Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.
Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Hosp Pediatr. 2023 Jul 1;13(7):e199-e206. doi: 10.1542/hpeds.2022-007102.
Pediatric interfacility transport teams facilitate access to subspecialty care, and physicians often guide management remotely as transport medical control (TMC). Pediatric subspecialty fellows frequently perform TMC duties, but tools assessing competency are lacking. Our objective was to develop content validity for the items required to assess pediatric subspecialty fellows' TMC skills.
We conducted a modified Delphi process among transport and fellow education experts in pediatric critical care medicine, pediatric emergency medicine, neonatal-perinatal medicine, and pediatric hospital medicine. The study team generated an initial list of items on the basis of a literature review and personal experience. A modified Delphi panel of transport experts was recruited to participate in 3 rounds of anonymous, online voting on the importance of the items using a 3-point Likert scale (marginal, important, essential). We defined consensus for inclusion as ≥80% agreement that an item was important/essential and consensus for exclusion as ≥80% agreement that an item was marginal.
The study team of 20 faculty drafted an initial list of items. Ten additional experts in each subspecialty served on the modified Delphi panel. Thirty-six items met the criteria for inclusion, with widespread agreement across subspecialties. Only 1 item, "discussed bed availability," met the criteria for inclusion among some subspecialties but not others. The study team consolidated the final list into 26 items for ease of use.
Through a consensus-based process among transport experts, we generated content validity for the items required to assess pediatric subspecialty fellows' TMC skills.
儿科交接转运团队为获得专科治疗提供了便利，医生通常作为转运医疗控制（TMC）人员远程指导治疗。儿科专科住院医师经常执行 TMC 任务，但缺乏评估其能力的工具。我们的目标是确定评估儿科专科住院医师 TMC 技能所需项目的内容效度。
我们在儿科危重病医学、儿科急诊医学、新生儿围产期医学和儿科医院医学的转运和住院医师教育专家中进行了改良 Delphi 法研究。研究团队在文献复习和个人经验的基础上，生成了一份初始项目清单。招募了一个改良 Delphi 专家组，其中包括来自各转运专业的专家，他们通过 3 轮匿名在线投票，对项目的重要性进行 3 分制（边缘、重要、关键）评分。我们将纳入标准定义为≥80%的专家认为项目重要/关键，排除标准定义为≥80%的专家认为项目边缘。
由 20 名教员组成的研究团队起草了一份初始项目清单。每个专科领域还增加了 10 名专家作为改良 Delphi 小组的成员。36 个项目符合纳入标准，在各专科领域均得到广泛认同。只有 1 个项目“讨论床位可用性”在某些专科领域符合纳入标准，但在其他领域则不符合。研究团队将最终清单合并为 26 个项目，以便于使用。
通过转运专家之间的共识过程，我们为评估儿科专科住院医师 TMC 技能所需的项目确定了内容效度。
