Core sepsis-related competencies for medical students: an international consensus by Delphi technique.
Competency
Curriculum
Education
Medical students
Septic shock
Severe sepsis
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
11 Jun 2024
11 Jun 2024
Historique:
received:
12
09
2023
accepted:
06
05
2024
medline:
12
6
2024
pubmed:
12
6
2024
entrez:
11
6
2024
Statut:
epublish
Résumé
Sepsis is a life-threatening condition which may arise from infection in any organ system and requires early recognition and management. Healthcare professionals working in any specialty may need to manage patients with sepsis. Educating medical students about this condition may be an effective way to ensure all future doctors have sufficient ability to diagnose and treat septic patients. However, there is currently no consensus on what competencies medical students should achieve regarding sepsis recognition and treatment. This study aims to outline what sepsis-related competencies medical students should achieve by the end of their medical student training in both high or upper-middle incomes countries/regions and in low or lower-middle income countries/regions. Two separate panels from high or upper-middle income and low or lower-middle income countries/regions participated in a Delphi method to suggest and rank sepsis competencies for medical students. Each panel consisted of 13-18 key stakeholders of medical education and doctors in specialties where sepsis is a common problem (both specialists and trainees). Panelists came from all continents, except Antarctica. The panels reached consensus on 38 essential sepsis competencies in low or lower-middle income countries/regions and 33 in high or upper-middle incomes countries/regions. These include competencies such as definition of sepsis and septic shock and urgency of antibiotic treatment. In the low or lower-middle income countries/regions group, consensus was also achieved for competencies ranked as very important, and was achieved in 4/5 competencies rated as moderately important. In the high or upper-middle incomes countries/regions group, consensus was achieved in 41/57 competencies rated as very important but only 6/11 competencies rated as moderately important. Medical schools should consider developing curricula to address essential competencies, as a minimum, but also consider addressing competencies rated as very or moderately important.
Sections du résumé
BACKGROUND
BACKGROUND
Sepsis is a life-threatening condition which may arise from infection in any organ system and requires early recognition and management. Healthcare professionals working in any specialty may need to manage patients with sepsis. Educating medical students about this condition may be an effective way to ensure all future doctors have sufficient ability to diagnose and treat septic patients. However, there is currently no consensus on what competencies medical students should achieve regarding sepsis recognition and treatment. This study aims to outline what sepsis-related competencies medical students should achieve by the end of their medical student training in both high or upper-middle incomes countries/regions and in low or lower-middle income countries/regions.
METHODS
METHODS
Two separate panels from high or upper-middle income and low or lower-middle income countries/regions participated in a Delphi method to suggest and rank sepsis competencies for medical students. Each panel consisted of 13-18 key stakeholders of medical education and doctors in specialties where sepsis is a common problem (both specialists and trainees). Panelists came from all continents, except Antarctica.
RESULTS
RESULTS
The panels reached consensus on 38 essential sepsis competencies in low or lower-middle income countries/regions and 33 in high or upper-middle incomes countries/regions. These include competencies such as definition of sepsis and septic shock and urgency of antibiotic treatment. In the low or lower-middle income countries/regions group, consensus was also achieved for competencies ranked as very important, and was achieved in 4/5 competencies rated as moderately important. In the high or upper-middle incomes countries/regions group, consensus was achieved in 41/57 competencies rated as very important but only 6/11 competencies rated as moderately important.
CONCLUSION
CONCLUSIONS
Medical schools should consider developing curricula to address essential competencies, as a minimum, but also consider addressing competencies rated as very or moderately important.
Identifiants
pubmed: 38862952
doi: 10.1186/s12909-024-05525-9
pii: 10.1186/s12909-024-05525-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
653Informations de copyright
© 2024. The Author(s).
Références
Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–11. Epub 2020/01/20.
doi: 10.1016/S0140-6736(19)32989-7
da Silva Ramos FJ, de Freitas FGR, Machado FR. Sepsis in patients hospitalized with coronavirus disease 2019: how often and how severe? Curr Opin Crit Care. 2021;27(5):474–4792.
doi: 10.1097/MCC.0000000000000861
Reinhart K, Daniels R, Kissoon N, et al. Recognizing sepsis as a global health priority - a WHO resolution. N Engl J Med. 2017;377(5):414–7. Epub 2017/06/29.
doi: 10.1056/NEJMp1707170
WHO Sepsis Technical Expert Meeting - Meeting Report. Geneva: World Health Organization; 2018.
Ryan MS, Blood AD, Park YS, et al. Competency-based frameworks in medical school education programs: a thematic analysis of the academic medicine snapshots. Acad Med. 2022;97(11S):63–70.
doi: 10.1097/ACM.0000000000004912
Marshall-Brown P, Namboya F, Pollach G. Evaluating sepsis training for medical students and nonphysicians in Malawi. J Clin Anesth. 2016;34:352–7. Epub 2016/10/01.
doi: 10.1016/j.jclinane.2016.05.013
Hansel M, Winkelmann AM, Hardt F, et al. Impact of simulator training and crew resource management training on final-year medical students’ performance in sepsis resuscitation: a randomized trial. Minerva Anestesiol. 2012;78(8):901–9. Epub 2012/04/17.
Nguyen HB, Daniel-Underwood L, Van Ginkel C, et al. An educational course including medical simulation for early goal-directed therapy and the severe sepsis resuscitation bundle: an evaluation for medical student training. Resuscitation. 2009;80(6):674–9. Epub 2009/04/28.
doi: 10.1016/j.resuscitation.2009.02.021
Ziglam HM, Morales D, Webb K, Nathwani D. Knowledge about sepsis among training-grade doctors. J Antimicrob Chemother. 2006;57(5):963–5. Epub 2006/03/15.
doi: 10.1093/jac/dkl042
Shrestha GS, Kwizera A, Lundeg G, et al. International Surviving Sepsis Campaign guidelines 2016: the perspective from low-income and middle-income countries. Lancet Infect Dis. 2017;17(9):893–5. Epub 2017/08/29.
doi: 10.1016/S1473-3099(17)30453-X
Castro R, Nin N, Rios F, et al. The practice of intensive care in Latin America: a survey of academic intensivists. Crit Care. 2018;22(1):39. Epub 2018/02/22.
doi: 10.1186/s13054-018-1956-6
Baelani I, Jochberger S, Laimer T, et al. Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers. Crit Care. 2011;15(1):10. Epub 2011/01/12.
doi: 10.1186/cc9410
Jones J, Hunter D. Consensus methods for medical and health services research. BMJ. 1995;311(7001):376–80. Epub 1995/08/05.
doi: 10.1136/bmj.311.7001.376
World Bank Operational Income Category. The World Bank; 2018.
Brown S. Likert scale examples for surveys. 2010. Available from: https://www.extension.iastate.edu/Documents/ANR/LikertScaleExamplesforSurveys.pdf .
Diamond IR, Grand RC, Feldman BM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67(4):401–9. Epub 2014/03/04.
doi: 10.1016/j.jclinepi.2013.12.002
Englander R, Cameron T, Ballard AJ, et al. Toward a common taxonomy of competency domains for the health professions and competencies for physicians. Acad Med. 2013;88(8):1088–94.
doi: 10.1097/ACM.0b013e31829a3b2b
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. Epub 2008/10/22.
doi: 10.1016/j.jbi.2008.08.010
Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208. Epub 2019/05/13.
doi: 10.1016/j.jbi.2019.103208
McGaghie WC, Miller GE, Sajid AW, Telder TW. Competency-based curriculum development in medical education - an introduction. Genf: WHO; 1978.
Li A, Ling L, Arabi YM, et al. Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings. Crit Care. 2024;28(1):30.
doi: 10.1186/s13054-024-04804-7
Shang Z. Use of Delphi in health sciences research: a narrative review. Medicine (Baltimore). 2013;102(7):e32829.
doi: 10.1097/MD.0000000000032829
Boulkedid R, Abdoul H, Loustau M, et al. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS One. 2011;6(6):e20476. Epub 2011/06/23.
doi: 10.1371/journal.pone.0020476
Smith AG, Brainard JC, Campbell KA. Development of an undergraduate medical education critical care content outline utilizing the Delphi method. Crit Care Med. 2020;48(1):98–103.
doi: 10.1097/CCM.0000000000004086
Evans L, Rhodes A, Alhazzani W, et al. Executive summary: surviving sepsis campaign: international guidelines for the management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):1974–82.
doi: 10.1097/CCM.0000000000005357