Developing a National Competency-Based Diabetes Curriculum in Undergraduate Medical Education: A Delphi Study

"Like, we can't keep adding": a mixed methods study to explore the feasibility of implementing co-produced 24-Hour Movement Guideline content

Background

Medical students must demonstrate competency in health promotion and illness prevention; however, movement behaviour promotion content is lacking in medical curricula. Canada's 24-Hour Movement Guidelines (24HMG) present an opportunity to transform medical curricula to promote movement behaviours within a 24-hour paradigm. We previously co-produced a 24HMG curriculum map and 14 curriculum objectives at one Canadian medical school. The aim of this study was to gain consensus on the curriculum map and objectives among faculty and medical students and explore implementation determinants.

Methods

This study followed a concurrent nested mixed methods design using a modified Delphi method to assess the level of (dis)agreement with map components followed by interviews to explore the implementability of the map. A preliminary survey was distributed to collect demographic and movement behaviour data, followed by three online modified Delphi surveys. Suggested improvements to the map were solicited through open-text boxes. Interviews were semi-structured and conducted online. Interview data were analyzed using content analysis guided by the Consolidated Framework for Implementation Research (CFIR) 2.0.

Results

Consensus was reached on 156/180 items (86.7%) in Survey 1 (faculty, n = 6; students, n = 8), 49/51 items (96.1%) in Survey 2 (faculty, n = 4; students, n = 7), and 8/8 items (100%) in Survey 3 (faculty, n = 3; students, n = 7). Implementation determinants encompassed all five CFIR 2.0 domains, mostly the inner setting (e.g., culture, structural barriers).

Conclusions

Reciprocity and open communication between medical schools and external change agents should be prioritized when co-producing curriculum change in the present landscape of inflation and medical professional burnout.

Developing a Canadian artificial intelligence medical curriculum using a Delphi study

The integration of artificial intelligence (AI) education into medical curricula is critical for preparing future healthcare professionals. This research employed the Delphi method to establish an expert-based AI curriculum for Canadian undergraduate medical students. A panel of 18 experts in health and AI across Canada participated in three rounds of surveys to determine essential AI learning competencies. The study identified key curricular components across ethics, law, theory, application, communication, collaboration, and quality improvement. The findings demonstrate substantial support among medical educators and professionals for the inclusion of comprehensive AI education, with 82 out of 107 curricular competencies being deemed essential to address both clinical and educational priorities. It additionally provides suggestions on methods to integrate these competencies within existing dense medical curricula. The endorsed set of objectives aims to enhance AI literacy and application skills among medical students, equipping them to effectively utilize AI technologies in future healthcare settings.

Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study

The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals' competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.

Brief Action Planning in Health and Health Care: A Scoping Review

Achieving maximal health outcomes via health promotion and disease prevention requires the adoption of healthy behaviors. Brief action planning (BAP) is a method for patient self-management, health behavior change, and health coaching with potentially broad implications for and clinical applications in health and health care contexts. This scoping review presents 5 major findings about the literature on BAP: the principal geographic locations and the clinical contexts of its application, the types of research evaluations that it has undergone to date, the theoretic frameworks in which it is grounded, and the fidelity of its use in clinical practice.

Using a Modified Delphi Method for Identifying Competencies in a Syrian Undergraduate Neonatology Curriculum

OBJECTIVES

There is a global shift toward competency-based medical education (CBME) to equip medical students with essential competencies required to meet healthcare needs. Syrian medical faculties lack a formal competency-based neonatology curriculum for undergraduate medical students. Therefore, our study aimed to develop a national consensus on the required competencies for undergraduate neonatology curricula in Syria.

METHODS

This study took place at the Syrian Virtual University between October 2021 and November 2021. The authors used a modified Delphi method to determine neonatal medicine competencies. A focus group of three neonatologists and one medical education professional identified initial competencies. In the first Delphi round, 75 pediatric clinicians rated the competencies on a 5-point Likert scale. After formulating the results, a second Delphi round was conducted with 15 neonatal medicine experts. To reach an agreement, 75% of participants must score a competency as 4 or 5. Correlation coefficients were used to compare clinicians' first Delphi ratings with experts' second Delphi ratings. Competencies with a weighted response greater than 4.2 were considered essential.

RESULTS

A list of 37 competencies (22 knowledge, 6 skills, and 9 attitudes) was identified after the second Delphi round, of which 24 were considered core competencies (11 knowledge, 5 skills, and 8 attitudes). The correlation coefficient for knowledge, skills, and attitudes competencies was 0.90, 0.96, and 0.80, respectively.

CONCLUSIONS

Neonatology competencies have been identified for medical undergraduates. These competencies aim to help students achieve the required skills and enable decision-makers to implement CBME in Syria and similar countries.

Development of a Standardized Curriculum for Nursing Informatics in Korea

OBJECTIVES

This study explored the current status of nursing informatics education in South Korea and developed a standardized curriculum for it.

METHODS

Data were collected in two stages: first, an online survey conducted from December 2020 to February 2021 among 60 nursing schools to analyze the current status of nursing informatics education; and second, a two-round Delphi survey with 15 experts from March to April 2021 to determine the mean and standard deviation of the demand for each learning objective in nursing informatics education. A standardized curriculum proposal was developed based on the results of the two-round Delphi survey.

RESULTS

Nursing informatics was most commonly taught in the fourth year (34%), with two credits. The proportion of elective major subjects was high in undergraduate and graduate programs (77.4% and 78.6%, respectively), while the proportion of nursing informatics majors was low (21.4%). The curriculum developed included topics such as nursing information system-related concepts, definitions and components of healthcare information systems, electronic medical records, clinical decision support systems, mobile technology and health management, medical information standards, personal information protection and ethics, understanding of big data, use of information technology in evidence-based practice, use of information in community nursing, genome information usage, artificial intelligence clinical information systems, administrative management systems, and information technology nursing education.

CONCLUSIONS

Nursing informatics professors should receive ongoing training to obtain recent medical information. Further review and modification of the nursing informatics curriculum should be performed to ensure that it remains up-to-date with recent developments.

Moving toward co-production: five ways to get a grip on collaborative implementation of Movement Behaviour curricula in undergraduate medical education

Several "calls to action" have imposed upon medical schools to include physical activity content in their overextended curricula. These efforts have often neither considered medical education stakeholders' views nor the full complexity of medical education, such as competency-based learning and educational inflation. With this external pressure for change, few medical schools have implemented physical activity curricula. Moreover, Canada's new 24-Hour Movement Guidelines focus on the continuum of movement behaviours (physical activity, sedentary behaviour, and sleep). Thus, a more integrated process to overcome the "black ice" of targeting all movement behaviours, medical education stakeholder engagement, and the overextended curriculum is needed. We argue for co-production in curriculum change and offer five strategies to integrate movement behaviour curricula that acknowledge the complexity of the medical education context, helping to overcome our "black ice." Our objectives were to investigate 24-Hour Movement Guideline content in the medical curriculum and develop an integrated process for competency-based curriculum renewal. Stakeholders were equal collaborators in a two-phased environmental scan of 24-Hour Movement Guideline content in the Queen's University School of Medicine. Findings and a working curriculum map highlight how new, competency-based content may be embedded in an effort to guide more relevant and feasible curriculum changes.

A Sisyphean task: Developing and revising public health nursing competencies

BACKGROUND

Competencies are intended to enhance the public health workforce's skills. Competencies used to evaluate public health nursing (PHN) practice and education have been promoted by several nursing organizations. Having multiple sets of competencies raises questions about redundancies and their usefulness in evaluating PHN, as well as the central question about the value of the competencies themselves.

METHODS

A literature review of psychometric evaluation research of the competencies was performed. Qualitative content analyses were conducted of seven documents: Association of Community Health Nursing Educators', 2000 and 2010 essentials; Quad Council Coalition's 2004, 2011, and 2018 competencies; and the American Nurses Association's, 2013 and the 2021 draft of PHN scope and standards of practice with respect to competency definition, conceptual basis, and use of an established taxonomy.

RESULTS

No psychometric evaluations of the competency sets were found. Textual content analysis revealed inconsistent and or missing competency definitions and theoretical frameworks with competencies proliferating over time. Taxonomy analysis identified minimal competencies at higher complexity levels according to Bloom's revised taxonomy.

CONCLUSIONS

Analyzed competencies lack reliability and validity testing, making assessment difficult for PHN educators and practitioners. Multiple and competing competencies further erode PHN's visibility, even among public health nurses. With unending revisions of PHN competencies and lack of supporting evidence regarding their effect and their integration into education or practice, recommendations for future efforts are offered.