Validating competencies for an undergraduate training program in rural medicine using the Delphi technique

Area of Science:

• Medical Education
• Rural Health
• Competency-Based Training

Background:

• Globally, rural and remote areas face a shortage of healthcare professionals, with less than 25% of doctors serving these regions.
• Brazil's vast size and diversity highlight the need for specialized medical training programs for rural and remote practice.
• Limited opportunities exist in Brazilian medical schools for students to gain experience in rural medicine.

Purpose of the Study:

• To develop a comprehensive framework of competencies for a longitudinal rural medicine training program.
• To integrate this framework into the broader medical education curriculum in Brazil.
• To address the disparity in healthcare access in rural and remote Brazilian communities.

Main Methods:

• A modified Delphi technique was employed with 20 specialists from the Brazilian Society of Family and Community Medicine's Rural Medicine Working Party.
• A literature-based questionnaire assessed the relevance of core and secondary competencies using a five-point Likert scale.
• Consensus was defined as 'very important' or 'indispensable' by a simple majority; exclusion required a simple majority deeming it 'should not be included' or 'of little importance'.

Main Results:

• All 26 core competencies were validated as relevant.
• 158 secondary competencies were established after consensus evaluation.
• Eight secondary competencies initially lacked consensus, with seven ultimately excluded, primarily those related to hospital procedures.

Conclusions:

• A validated framework of 26 core and 158 secondary competencies for rural medicine programs has been developed.
• This framework provides a foundation for creating competency-based curricula in rural medicine for Brazilian medical education.
• The study contributes to improving medical training for practice in underserved rural and remote areas of Brazil.