A modified Delphi study for development of an adolescent medicine curriculum for emergency medicine residents

Eileen S Williams, Lauren A Bretz, Kathryn M Fisher
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Abstract

Purpose: More than 1,500,000 adolescents in the United States report using emergency services for the majority of their medical needs. Although the American Council for Graduate Medical Education offers some guidance on the inclusion of pediatric topics in an emergency medicine (EM) residency curriculum, it does not specifically address adolescent-related competencies. We aimed to develop a consensus on which adolescent health topics are most important to cover in a didactic curriculum for EM residents.Methods: Physicians from multiple specialties, such as EM, pediatric EM, and adolescent medicine, were invited as panelists in a modified Delphi process. In round 1, the panelists were asked to determine which competencies in adolescent medicine are most important for a graduating EM resident to master. In round 2, they were asked to specify the competencies that should be included in an EM residency didactic curriculum. In round 3, they prioritized the most critical competencies for curriculum inclusion.Results: Consensus was reached on a total of 26 topics that were found crucial to be included in a didactic curriculum for EM residents. Of these, the panel prioritized the following: (1) “manage a patient presenting after reported sexual assault,” (2) “accurately diagnose ovarian torsion,” and (3) “manage a patient presenting for symptoms of sexually transmitted infection.” Conclusion: The modified Delphi process yielded recommendations to guide the development of an adolescent medicine curriculum for EM residents. Sexual and reproductive healthcare issues were identified as the most important topics.
为急诊医学住院医师开发青少年医学课程的改良德尔菲研究
目的:美国有超过 150 万名青少年表示,他们的大部分医疗需求都是通过急诊服务解决的。尽管美国研究生医学教育委员会(American Council for Graduate Medical Education)在急诊医学(EM)住院医师培训课程中纳入儿科主题方面提供了一些指导,但并未具体涉及与青少年相关的能力。我们的目标是就急诊科住院医师教学课程中哪些青少年健康主题最重要达成共识:方法:我们邀请了来自多个专科的医生,如急诊科、儿科急诊科和青春期医学科的医生,以改良的德尔菲程序作为小组成员。在第一轮中,小组成员被要求确定哪些青少年医学能力对于即将毕业的急诊科住院医师来说最为重要。在第二轮中,他们被要求明确指出应纳入急诊科住院医师教学课程的能力。在第三轮中,他们对课程中最关键的能力进行了优先排序:结果:共就 26 个主题达成共识,这些主题被认为是纳入急诊科住院医师教学课程的关键。其中,专家组优先考虑了以下内容:(1) "处理报告性侵犯后就诊的患者";(2) "准确诊断卵巢扭转";(3) "处理出现性传播感染症状的患者"。结论:修改后的德尔菲过程提出了一些建议,以指导为急诊科住院医师开发青春期医学课程。性保健和生殖保健问题被认为是最重要的主题。
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