A Nationwide Needs Assessment to Identify and Prioritize Technical Procedures for Simulation in Obstetrics and Gynaecology: A Delphi Study.

Abstract

The aims of the study were to identify and prioritize technical procedures that should be developed and integrated in a simulation-based curriculum for obstetrics and gynaecology residents. The Delphi method was used, consisting of three rounds of survey questionnaires. Key leaders across Denmark were invited to participate. In Delphi round 1, the participants individually identified technical procedures that newly authorized specialists should be able to perform. These procedures were sent to round 2 to be explored for need for simulation-based training by estimating frequency of procedures, number of doctors, potential patient risk and/or discomfort, and feasibility of simulation. Round 3 consisted of elimination and prioritization of remaining procedures (Canadian Task Force Classification III). A total of 165 key leaders were invited. Response rates were 61%, 50%, and 53%, respectively. Identified procedures in Round 1 were as follows: gynaecology (n = 51), obstetrics (n = 40), and general procedures (n = 10). A needs assessment formula was used to calculate needs for training on the basis of the answers in round 2 and produce a preliminary prioritized list that was sent to round 3 for final exploration. Round 3 consisted of elimination and final prioritization, where gynaecology (n = 17) prioritized basic laparoscopy, vaginal ultrasound, and laparoscopy with salpingostomy and salpingectomy; obstetrics procedures (n = 16) prioritized basic resuscitation of newborn, vacuum extraction, and management of shoulder dystocia; and one general procedure (basic adult resuscitation) was included. A needs assessment using the Delphi method produced a prioritized list of technical procedures suitable for simulation. This can guide the development of simulation-based training programs.