Sumathy Masanam Kasi, Zayapragassarazan Zayabalaradjane, Pai Dinker Ramananda, Wyawahare Mukta
Department of Medical Education, Jawaharlal Institute of Medical Education and Research (JIPMER), Puducherry, India.
Surgery and Director of Medical Simulation Centre, Mahatma Gandhi Medical College and Research Centre, Puducherry, India.
J Adv Med Educ Prof. 2024 Apr 1;12(2):88-94. doi: 10.30476/JAMP.2023.100111.1873. eCollection 2024 Apr.
While medical students are expected to learn procedural skills during their training, there is no consensus on their level of learning. Further, the most essential procedural skills across medical curricula which need to be taught during their III-year clinical posting are often not considered. The purpose of this study was to identify the core procedural skills needed to be taught during the III-year undergraduate medical students clinical posting.
A three-round, online Modified Delphi method was used to identify consensus on selecting the most essential procedural skills prescribed in National Medical Commission (NMC) curriculum 2019. In Round 1, a list of 54 procedural skills from the National Medical Commission's (NMC) Graduate Medical Education Regulations (GMER) 2019 curriculum was distributed to 22 experts in pre-clinical medical education and multidisciplinary clinicians.They rated the skills in terms of importance. In Round 2, the skills that received consensus in Round 1 were presented, resulting in 13 skills for evaluation. Round 3 further narrowed down the skills to a final consensus of 6. An interclass correlation coefficient of 0.767 among experts indicates a substantial level of reliability.
Consensus was achieved for six procedural skills, each demonstrating over 80% agreement among the experts. These skills include basic life support, intravenous cannulation, urinary catheterization for both male and female patients, nasogastric tube insertion, oxygen administration, and basic suturing. Notably, all these skills received the highest level of agreement, surpassing 90% consensus.
The results of the modified Delphi study offer crucial insights into the procedural skills that should be included in the curriculum for third-year undergraduate medical students during their clinical rotations in a tertiary care teaching hospital. Faculty members at these institutions differ in their opinions regarding the importance of teaching specific procedural skills, influenced by their teaching background and the student cohorts they instruct. From a comprehensive list, six skills have been pinpointed as the most vital through the modified Delphi technique. Moreover, the Delphi technique is acknowledged as a valuable method for achieving a consensus on prioritizing the training of certifiable skills.
虽然医学生在培训期间需要学习操作技能,但对于他们的学习水平尚无共识。此外,在本科三年级临床实习期间需要教授的医学课程中最基本的操作技能往往未被考虑。本研究的目的是确定本科三年级医学生临床实习期间需要教授的核心操作技能。
采用三轮在线改良德尔菲法,就2019年国家医学委员会(NMC)课程规定的最基本操作技能的选择达成共识。在第一轮中,将国家医学委员会2019年研究生医学教育条例(GMER)课程中的54项操作技能清单分发给22名临床前医学教育专家和多学科临床医生。他们根据重要性对这些技能进行评分。在第二轮中,展示了在第一轮中达成共识的技能,从而有13项技能可供评估。第三轮进一步将技能范围缩小到最终达成共识的6项。专家之间的组内相关系数为0.767,表明可靠性水平较高。
就六项操作技能达成了共识,每项技能在专家中都有超过80%的认可度。这些技能包括基本生命支持、静脉置管、男女患者导尿、鼻胃管插入、给氧和基本缝合。值得注意的是,所有这些技能都获得了最高水平的认可,超过了90%的共识。
改良德尔菲研究的结果为本科三年级医学生在三级护理教学医院临床轮转期间课程中应包含的操作技能提供了重要见解。这些机构的教师对特定操作技能教学重要性的看法存在差异,这受到他们的教学背景和所指导学生群体的影响。通过改良德尔菲技术,从一份综合清单中确定了六项最为重要的技能。此外,德尔菲技术被认为是一种在确定可认证技能培训优先级方面达成共识的有价值方法。