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Introduction <p>Low anaesthesia workforce numbers contribute to shortfalls in access to surgical care globally. Investment in contextualised education and training can help address this issue by inspiring graduates to enter into training and imparting important knowledge and skills to non-specialists. We undertook a modified Delphi study to identify physician anaesthesiologist consensus on themes, topics, and skills for inclusion in undergraduate anaesthesia and critical care (ACC) medical school curricula in sub-Saharan Africa (SSA) and Rwanda.</p> Methods <p>A list of ACC topics/skills was compiled through grey literature review, guiding survey development for a 3-round Delphi process. The first two rounds solicited responses from physician anaesthesiologists across SSA. The final round included only Rwandan physician anaesthesiologists. Respondents rated topics/skills on a 4-point Likert scale from 1 (“exclude from the curriculum”) through 4 (“essential for inclusion”). Item-level Content Validity Index (I-CVI, the proportion of respondents rating a topic/skill as 3 or 4) was used for stratification. A first-round I-CVI threshold of 80% and 70% for subsequent rounds was used to define consensus for inclusion. Excluded topics/skills were considered for re-inclusion in subsequent rounds; 50% agreement was set as threshold for re-inclusion. The first round also sought consensus regarding aims, objectives, and delivery methodology.</p> Results <p>A total of 147 topics/skills across 12 domains were identified for initial survey inclusion.</p> <p>Fifty-one respondents from 12 countries completed round one. Ninety-six (65.3%) topics/skills met consensus threshold. One additional skill (“pain assessment”) was incorporated into round two following suggestions from respondents. The clerkship outcome ranked as most important and achievable was to ‘inspire students to undertake anaesthesia specialty training’ (n = 25, 49.0% and n = 26, 51.0% respectively). Thirty-six respondents from 12 countries completed round two. Eighty (82.5%) topics/skills met consensus threshold. Seventeen Rwandan specialists completed round three. Seventy-eight (97.5%) topics/skills met consensus threshold. From 67 previously excluded topics/skills, 14 (20.9%) met re-inclusion threshold.</p> Discussion and conclusion <p>A modified Delphi process identified 92 essential topics/skills for inclusion in a Rwandan undergraduate ACC clerkship. Experts prioritised ‘inspiring students’ over ‘achieving clinical competence’ for undergraduates. A similar Delphi approach may be useful for educational content development in other settings across the African continent and for other specialties.</p> Trial registration <p>Not applicable (study described is not a clinical trial).</p> <p>UGHE IRB protocol number: 194.</p>

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Identification of essential topics and procedural skills for inclusion in a contextualised undergraduate anaesthesia and critical care clerkship in Rwanda: results of a modified Delphi process

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  • 发表日期：

    2025年4月7日

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  • Callum Forbes,
  • Bruce Mutembe Nzobele,
  • Barnabas T. Alayande,
  • Françoise Nizeyimana,
  • Jean Paul Mvukiyehe,
  • Jocelyn M. Booth,
  • Selam Degu Woldegiorgis,
  • Benoucheca Pierre,
  • James Littlejohn,
  • Sheida Tabaie,
  • Abebe Bekele,
  • Craig D. McClain,
  • Gaston Nyirigira,
  • Ahmed Rhassane El Adib,
  • Alain Irakoze,
  • Alhassan Datti Mohammed,
  • Allan Kochi,
  • Ansbert Ndebea,
  • Bisola Onajin-Obembe,
  • Brigitte Kalala Mwadi,
  • Chabiya Bala,
  • Christian Ndaribitse,
  • Claude Gakumba,
  • Dagmawi Tsegaye Bekele,
  • David Nekyon,
  • Diriba Fayisa,
  • Edwin Lugazia,
  • Egide Buregeya,
  • Elizabeth Igaga,
  • Eric Vreede,
  • Fred Bulamba,
  • Fredson Mwiga,
  • Hamisu Yakubu,
  • Hitayezu Donatien,
  • Ibironke Desalu,
  • Jackson Kwizera Ndekezi,
  • Jean Claude Uwimana,
  • Jean de Dieu H. Tuyishime,
  • Lankoandé Martin,
  • Lemi Bayisa,
  • Lomangisi Dlamini-Sserumaga,
  • Marie Goretti Hategekimana,
  • Michel Manika Muteya,
  • Mpoki Ulisubisya,
  • Mwemezi Kaino,
  • Naol Bekalu Terfasa,
  • Ntegerejuwampaye Angelique,
  • Nyandwi Jean Damascène,
  • Obashina Ogunbiyi,
  • Olubusola Alagbe-Briggs,
  • Saheed Adesope,
  • Senait Kifle,
  • Thierry Rwibutso,
  • Tsega Firdu Gebretsadik,
  • Tsegay Gesesew Mesfin,
  • Tuma Kasole,
  • Twisungane Protogene,
  • Uwineza Jean Bonaventure

摘要

Introduction

Low anaesthesia workforce numbers contribute to shortfalls in access to surgical care globally. Investment in contextualised education and training can help address this issue by inspiring graduates to enter into training and imparting important knowledge and skills to non-specialists. We undertook a modified Delphi study to identify physician anaesthesiologist consensus on themes, topics, and skills for inclusion in undergraduate anaesthesia and critical care (ACC) medical school curricula in sub-Saharan Africa (SSA) and Rwanda.

Methods

A list of ACC topics/skills was compiled through grey literature review, guiding survey development for a 3-round Delphi process. The first two rounds solicited responses from physician anaesthesiologists across SSA. The final round included only Rwandan physician anaesthesiologists. Respondents rated topics/skills on a 4-point Likert scale from 1 (“exclude from the curriculum”) through 4 (“essential for inclusion”). Item-level Content Validity Index (I-CVI, the proportion of respondents rating a topic/skill as 3 or 4) was used for stratification. A first-round I-CVI threshold of 80% and 70% for subsequent rounds was used to define consensus for inclusion. Excluded topics/skills were considered for re-inclusion in subsequent rounds; 50% agreement was set as threshold for re-inclusion. The first round also sought consensus regarding aims, objectives, and delivery methodology.

Results

A total of 147 topics/skills across 12 domains were identified for initial survey inclusion.

Fifty-one respondents from 12 countries completed round one. Ninety-six (65.3%) topics/skills met consensus threshold. One additional skill (“pain assessment”) was incorporated into round two following suggestions from respondents. The clerkship outcome ranked as most important and achievable was to ‘inspire students to undertake anaesthesia specialty training’ (n = 25, 49.0% and n = 26, 51.0% respectively). Thirty-six respondents from 12 countries completed round two. Eighty (82.5%) topics/skills met consensus threshold. Seventeen Rwandan specialists completed round three. Seventy-eight (97.5%) topics/skills met consensus threshold. From 67 previously excluded topics/skills, 14 (20.9%) met re-inclusion threshold.

Discussion and conclusion

A modified Delphi process identified 92 essential topics/skills for inclusion in a Rwandan undergraduate ACC clerkship. Experts prioritised ‘inspiring students’ over ‘achieving clinical competence’ for undergraduates. A similar Delphi approach may be useful for educational content development in other settings across the African continent and for other specialties.

Trial registration

Not applicable (study described is not a clinical trial).

UGHE IRB protocol number: 194.