Building consensus on clinical procedural skills for South African family medicine training using the Delphi technique

  • Bob Mash Stellenbosch University
  • Ian Couper University of Witwatersrand
  • Jannie Hugo University of Pretoria
Keywords: Family medicine, clinical skills, Delphi technique, postgraduate training, medical education

Abstract

Background The development of registrar training as part of the newly created speciality of family medicine in South Africa requires the development of a national consensus on the clinical procedural skills outcomes that should be expected of training programmes. Methods This study utilized a Delphi technique to establish a national consensus between 35 experts from training institutions, those already in family practice and managers who might be employing family physicians in both private and public sector contexts. Results Consensus was reached on 214 core skills at different levels of desired competency and 23 elective skills. The core skills were divided into 58 that should be taught by family physicians, 101 that should be performed independently and 55 that should be performed during training under supervision. The panel were unable to reach consensus on a further 21 skills. Conclusion This is the first study that has proposed a set of essential clinical procedural skills for the training of family physicians in South Africa. The findings will act as a benchmark for programmes in South Africa and through the new initiative of ‘FaMEC in Africa’ may influence curriculum development in other African countries. They may be used as a guide for curriculum planning, as a way of monitoring skills development and as an indication to registrars of the skills they need to achieve for assessment purposes. The findings may also inform the planning of training programmes for the proposed mid-level health worker (clinical associate) in South Africa as their skills will be a sub-set of these skills and will be taught by family physicians within district hospitals. Training programmes for undergraduates and interns in family medicine may also want to position themselves as stepping stones in line with these final outcomes of postgraduate training.

Author Biographies

Bob Mash, Stellenbosch University
MBChB DCH DRCOG MRCGP PhD Associate Professor
Ian Couper, University of Witwatersrand
MBBCh MFamMed Chair of Rural Health Department of Family Medicine University of the Witwatersrand
Jannie Hugo, University of Pretoria
MBChB MFamMed Associate Professor Department of Family Medicine University of Pretoria
Published
2006-11-12
Section
Original Research