Key Competencies in Emergency Medicine Training in Belgium: A New Criteria-Based Evaluation Strategy

Background In French-speaking Belgium, Emergency Medicine (EM) has been a recognized professional qualification for the last two decades. Currently, there is no consensus on the core competencies required for EM postgraduates. During the six-year training period, the acquisition of technical skills (scientific knowledge and technical procedures) is emphasized, but little account is taken regarding the development of non-technical skills such as communication, collaboration, leadership, and professionalism. Furthermore, currently, there is no criteria-based assessment grid to evaluate the achievement of skills at the end of each three-month clinical rotation. The subjectivity inherent in the current evaluation process increases the inequity and variability from one clinical rotation to another. This study aimed to develop a practical tool: a criteria-based assessment grid to identify the core competencies required of EM postgraduates, help learners identify skills that have been acquired and those not yet attained, and establish an evaluation process that is equitable, objective, and uniform. Methodology Using a group facilitation technique, we developed a consensus among a panel of expert emergency department clinical rotation supervisors from three French-speaking universities. During the first phase of the study, the experts validated a list of core competencies adapted from different existing competency frameworks. The validated core competencies constituted the evaluation criteria for the assessment grid. During the second phase of the study, the experts determined the level of skill expertise expected for each of these competencies, depending on the training level of the EM postgraduate. In our assessment grid, five levels of skill expertise and three levels of EM postgraduate training were defined. Results A total of 18 Emergency department clinical rotation supervisors from the three French-speaking universities participated during the first round of the process, 12 during the second round, and 11 during the third round. Of the 81 initial competencies proposed, 78 reached consensus. For each of these competencies, the level of skill expertise was determined for the three levels of training. Conclusions A criteria-based assessment grid was developed by consensus. The grid identifies the core competencies required of EM postgraduates, integrating technical and non-technical skills. Used at the end of each clinical rotation, it determines which skills have been acquired and where gaps exist, allowing for improvements in EM training. The assessment grid promotes an evaluation that is criteria-based, objective, and uniform from one clinical rotation to another.