Defining minimum expected competencies for orthopaedic surgery residency training in Chile: A national Delphi consensus.
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Ошибки и ограничения
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Guiloff Rodrigo, Figueroa David, Seitz Ignacio, Arteaga José Tomás, Armijo-Rivera Soledad, Irarrázaval Sebastián, Toro Felipe, Moraga Claudio, Izquierdo Guillermo, Yurac Ratko, Zamorano Juan José, Molina Marcelo, Valencia Manuel, Moya Luis, Besomi Javier, Calvo Rafael, Vaisman Alex, Schmidt-Hebbel Andrés, Arellano Sergio, Keller Andrés, Hodgson Felipe, Orrego Mario, Besa Pablo, De Marinis Rodrigo, Baar Alejandro, Ekdahl Max, Barra Emilio, Pizarro Felipe, Troncoso Abelardo, Valiente Diego, Munjin Aleksander, Vergara Pamela, Piga Camilo, Chávez Jorge
Аннотация
METHODS: A multicentre modified Delphi study was conducted involving academic leaders from orthopaedic residency programmes across Chile. An initial round of open-ended questions among programme directors generated draft competency statements, which were refined through two subsequent rounds using a 5-point Likert scale. Consensus was predefined as ≥ 80% agreement (ratings of 4 or 5) with an interquartile range ≤ 1. Competencies were organised into six ACGME core competencies and one CanMEDS role.
RESULTS: Twenty-eight experts completed the final rounds. Consensus was achieved on 32 competency statements spanning patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, system-based practice, and scholar-research. Agreement was observed for non-procedural competencies and foundational surgical skills. In contrast, consensus was not reached regarding autonomy, even under supervision, for advanced surgical procedures, particularly arthroplasty and selected soft-tissue procedures. Qualitative feedback attributed disagreement to patient-safety considerations, procedural complexity, and differing views on the boundary between residency and fellowship-level competence.
CONCLUSIONS: This national Delphi study establishes the first consensus-based definition of minimum expected competencies for orthopaedic surgery residency training in Chile. The resulting framework provides a shared reference aligned with international competency-based principles while remaining responsive to local training contexts, and is intended to inform educational development and accreditation discussions in similar training settings rather than mandate a uniform training model.