Brainard Jason, Alber Sarah, Smith Andrew G, Roosevelt Genie E, Rustici Matt
The following authors are at the University of Colorado School of Medicine, Aurora, CO: Jason Brainard is an Associate Professor in the Department of Anesthesiology; Sarah Alber is an Assistant Professor in the Department of Anesthesiology; Genie E. Roosevelt is a Professor in the Department of Emergency Medicine; and Matt Rustici is an Associate Professor in the Department of Pediatrics. Andrew G. Smith is an Associate Professor in the Department of Pediatrics, Division of Critical Care, University of Utah School of Medicine, Salt Lake City, UT.
J Educ Perioper Med. 2024 Sep 30;26(3):E728. doi: 10.46374/VolXXVI_Issue3_Brainard. eCollection 2024 Jul-Sep.
Critical care education is an important, mandatory component of residency training in anesthesiology. Currently, there is no accepted national standardized curriculum, and a prioritized critical care content outline would be beneficial to the creation of a pragmatic standardized residency curriculum. The modified Delphi method is a recognized method for establishing consensus in medical education.
We developed a prioritized critical care content outline using the modified Delphi method. Topics were selected from critical care topics included in the Program Requirements for Graduate Medical Education in Anesthesiology and the American Board of Anesthesiology Content Outline. Panel members rated critical care topics on a 9-point Likert scale (). Consensus was defined as ≥75% rating the topic as very important to mandatory for inclusion (Likert scale 7-9). Topics with >80% consensus were removed from subsequent surveys and included in the final list, and topics with <50% were removed. Members were asked to select the ideal timing of topic delivery during residency (Foundational-Early Residency, Intermediate-Mid Residency, Advanced-Late Residency).
A total of 158 panel members who were contacted using national anesthesiology organization email lists completed the initial round, 119 (75%) completed the second iteration, and 116 (73%) completed the third. Response rate on the first survey was (22/55) 40% for anesthesiology critical care program directors, (18/132) 14% for core anesthesiology residency program directors, and (77/1150) 7% for the remaining respondents. Trainees (n = 41) were not included in response rate calculations. Most participants (103/158, 65%) had completed both core anesthesiology and subspecialty critical care medicine training and most (87/158, 55%) had formal roles in medical education. Forty-one (26%) responders were currently in training. All panelists worked in institutions with graduate medical education (GME) learners. Fifty-eight of 136 (43%) topics met consensus for inclusion. Most consensus topics (50/58, 86%) were recommended to be delivered early during residency with the other 8 topics to be delivered in the middle of residency.
We developed a prioritized critical care content outline for anesthesiology residents that includes highly recommended critical care topics with ideal timing for inclusion in residency. This outline provides the first step in developing a pragmatic standardized curriculum to guide faculty and programs in critical care education.
重症监护教育是麻醉学住院医师培训的一个重要且必修的组成部分。目前，尚无公认的全国标准化课程，而一份经过优先排序的重症监护内容大纲将有助于制定实用的标准化住院医师课程。改良德尔菲法是医学教育中达成共识的一种公认方法。
我们使用改良德尔菲法制定了一份经过优先排序的重症监护内容大纲。主题选自《麻醉学研究生医学教育项目要求》和美国麻醉学委员会内容大纲中包含的重症监护主题。小组成员采用9点李克特量表对重症监护主题进行评分（）。共识定义为≥75%的成员将该主题评为对纳入来说非常重要至必不可少（李克特量表7 - 9）。共识率>80%的主题从后续调查中剔除并纳入最终列表，共识率<50%的主题被剔除。成员们被要求选择在住院医师培训期间讲授主题的理想时间（基础 - 住院医师培训早期、中级 - 住院医师培训中期、高级 - 住院医师培训后期）。
通过全国麻醉学组织电子邮件列表联系的158名小组成员完成了第一轮调查，119名（75%）完成了第二轮，116名（73%）完成了第三轮。第一次调查的回复率，麻醉学重症监护项目主任为（22/55）40%，麻醉学核心住院医师培训项目主任为（18/132）14%，其余受访者为（77/1150）7%。学员（n = 41）未纳入回复率计算。大多数参与者（103/158，65%）完成了麻醉学核心培训和亚专业重症监护医学培训，大多数（87/158，55%）在医学教育中担任正式职务。41名（26%）受访者目前正在接受培训。所有小组成员都在有研究生医学教育（GME）学员的机构工作。136个主题中有58个（43%）达到了纳入共识。大多数达成共识的主题（50/58，86%）被建议在住院医师培训早期讲授，另外8个主题在住院医师培训中期讲授。
我们为麻醉学住院医师制定了一份经过优先排序的重症监护内容大纲，其中包括高度推荐的重症监护主题以及纳入住院医师培训的理想时间。这份大纲为制定实用的标准化课程以指导重症监护教育中的教师和项目提供了第一步。
