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Purpose: Mastering technical procedures is a key component in succeeding as a newly graduated medical doctor and is of critical importance to ensure patient safety. The efficacy of simulation-based education has been demonstrated but medical schools have different requirements for undergraduate curricula. We aimed to identify and prioritize the technical procedures needed by newly graduated medical doctors.Methods: We conducted a national needs assessment survey using the Delphi technique to gather consensus from key opinion leaders in the field. In the first round, a brainstorm was conducted to identify all potential technical procedures. In the second round, respondents rated the need for simulation-based training of each procedure using the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF). The third round was a final elimination and prioritization of the procedures.Results: In total, 107 experts from 21 specialties answered the first round: 123 unique technical procedures were suggested. Response rates were 58% and 64% in the second and the third round, respectively. In the third round, 104 procedures were eliminated based on the consensus criterion, and the remaining 19 procedures were included and prioritized. The top five procedures were: (i) insert peripheral intravenous catheter, (ii) put on personal protection equipment, (iii) perform basic airway maneuvers, (iv) perform basic life support, and (v) perform radial artery puncture.Conclusion: Based on the Delphi process a final list of 19 technical procedures reached expert consensus to be included in the undergraduate curriculum for simulation-based education. Purpose: Mastering technical procedures is a key component in succeeding as a newly graduated medical doctor and is of critical importance to ensure patient safety. The efficacy of simulation-based education has been demonstrated but medical schools have different requirements for undergraduate curricula. We aimed to identify and prioritize the technical procedures needed by newly graduated medical doctors.Methods: We conducted a national needs assessment survey using the Delphi technique to gather consensus from key opinion leaders in the field. In the first round, a brainstorm was conducted to identify all potential technical procedures. In the second round, respondents rated the need for simulation-based training of each procedure using the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF). The third round was a final elimination and prioritization of the procedures.Results: In total, 107 experts from 21 specialties answered the first round: 123 unique technical procedures were suggested. Response rates were 58% and 64% in the second and the third round, respectively. In the third round, 104 procedures were eliminated based on the consensus criterion, and the remaining 19 procedures were included and prioritized. The top five procedures were: (i) insert peripheral intravenous catheter, (ii) put on personal protection equipment, (iii) perform basic airway maneuvers, (iv) perform basic life support, and (v) perform radial artery puncture.Conclusion: Based on the Delphi process a final list of 19 technical procedures reached expert consensus to be included in the undergraduate curriculum for simulation-based education.

OBJECTIVES To identify and prioritize technical procedures for simulation-based training to be integrated into the thoracic surgical curriculum. METHODS A 3-round Delphi survey was conducted from February 2022 to June 2022 among 34 key opinion leaders in thoracic surgery from 14 countries worldwide. The 1st round was a brainstorming phase to identify technical procedures that a newly qualified thoracic surgeon should be able to perform. All the suggested procedures were categorized, qualitatively analysed and sent to the 2nd round. The second round investigated: the frequency of the identified procedure at each institution, the number of thoracic surgeons that should be able to perform these procedures, the degree of risk to the patient if the procedure is performed by a non-competent thoracic surgeon and the feasibility of simulation-based education. In the 3rd round, elimination and re-ranking of the procedures from the 2nd round were performed. RESULTS Response rates in the 3 iterative rounds were 80% (28 out of 34), 89% (25 out of 28) and 100% (25 out of 25) in the 1st, 2nd and 3rd round, respectively. Seventeen technical procedures were included for simulation-based training in the final prioritized list. The top 5 procedures were Video-Assisted Thoracoscopic Surgery (VATS) lobectomy, VATS segmentectomy, VATS mediastinal lymph node dissection, diagnostic flexible bronchoscopy and robotic-assisted thoracic surgery port placement, robotic-assisted thoracic surgery docking and undocking. CONCLUSIONS The prioritized list of procedures represents a consensus of key thoracic surgeons worldwide. These procedures are suitable for simulation-based training and should be integrated in the thoracic surgical curriculum.

Additional file 1. Assessment sheet items.

OBJECTIVE This study explored the status and availability of simulation based education (SBE) for learning vascular surgical procedures identified in the 2019 General Needs Assessment in vascular surgery in Europe (GNA-2019) and identified facilitators and barriers to SBE implementation in vascular surgery. METHODS A three round iterative survey was distributed via the European Society for Vascular Surgery and the Union Européenne des Médecins Spécialistes. Members from leading committees and organisations within the European vascular surgical community were invited to participate as key opinion leaders (KOLs). Three online survey rounds explored demographics, SBE availability, and facilitators and barriers to SBE implementation. RESULTS Overall, 147 KOLs (target population 338) accepted invitation to round 1, representing 30 European countries. The dropout rates for rounds 2 and 3 were 29% and 40%, respectively. Most respondents (88%) were senior, on consultant level or higher. No mandatory SBE training was required in their department before training on patients, according to 84% of the KOLs. There was a high consensus on the need for structured SBE (87%) and mandatory SBE (81%). SBE is available for the top three prioritised procedures in GNA-2019 (basic open skills, basic endovascular skills, and vascular imaging interpretation) in 24, 23, and 20 of the 30 represented European countries, respectively. The highest ranking facilitators were structured SBE programmes, availability of simulation equipment locally and regionally, good quality simulators, and having a dedicated person running the SBE. The highest ranked barriers were lack of structured SBE curriculum, equipment costs, lack of "SBE culture", no or limited dedicated time for faculty to teach in SBE, and clinical work overload. CONCLUSION Based largely on the opinions of KOLs in vascular surgery in Europe, this study revealed that SBE is needed in vascular surgery training and that systematic and structured programmes are required to ensure successful implementation.

Additional file 2. Complete list of equipment.

Background and Objectives: During recent years, the demand for EUS has increased. However, standardized training programs and assessments of clinical quality measures are lacking. We therefore aimed to establish a basic curriculum for EUS fellows that includes a prioritized list of interpretational capabilities and technical skills. Materials and Methods: International key-opinion leaders were invited to participate in a Delphi process. An electronic three-round iterative survey was performed to attain consensus on skills that 70% of the participants found either very important or essential for a newly graduated endosonographer. Results: Of 125 invited experts, 77 participated in the survey. Initially, 1,088 skills were suggested, resulting in a core curriculum containing 29 interpretational skills and 12 technical skills. The top-five interpretation skills included abilities to discern between normal anatomy and pathology, to identify the entire pancreas and ampullary region, to identify solid versus fluid-filled structures, to detect bile duct and gallstones, and to identify a pancreatic mass of 5 mm or larger. For technical skills, ability to insert the endoscope from the mouth to the second part of duodenum, to obtain FNA adequately and safely, to navigate the scope tip to follow anatomical landmark structures, to achieve endoscopic position of each of the four stations, and to perform passage of the scope past a hiatal hernia were given the highest ranking. Conclusions: After a structured Delphi process involving 77 international experts, a consensus was reached for a basic curriculum for EUS fellows to be included during training.

Background and Objectives: EUS has become a very frequently used procedure for both diagnostic and therapeutic indications. However, skilled operators are essential for improved outcomes and patient safety which make efficient training and certification programs essential. Our aim was to explore the acquisition and assessment of EUS competencies in China as practiced in the past, today, and in the future. Methods: We identified key opinion leaders (KOLs) from hospitals in different cities in China. Each KOL answered 43 questions regarding demographics and EUS experience, their learning experience as a trainee, experience as a supervisor, and their thoughts about current and future training. Descriptive statistics were used for reporting the results. Results: Eleven men and five females from eight major Chinese cities (Beijing, Changsha, Chengdu, Chongqing, Guangzhou, Shanghai, Shenzhen, and Wuhan) were included. They offered a good variance regarding age (33-53 years old), EUS experience (½-20 years), and performed procedures (20-6000 procedures). Most (n = 13) learned EUS through apprenticeship training model but three were self-taught. The KOLs also used the apprenticeship model to train their own trainees. First, they demonstrated EUS for median 2 months before their trainees took over the scope and performed a median 50 supervised procedures during a median of 3 months. Then they were allowed to perform EUS procedures independently. Simulation-based training and standardized assessment of competence were used very sparingly, but most of the KOLs wanted to shift towards these contemporary methods in the future. Conclusions: The classical apprenticeship training is still used to learn EUS in China and the amount of training required before being allowed to practice independently varies considerably. Several of the KOLs requested improved conditions for training and wanted a standardized curriculum leading to certification of new EUS operators based on a valid assessment of competence.

Intro: Chest Tube Insertion (CTI) should be trained in simulated settings prior to patient contact. Feedback and certification is based on valid assessments, especially in simulation-based training. This study aimed to develop a novel assessment tool for CTI and to ensure content validity based on expert opinion collected through a structured Delphi study. Methods: A diverse European expert panel was invited to participate. In round 1, the experts provided at least five procedural steps and three errors involved in CTI. Round 2 evaluated the level of agreement with the inclusion of each item in the assessment tool on a five-point Likert scale. In round 3, experts rated their agreement on inclusion of the procedural step with its descriptive anchors. Consensus was reached when >= 80% of participants agreed on an item's inclusion. Results: Thirty-six of 105 (34%) invited surgeons (26/75, 35%), pulmonologists (8/23, 35%) and emergency physicians (2/7, 29%) participated. The overall response rate was 81% (29/36): 100% (36/36) in round 1, 83% (30/36) in round 2, and 97% (29/30) in round 3. Round 1 resulted in 23 steps and 44 errors after condensation and removal of duplicates. In round 2 consensus was achieved for 15 steps (65%) and 14 errors (32%). Nineteen steps were adapted into a rating scale with descriptive anchors and a list of 16 errors was presented to the panel. In round 3, experts reached consensus on the inclusion of 17 procedural steps (89%) with descriptive anchors and on all 16 errors. Conclusion: A multidisciplinary expert panel achieved consensus in the development of the ACTION (Assessment of Competence in Chest Tube Insertion) tool. This procedure-specific rating scale of 17 steps, supplemented with a checklist of 16 errors, requires further research to collect validity evidence.

Additional file 2. Full search strategy.

Additional file 3. Data extraxtion.

Additional file 1. General search strategy.

Additional file 1. Examples of the simulator-generated feedback of passed and failed simulated procedures at different competency levels.

The appendix includes an overview of the scoring instruments, flowchart for collecting validity evidence, analysis of individual item scores and results of the generalizability analysis. (PDF 626 kb)