
The United States ◽  
Age Group ◽  
Music Therapists ◽  
Therapy Services ◽  
Therapy Sessions

Abstract In response to the COVID-19 pandemic, many music therapists in the United States turned to telehealth music therapy sessions as a strategy to continue services with older adults. However, the nature and perception of telehealth music therapy services for this age group are unknown. The purpose of this study was to describe music therapy telehealth practices with older adults in the United States including information related to session implementation, strengths and challenges, and adaptations to clinical practice. Of the 110 participants in the United States who responded to the survey (25.2% response rate), 69 reported implementing telehealth music therapy services with older adults and responded to a 32-item survey. Quantitative and qualitative analyses were conducted. Results indicated that while all participants had provided telehealth music therapy for no more than 6 months, their experiences with telehealth varied. Based on participant responses, telehealth session structure, strengths, challenges, and implemented changes are presented. Overall, 48% of music therapists reported that they planned to continue telehealth music therapy with older adults once pandemic restrictions are lifted. Further study on the quality, suitability, and acceptability of telehealth services with older adults is recommended.

scholarly journals Core corporate governance dilemmas facing boards: a South African perspective

2011 ◽  
Vol 12 (2) ◽  
pp. 194-210
Author(s):  
Hyram Serretta ◽  
Mike Bendixen ◽  
Margie Sutherland
Keyword(s):  
Corporate Governance ◽  
South African ◽  
Delphi Technique ◽  
Board Members ◽  
International Literature ◽  
The Core ◽  
Good Corporate Governance ◽  
Key Factor ◽  
African Perspective ◽  
Managing Complexity

Directors and boards face many challenges in terms of managing complexity. A key factor of success in practicing good corporate governance is the board’s ability to cope with paradox. The purpose of this research has been to explore the core corporate governance dilemmas facing boards. The investigation was qualitative in nature using the Delphi technique. Six core corporate governance dilemmas facing board members were identified one of which is not mentioned in the international literature. The findings should provide directors with an ability to identify the nature of the paradoxes they need to respond to.

scholarly journals Competency Assessment of Final-Year Dental Students in Tunisia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
F. Chouchene ◽  
N. Taktak ◽  
F. Masmoudi ◽  
A. Baaziz ◽  
F. Maatouk ◽  
...  
Keyword(s):  
Educational Program ◽  
Response Rate ◽  
Treatment Plan ◽  
Descriptive Study ◽  
Program Assessment ◽  
Dental Students ◽  
Competency Assessment ◽  
Cross Sectional ◽  
Dental Radiographs ◽  
Subgingival Scaling

Introduction. The educational program assessment has always been the main objective of quality improvement in all curricula. The aim of this study was to describe the levels of competency of final-year students of the Faculty of Dental Medicine of Monastir in Tunisia in the major skills needed for a new dentist. Methods. In this cross-sectional descriptive study, 154 students filled out a questionnaire including 53 competencies, rated on a four-point Likert scale, broadly based on the competencies described in the profile and competences for the graduating dentist in Europe. Results. The response rate was 67% (145/230). For twenty items in the questionnaire, over 75% of the students reported being competent. The five items with the highest percentages were “undertaking supragingival and subgingival scaling-Item 22” (97.2%), “evaluating the periodontium, establishing a diagnosis and formulating a treatment plan-Item 2” (96.6%), “identify the location and degree of activity of dental caries-Item 24 (95.9%), “taking and interpreting dental radiographs-Item 12” (94.4%), “restoring damaged teeth-Item 25” (93.8%), and “managing primary oral health care-Item 16” (93.8%). For eighteen skills, more than 75% of students self-rated being not competent, demonstrating a need of more thorough training, notably in periodontal surgery and implantology, among these, five skills were found that demand in-depth acquisition according to the students. Conclusion. The general state of competency of the last-year dental students was described as fairly satisfactory based on the students’ self-reported responses. However, theoretical and practical backgrounds related to some subjects in the school need to be improved.

scholarly journals VALIDATION OF THE COMPETENCE PROFILE PROPOSAL FOR THE TRAINING OF NURSES

2019 ◽  
Vol 28 ◽  
Author(s):  
Andreia Correia de Souza Cioffi ◽  
Mara Regina Rosa Ribeiro ◽  
Juarez Coimbra Ormonde Júnior
Keyword(s):  
Data Collection ◽  
Delphi Technique ◽  
Descriptive Study ◽  
Educational Tool ◽  
Validity Index ◽  
Undergraduate Nursing ◽  
Managerial Attention ◽  
Competence Profile ◽  
Nursing Courses ◽  
E Mail

ABSTRACT Objective: to estimate the validity of the competence profile content developed for the training of the generalist nurse in the health and administrative and managerial attention areas. Method: descriptive study, with quantitative approach. The data collection and validation occurred through the Delphi technique, in a virtual way, with questionnaire sent by e-mail, between April and May 2016, with the participation of 28 professional judges and 26 nursing specialists judges from all regions of the country. For the calculation of the degree of agreement among the answers of the experts, signed in at least 70% for the Content Validity Index, and the binomial test for dichotomous analysis of the proportion of the answers of the specialists. Results: considering the 14 items of the care area profile, a content degree of 93% by professional area and 97% by education area was obtained. The 18 items of the administrative and management profile were approved with a degree of agreement of 95% by the professional area and 99% by the education area. Conclusion: the competence profile validated in content may help undergraduate nursing courses in the country and is a safe educational tool, aiming at the implementation of the Course Pedagogical Projects.

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