Identifying essential procedural skills and competencies in Sri Lankan undergraduate medical curricula

Abstract

Medical students need to acquire certain procedural skills to function effectively upon graduation. However, there is no agreement on the procedural skills that should be mastered. The level of competency required for any skill varies between different medical schools and the supervising consultants. The aim of this study was to identify core procedural skills competencies for Sri Lankan medical students. A three-round, online modified Delphi survey was used to identify consensus on competencies of procedural skills for graduating medical students in Sri Lanka. In Round 1, an initial structured questionnaire was developed using content identified from the literature and current logbooks. 17 clinician experts involved in both supervision of intern medical officers and teaching of medical students rated their agreement on 70 procedural skills. In Round 2, experts re-appraised the importance of skills and rated the level of procedural competency (i.e., Observer, Novice, Competent, Proficient) expected for each skill upon graduation. In Round 3, experts re-appraised the procedural competency, achieving consensus. Consensus, defined as > 75% agreement, was established with 36 procedural skills across eight categories with the highest level of agreement for blood transfusion, handwashing, and surgical scrub, gown and gloving. Several common procedures that medical students were expected to be proficient by graduation were negated by the expert panel. The findings from the Delphi study provide critical information about procedural training for Sri Lankan medical students. The study findings demonstrate the importance of restructuring the current undergraduate procedural curricula to produce doctors capable of effective delivery of patient care in the near future.