EMERGENCY MEDICINE CLERKSHIP CORE COMPETENCIES:                                              

DEVELOPING A CANADIAN CONSENSUS USING A DELPHI PROCESS

This was a project that I lead starting in 2007 in collaboration with Jill McEwen, Trevor Langhan, Richard Lee, Rob Woods, and Glen Bandiera - colleagues from across Canada. We had recently formed a Canadian Emergency Medicine Undergraduate Committee consisting of Education Leads from across Canada.  One of our early projects we identified was the need to establish some type of standardized curriculum in Emergency Medicine at the undergraduate level.

This project was important on a number of levels.  We learned how to conduct a Delphi Process and showed that it could be an effective methodology for establishing a curriculum.  We successfully published this in 2011 in Medical Teacher.

Penciner R, Langhan T, Lee R, McEwen J, Woods R, Bandiera G. Using a Delphi process to establish consensus on emergency medicine clerkship competencies. Medical Teacher. 2011; 33: e333-e339.

We also established an enduring list of competencies on which Emergency Medicine program across Canada can build their curriculums.  The consensus document was subsequently published in 2013 in the Canadian Journal of Emergency Medicine.

Penciner R, Woods R, McEwen J, Lee R, Langhan T, Bandiera G. Core competencies for Emergency Medicine clerkships: Results of a Canadian consensus initiative From the Canadian Association of Emergency Physicians Undergraduate Education Committee. Canadian Journal of Emergency Medicine. 2013;15(1):24-33.

Here is a full list of the core competencies.

Emergency Medicine Clerkship Core Competencies: Developing a Canadian Consensus using a Delphi Process

Rick Penciner MD*, Jill McEwen MD†, Trevor Langhan MD‡, Richard Lee MD¶, Rob Woods MD¥, Glen Bandiera MD*

Background:  

Currently, there is no consensus on the core competencies required for emergency medicine (EM) clerkships in Canada.  Existing EM curricula have been developed through informal consensus or local efforts.  The purpose of this project was to define core competencies for EM clerkships in Canada and to validate a Delphi process in the context of national curriculum development.   

Methods:

Using a modified Delphi process we developed a consensus amongst a panel of expert emergency medicine educators from across Canada utilizing the CanMEDS 2005 Physician Competency Framework.  Using descriptive statistics, the competencies were rank-ordered based on per cent response of “must include”.  Competencies ranked by 75% or more of respondents as “must include” were included in the final list.  Upon completion, the project was reviewed by 4 external reviewers.   

Results:

Thirty (30) experts from 9 different medical schools across Canada participated on the panel.  The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework.  After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction).  The external reviewers commented that the results were valid and applicable to EM clerkships in Canada.

Conclusion:

This study demonstrated that a modified Delphi process can result in a strong consensus around a realistic number of core competencies for EM clerkships.