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运用改良德尔菲法制定国际本科谵妄课程。

Development of an international undergraduate curriculum for delirium using a modified delphi process.

机构信息

Department of Ageing & Health, Forth Valley Royal Hospital, NHS Forth Valley, UK.

Department of Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust, UK.

出版信息

Age Ageing. 2018 Jan 1;47(1):131-137. doi: 10.1093/ageing/afx133.

Abstract

BACKGROUND

delirium is a medical emergency affecting approximately 30% of hospitalised older patients. Recent work examining UK undergraduate medical curricula highlighted inconsistencies in the delivery of teaching on delirium. The aim of this project was to develop consensus agreement on a delirium curriculum for medical undergraduates.

METHODS

a modified Delphi process was used to determine consensus amongst experts in an iterative manner. Experts at the European Delirium Association Conference (London, 2015) were invited to participate. Participants were asked to consider: (i) What should be taught? (ii) How should teaching be delivered? (iii) Who should deliver the teaching? (iv) Where should the teaching be delivered? (v) When should the teaching be delivered? Delphi rounds continued until consensus on curriculum content (defined as 80% agreement) was achieved.

RESULTS

consensus was reached after three rounds. A recurrent theme was the need to involve patients, families and carers to help drive attitudinal change. The final curriculum, along with data pertaining to agreement with each curriculum item during the Delphi process, is presented.

CONCLUSION

this Delphi process enabled an international group of experts from a broad range of specialties, to reach consensus agreement on the components of an undergraduate curriculum for delirium. The curriculum represents an important step in the development of delirium education within medical training. Despite competing demands of increasingly crowded undergraduate curricula, delirium, given its relevance to 21st century healthcare, must be prioritised. We call on Medical Schools to consider integrating this delirium curriculum into their degree programmes.

摘要

背景

谵妄是一种影响约 30%住院老年患者的医疗急症。最近一项检查英国本科医学课程的工作强调了在讲授谵妄方面的不一致性。本项目旨在就本科医学生的谵妄课程达成共识。

方法

采用改良 Delphi 法,通过迭代方式确定专家间的共识。邀请欧洲谵妄协会会议(2015 年伦敦)的专家参与。参与者被要求考虑:(i)应该教授什么?(ii)应该如何进行教学?(iii)谁应该进行教学?(iv)应该在哪里进行教学?(v)应该何时进行教学?Delphi 轮次继续进行,直到达到课程内容的共识(定义为 80%的同意)。

结果

经过三轮达成了共识。一个反复出现的主题是需要让患者、家属和护理人员参与,以帮助推动态度的改变。最终的课程以及在 Delphi 过程中与每个课程项目的协议相关的数据都已呈现。

结论

这个 Delphi 过程使来自广泛专业领域的国际专家小组就本科谵妄课程的组成部分达成了共识。该课程代表了在医学培训中发展谵妄教育的重要一步。尽管本科课程的需求日益增加,但鉴于其与 21 世纪医疗保健的相关性,谵妄必须优先考虑。我们呼吁医学院考虑将这一谵妄课程纳入其学位课程。

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