Consensus development of core competencies in intensive and critical care medicine training in China
Hu et al. Critical Care
Consensus development of core competencies in intensive and critical care medicine training in China
Xiaoyun Hu 0
Xiuming Xi
Penglin Ma
Haibo Qiu
Kaijiang Yu
Yaoqing Tang
Chuanyun Qian
Qiang Fang
Yushan Wang
Xiangyou Yu
Yuan Xu
Bin Du 0
for the China Critical Care Clinical Trials Group (CCCCTG)
the Task Force of Core Competencies in Intensive
Critical Care Medicine Training in China
0 Medical Intensive Care Unit, Peking Union Medicine Collage Hospital , 1 Shuai Fu Yuan, Beijing 100730 , China
Background: The aim of this study is to develop consensus on core competencies required for postgraduate training in intensive care medicine. Methods: We used a combination of a modified Delphi method and a nominal group technique to create and modify the list of core competencies to ensure maximum consensus. Ideas were generated modified from Competency Based Training in Intensive Care Medicine in Europe collaboration (CoBaTrICE) core competencies. An online survey invited healthcare professionals, educators, and trainees to rate and comment on these competencies. The output from the online survey was edited and then reviewed by a nominal group of 13 intensive care professionals to identify each competence for importance. The resulting list was then recirculated in the nominal group for iterative rating. Results: The online survey yielded a list of 199 competencies for nominal group reviewing. After five rounds of rating, 129 competencies entered the final set defined as core competencies. Conclusions: We have generated a set of core competencies using a consensus technique which can serve as an indicator for training program development.
Intensive care; Critical care; Training; Core competence; Delphi; Nominal group
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Background
Critical care medicine was recognized by the
government as an independent specialty in China in 2008,
almost three decades after its introduction in the 1980s
[1]. Despite the lack of national census, it is a common
belief that there has been great progress in critical care
resources during the past 10 years; the provision of
qualified intensivists through accredited training
programs has therefore become a major challenge to meet
increasing needs.
Postgraduate medical education in different fields of
healthcare in China has been undergoing standardization
for years, but standardized resident training in critical
care is still under development. Up to 2010, there was
no formal accredited critical care training program in
China [1]. Moreover, there is no nationwide agreement
upon evaluation and accreditation of critical care trainees,
which makes it more difficult to attain the government
objective of free movement of medical professionals as
proposed by China’s healthcare reform plan [2].
Physician licensing has been slowly transforming from
examination of knowledge to evaluation of competencies
[3], which should develop during residency and
fellowship training based on the Dreyfus model of knowledge
development [4], and core competencies for graduates of
fellowship programs in critical care have therefore been
defined by multiple critical care societies in western
countries [5–8]. In spring 2012, the Chinese College of
Intensive and Critical Care Medicine (CCICCM)
affiliated to the Chinese Medical Doctors’ Association
(CMDA) called for a task force to define the minimum
competencies of intensive and critical care training in
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China, using consensus techniques. The goal does not
encompass developing a comprehensive curriculum
inclusive of teaching techniques and assessment methods,
but to allow individual training centers to harmonize
their training program or curriculum focused on
producing intensive care specialists with common core skills.
The present article describes the process and outcome
related to this mandate, and we wish to set an example
for such efforts in low and middle-income countries.
Methods
We used a combination of a modified Delphi method
and a nominal group (NG) to generate and rate the
importance of core competencies for critical care training
[9, 10]; this approach has been used successfully by
others to develop competency-based critical care
training [5–8]. The Delphi technique, originally developed in
the 1950s at The RAND Corporation, is designed to
gather input from expert contributors using an iterative
process with feedback of individ (...truncated)