Identifying Essential Procedural Skills for Medical Students: A Modified Delphi Technique

Although Sri Lankan medical students need to acquire specific procedural skills during their undergraduate training, agreement on what skills they should obtain is inconclusive. This study aimed to generate consensus of the expert panel on essential procedural skills and level of expertise to be attained for Sri Lankan medical students and need for developing and implementing a pre-clerkship procedural training curriculum to improve procedural expertise.

A three-round online modified Delphi study was conducted between August 2022 and January 2023. The initial questionnaire was developed from existing student logbooks and published literature. Round one invited the expert panel to rate their agreement on the inclusion of essential procedures for undergraduate medical training. In Round two, the panel rated their expectation of procedural expertise for a medical graduate on the first day of internship (ie, Observer to Proficient). Round three established the consensus on the need for a pre-clerkship procedural curriculum.

The expert panel included 17 clinicians involved in undergraduate medical education and supervision of intern medical doctors. In Round 1, they rated their agreement on including teaching of 64 procedures and suggested four additional procedures. In Round 2, experts re-appraised 33 items and rated the level of procedural expertise. In Round 3, experts re-appraised the ratings of 14 essential procedures and rated the support for a pre-clerkship procedural curriculum for medical students. Consensus defined as > 75% agreement was established with 35 essential procedural skills. Most of the experts expressed the need for a pre-clerkship procedural curriculum for medical students.

Through three rounds of modified Delphi, the current study established 35 procedural skills essential for a Sri Lankan medical graduate. The results also support the need for developing and implementing a pre-clerkship procedural training curriculum to improve procedural expertise of graduating doctors which demonstrate the importance of aligning existing medical curricula with competency-based medical education.