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Simulation curricular content in postgraduate emergency medicine: A multicentre Delphi study

  • Nicole Kester-Greene (a1), Andrew K Hall (a2) and Catharine M Walsh (a3) (a4)
Abstract
Objectives

There is increasing evidence to support integration of simulation into medical training; however, no national emergency medicine (EM) simulation curriculum exists. Using Delphi methodology, we aimed to identify and establish content validity for adult EM curricular content best suited for simulation-based training, to inform national postgraduate EM training.

Methods

A national panel of experts in EM simulation iteratively rated potential curricular topics, on a 4-point scale, to determine those best suited for simulation-based training. After each round, responses were analyzed. Topics scoring <2/4 were removed and remaining topics were resent to the panel for further ratings until consensus was achieved, defined as Cronbach α ≥ 0.95. At conclusion of the Delphi process, topics rated ≥ 3.5/4 were considered “core” curricular topics, while those rated 3.0-3.5 were considered “extended” curricular topics.

Results

Forty-five experts from 13 Canadian centres participated. Two hundred eighty potential curricular topics, in 29 domains, were generated from a systematic literature review, relevant educational documents and Delphi panellists. Three rounds of surveys were completed before consensus was achieved, with response rates ranging from 93-100%. Twenty-eight topics, in eight domains, reached consensus as “core” curricular topics. Thirty-five additional topics, in 14 domains, reached consensus as “extended” curricular topics.

Conclusions

Delphi methodology allowed for achievement of expert consensus and content validation of EM curricular content best suited for simulation-based training. These results provide a foundation for improved integration of simulation into postgraduate EM training and can be used to inform a national simulation curriculum to supplement clinical training and optimize learning.

Objectif

De plus en plus d’études étayent l'intégration de la simulation dans la formation médicale; toutefois, il n'existe aucun programme national de simulation en médecine d'urgence (MU). Aussi l’étude menée selon la méthode Delphi visait-elle à dégager des sujets d'intérêt et à valider le contenu du programme convenant le mieux à l'apprentissage par simulation en MU de l'adulte, en vue de l’élaboration d'une formation postdoctorale, à l’échelle du pays.

Méthode

Un groupe national d'experts en simulation en MU a évalué par itération, sur une échelle de 4 points, des sujets d'intérêt en vue de déterminer ceux qui convenaient le mieux à une formation axée sur la simulation. Il y a eu analyse des réponses à chaque tour. Les sujets qui avaient recueilli une cote < 2/4 étaient retirés et les autres étaient soumis de nouveau au groupe pour évaluation, et ce, jusqu’à l'atteinte d'un consensus, défini comme une valeur alpha de Cronbach ≥ 0,95. À la fin du processus Delphi, les sujets ayant obtenu une cote ≥ 3,5/4 étaient considérés comme des matières majeures, et ceux ayant obtenu une cote 3,0-3,5, comme des matières mineures.

Résultats

Ont participé à l'exercice 45 experts provenant de 13 centres canadiens de formation. Une revue systématique de la documentation, un examen du matériel didactique pertinent et l'avis des experts en méthode Delphi ont permis de dégager 280 sujets d'intérêt, dans 29 domaines. Il y a eu atteinte d'un consensus après trois tours d’évaluation, et les taux de réponse variaient de 93 à 100%. À la fin du processus, 28 sujets, dans 8 domaines, ont été classés majeurs, et 35 autres, dans 14 domaines, mineurs.

Conclusion

L’étude menée selon la méthode Delphi a permis de valider, après l'atteinte d'un consensus par les experts, le contenu du programme convenant le mieux à une formation axée sur la simulation en MU. Les résultats pourront servir d'assises à une meilleure intégration de l'apprentissage par simulation dans la formation postdoctorale en MU et, par suite, à l’élaboration d'un programme national de simulation visant à enrichir la formation clinique et à maximiser l'apprentissage.

Copyright
Corresponding author
Correspondence to: Dr. Nicole Kester-Greene, Sunnybrook Health Sciences Centre, Department of Emergency Services, 2475 Bayview Ave, Toronto, ON M4N 3M5; Email: nicole.kestergreene@sunnybrook.ca
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