Development of a Delphi survey questionnaire to identify core procedural competencies for undergraduate medical curricula in Sri Lanka

Abstract

The Delphi technique, a well-recognized research method that combines both quantitative and qualitative approaches, is used to arrive at group consensus across a range of subject areas. This method is used in academic medicine to arrive at a consensus with regard to developing and modifying curricula. In the absence of a national undergraduate curriculum, there is a lack of specificity as to which skills a graduate doctor should be equipped with to perform successfully during the internship and the level of competency required for a specific skill. Thus, a modified Delphi questionnaire was developed to identify the core procedural competencies required of a medical graduate. For this purpose, GMC guidelines on practical skills and procedures, competency-based medical education guidelines, current procedural curricula, and student logbooks were reviewed for the inclusion of items to the questionnaire. Existing literature on procedural skills was searched using key words and phrases such as procedural skills competency, curricula, medical students, and Boolean combinations. Databases searched included PubMed, MEDLINE, Scopus, and Web of Science. From this material, a core list of procedural skills that might be considered essential for the preparation of future graduate doctors was prepared. The list comprised of 64 procedural skills across nine categories: cardiovascular, respiratory, gastrointestinal, surgical, women's health, urogenital, injections/ intravenous, trauma, and diagnostic/ measurement procedures. The subsequent Delphi survey with clinician educators achieved consensus on 25 core procedural competencies for undergraduate medical curricula in Sri Lanka. Formal integration of procedural training into undergraduate medical curricula and assessment of core procedural competencies as an exit qualification are recommended to ensure that future patients are under the care of competent physicians.