Larouche Jeremie, Yee Albert J M, Wadey Veronica, Ahn Henry, Hedden Douglas M, Hall Hamilton, Broad Robert, Bailey Chris, Nataraj Andrew, Fisher Charles, Christie Sean, Fehlings Michael, Moroz Paul J, Bouchard Jacques, Carey Timothy, Chapman Michael, Chow Donald, Lundine Kris, Dommisse Iain, Finkelstein Joel, Fox Richard, Goytan Michael, Hurlbert John, Massicotte Eric, Paquet Jerome, Splawinski Jan, Tsai Eve, Wai Eugene, Wheelock Brian, Paquette Scott
*Laval University,Quebec City, Quebec †University of Toronto, Toronto, Ontario, Canada ‡University of Alberta, Edmonton, Alberta, Canada §University of Western Ontario, London, Ontario, Canada ¶University of British Columbia, Vancouver, British Columbia, Canada ||Dalhousie University, Halifax, Nova Scotia, Canada **University of Ottawa, Ottawa, Ontario, Canada ††University of Calgary, Calgary, Alberta, Canada §§The Scarborough Hospital, Scarborough, Ontario, Canada ¶¶University of Manitoba, Winnipeg, Manitoba, Canada ||||Vernon Jubilee Hospital, Vernon, BC ***Saint John Regional Hospital, Saint John, NB.
Spine (Phila Pa 1976). 2016 Mar;41(6):530-7. doi: 10.1097/BRS.0000000000001251.
Modified-Delphi expert consensus method.
The aim of this study was to develop competence-based spine fellowship curricula as a set of learning goals through expert consensus methodology in order to provide an educational tool for surgical educators and trainees. Secondarily, we aimed to determine potential differences among specialties in their rating of learning objectives to defined curriculum documents.
There has been recent interest in competence-based education in the training of future surgeons. Current spine fellowships often work on a preceptor-based model, and recent studies have demonstrated that graduating spine fellows may not necessarily be exposed to key cognitive and procedural competencies throughout their training that are expected of a practicing spine surgeon.
A consensus group of 32 spine surgeons from across Canada was assembled. A modified-Delphi approach refined an initial fellowship-level curriculum set of learning objectives (108 cognitive and 84 procedural competencies obtained from open sources). A consensus threshold of 70% was chosen with up to 5 rounds of blinded voting performed. Members were asked to ratify objectives into either a general comprehensive or focused/advanced curriculum.
Twenty-eight of 32 consultants (88%) responded and participated in voting rounds. Seventy-eight (72%) cognitive and 63 (75%) procedural competency objectives reached 70% consensus in the first round. This increased to 82 cognitive and 73 procedural objectives by round 4. The final curriculum document evolved to include a general comprehensive curriculum (91 cognitive and 53 procedural objectives), a focused/advanced curriculum (22 procedural objectives), and a pediatrics curriculum (22 cognitive and 9 procedural objectives).
Through a consensus-building approach, the study authors have developed a competence-based curriculum set of learning objectives anticipated to be of educational value to spine surgery fellowship educators and trainees. To our knowledge, this is one of the first nationally based efforts of its kind that is also anticipated to be of interest by international colleagues.
改良德尔菲专家共识法。
本研究旨在通过专家共识法制定基于能力的脊柱专科培训课程，作为一套学习目标，以便为外科教育工作者和学员提供一种教育工具。其次，我们旨在确定各专业在对既定课程文件学习目标的评分上的潜在差异。
近期，未来外科医生培训中的基于能力的教育受到关注。当前的脊柱专科培训通常采用带教模式，近期研究表明，即将毕业的脊柱专科医生在其整个培训过程中未必能接触到执业脊柱外科医生应具备的关键认知和操作能力。
组建了一个由来自加拿大各地的32名脊柱外科医生组成的共识小组。采用改良德尔菲法完善了一套最初的专科培训水平的学习目标课程（从公开来源获取108项认知能力和84项操作能力）。选择了70%的共识阈值，进行了多达5轮的匿名投票。要求成员将目标批准纳入一般综合课程或重点/高级课程。
32名顾问中有28名（88%）回复并参与了投票轮次。78项（72%）认知能力目标和63项（75%）操作能力目标在第一轮达到了70%的共识。到第4轮时，这一数字增加到82项认知目标和73项操作目标。最终的课程文件演变为包括一个一般综合课程（91项认知目标和53项操作目标）、一个重点/高级课程（22项操作目标）和一个儿科课程（22项认知目标和9项操作目标）。
通过一种建立共识的方法，研究作者制定了一套基于能力的学习目标课程，预计对脊柱外科专科培训的教育工作者和学员具有教育价值。据我们所知，这是同类基于全国范围的首批努力之一，预计也会引起国际同行的兴趣。
