Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA.
Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Ave., Room 3C38, San Francisco, CA, 94110, USA.
Can J Anaesth. 2023 Oct;70(10):1611-1622. doi: 10.1007/s12630-023-02536-w. Epub 2023 Aug 3.
The standard for anesthesia residency training in the USA mainly relies on the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project, a framework that lacks specific directives for subspecialties including obstetric anesthesia. We aimed to identify core competencies in obstetric anesthesiology that can be adapted to different residency training programs to help improve the quality of training and accountability of the institutions within the USA.
We identified a preliminary list of competencies from review of existing competency-based obstetric anesthesia training curricula and practice guidelines. We used a modified Delphi methodology to achieve expert consensus among members of the Society for Obstetric Anesthesia and Perinatology education committee. The panellists were asked to evaluate the importance of each competency using a five-point Likert scale, with consensus after two rounds defined at 80% agreement. The responders were also asked at which level of training each competency should be attained.
The Delphi rounds had 75% response rate and derived 94 competencies that were categorized under the six ACGME domains: patient care (38), medical knowledge (45), system-based practice (two), practice-based learning and improvement (five), interpersonal communication skills (two), and professionalism (two).
We generated a residency training competency list for obstetric anesthesiology through expert consensus. This list can be used by residency training programs to develop a structured competency-based curriculum with tangible milestones, thereby reducing heterogeneity in the standard of training.
美国麻醉住院医师培训的标准主要依赖于研究生医学教育认证委员会（ACGME）的成果项目，该框架缺乏包括产科麻醉在内的专业的具体指导方针。我们旨在确定产科麻醉学的核心能力，这些能力可以适应不同的住院医师培训计划，以帮助提高培训质量和美国机构的问责制。
我们从现有的基于能力的产科麻醉培训课程和实践指南的审查中确定了一份初步的能力清单。我们使用改良的德尔菲法，在产科麻醉和围产医学教育委员会的成员中达成专家共识。小组成员被要求使用五点李克特量表评估每个能力的重要性，两轮后达到 80%的共识。应答者还被要求回答每个能力应该在哪个培训水平上获得。
德尔菲两轮的回复率为 75%，得出了 94 项能力，这些能力分为六个 ACGME 领域：患者护理（38 项）、医学知识（45 项）、系统实践（2 项）、基于实践的学习和改进（5 项）、人际沟通技能（2 项）和专业精神（2 项）。
我们通过专家共识生成了一份产科麻醉学住院医师培训的能力清单。该清单可用于住院医师培训计划，制定具有明确里程碑的结构化基于能力的课程，从而减少培训标准的异质性。
