Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa.
Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa.
Int J Environ Res Public Health. 2023 Nov 30;20(23):7126. doi: 10.3390/ijerph20237126.
Despite the widespread availability of ultrasound machines in South African district hospitals, there are no guidelines on the competency in point-of-care ultrasound (POCUS) use required by generalist doctors in this setting. This study aimed to define the required POCUS competencies by means of consensus via the Delphi method.
An online Delphi process was initiated in June 2022, using the existing American Academy of Family Physicians' ultrasound curriculum (84 skillsets) as the starting questionnaire. Panelists were selected across the country, including two from district hospitals in each province and two from each academic family medicine department in South Africa ( = 36). In each iterative round, the participants were asked to identify which POCUS skillsets were essential, optional (region-specific), or non-essential for South African district hospitals. This process continued until consensus (>70% agreement) was achieved on all of the skillsets.
Consensus was achieved on 81 of the 84 skillsets after 5 iterative rounds (96.4%), with 3 skillsets that could not achieve consensus (defined as <5% change over more than 2 consecutive rounds). The final consensus identified 38 essential, 28 optional, and 15 non-essential POCUS skillsets for the South African district hospital context.
The list of essential POCUS skillsets provided by this study highlights the predominance of obstetric- and trauma-based skillsets required for generalist healthcare workers in South African district hospitals. The findings will require priority setting and revalidation prior to their implementation across the country.
尽管南非地区医院广泛配备了超声机，但针对该环境下普通医生在即时护理超声（POCUS）使用方面所需的能力，尚无相关指南。本研究旨在通过德尔菲法达成共识，确定所需的 POCUS 能力。
2022 年 6 月启动了在线德尔菲法流程，以美国医师学院家庭医学超声课程（84 项技能）作为初始问卷。全国各地的专家组成员被选中，每个省有来自地区医院的 2 名成员，以及南非每个学术家庭医学部门的 2 名成员（共 36 名）。在每一轮迭代中，参与者被要求确定哪些 POCUS 技能对于南非地区医院是必要的、可选的（特定于区域的）还是非必要的。此过程持续进行，直到所有技能都达成共识（>70%的人同意）。
经过 5 轮迭代，84 项技能中有 81 项达成共识（96.4%），其中 3 项技能无法达成共识（定义为超过 2 轮连续变化<5%）。最终共识确定了 38 项必要、28 项可选和 15 项非必要的 POCUS 技能，适用于南非地区医院的背景。
本研究提供的必要 POCUS 技能列表突出了南非地区医院普通保健工作者所需的以产科和创伤为基础的技能。这些发现需要在全国范围内实施之前进行优先排序和重新验证。
