A Modified Delphi Study for Development of a Pediatric Curriculum for Emergency Medicine Residents

Abstract

Objectives: Emergency medicine (EM) trainees are expected to learn to provide acute care for patients of all ages. The American Council for Graduate Medical Education provides some guidance on topics related to caring for pediatric patients; however, education about pediatric topics varies across residency programs. The goal of this project was to develop a consensus curriculum for teaching pediatric emergency care.Methods: We recruited 13 physicians from six academic health centers to participate in a three-round electronic modified Delphi project. Participants were selected on the basis of expertise with both EM resident education and pediatric emergency care. The first modified Delphi survey asked participants to generate the core knowledge, skills, and experiences needed to prepare EM residents to effectively treat children in an acute care setting. The qualitative data from the first round was reformulated into a second-round questionnaire. During the second round, participants used rating scales to prioritize the curriculum content proposed during the first round. In round 3, participants were asked to make a determination about each curriculum topic using a three-point scale labeled required, optional, or not needed. Results:The first modified Delphi round yielded 400 knowledge topics, 206 clinical skills, and 44 specific types of experience residents need to prepare for acute pediatric patient care. These were narrowed to 153 topics, 84 skills, and 28 experiences through elimination of redundancy and two rounds of prioritization. The final lists contain topics classified by highly recommended, partially recommended, and not recommended. The partially recommended category is intended to help programs tailor their curriculum to the unique needs of their learners as well as account for variability between 3-and 4-year programs and the amount of time programs allocate to pediatric education. Conclusion:The modified Delphi process yielded the broad outline of a consensus core pediatric emergency care curriculum.E mergency medicine (EM) physicians acquire proficiency in the emergent management of all patients including pediatric patients during their training. Despite the growth of pediatric EM as a subspecialty, pediatric EM (PEM) subspecialists only care for 10% to 20% of the pediatric patients in the emergency setting across the United States.1 The remaining 80% to 90% of pediatric emergency care patients are cared for by EM physicians and/or general practice pediatricians.2-5 The Accreditation Council for Graduate Medical Education (ACGME) requires EM residents to have approximately 20% of their patient encounters with patients less than 18 years of age, including the critical care of infants and children.6 While time dedicated to pediatrics has increased in recent years, 7 concerns remain as to whether this allows sufficient experience to develop the mastery level competency for the EM physician to effectively care for children. 4,7 Although the type of clinical experiences available is beyond the...

Developing a workplace lactation promotion model in Indonesia using Delphi technique

“…The availability of lactation facilities and supportive program at workplace increases lactation practice by three-fold and increases the exclusive breastfeeding rate by six-fold [ 11 ]. It is also related with the productivity improvement and lower absenteeism [ 12 ]. However, previous study identified only 21.5% of female workers obtained the access of lactation facilities at work and 7.5% of them had lactation support program at their workplace [ 11 ].…”

“…To our best knowledge, this is the first study developing a workplace-based lactation promotion model in Indonesia. Delphi study is a common method in developing the medical curriculum [ 12 – 14 ]. In electronic survey, a minimum response rate of 50% is necessary to obtain a valid result [ 15 ].…”

Redefining Medical Competencies for an Oral Medicine Specialty Training Curriculum Using a Modified Delphi Technique

“…In 1996, Adler and Ziglio described their use of the Delphi technique, building on the description by Brown at the Rand Corporation in 1968 5 , 6 . The Delphi method is a well‐established method for generating curriculum content as this process represents expert consensus and can be considered an evidence‐based process in educational research 7 . The technique uses face‐to‐face meeting and voting on each item successively until a consensus is reached.…”

“…5,6 The Delphi method is a well-established method for generating curriculum content as this process represents expert consensus and can be considered an evidence-based process in educational research. 7 The technique uses face-toface meeting and voting on each item successively until a consensus is reached. A modification of this method has been described in which mail or email is used to achieve consensus.…”

2018 Academic Emergency Medicine Consensus Conference: Advancing Pediatric Emergency Medicine Education Through Research and Scholarship

“…Even after three decades of efforts to improve PEM education for medical students, residents, and emergency providers, there remains no clearly defined core PEM curriculum that unifies and drives the learning process . A central tenet of the consensus discussion was that dissemination of PEM knowledge must be achieved through a standardized pediatric emergency curriculum, notably for board certification of emergency medicine residents and ultimately for maintenance of certification .…”