From consensus to classroom: Delphi-derived epilepsy management competencies for school teachers

Children with epilepsy are particularly vulnerable to stigma, inadequate management, and exclusion from educational opportunities, especially in low-resource school environments. Despite the high prevalence of epilepsy, current school-based educational interventions are often fragmented and lack a structured, evidence-informed framework. This study aimed to develop a competency-based epilepsy education curriculum for school teachers to enhance seizure identification, appropriate response, and inclusive classroom support.

A mixed-methods, Delphi-guided study was conducted from February to July 2024 across five diverse Indian regions (urban and rural). Curriculum development followed Kern's six-step model, informed by Social Cognitive Theory and Adult Learning Principles. A comprehensive needs assessment identified core domains, including focus group discussions, stakeholder interviews, and literature review. A 42-member multidisciplinary expert panel participated in two Delphi rounds to refine content and learning objectives. Quantitative analysis (mean scores, per cent agreement, IQR) guided item consensus classification. Reflexive thematic analysis was applied to qualitative inputs.

A comprehensive competency-based epilepsy awareness curriculum for school teachers was developed. A needs assessment involving 60 participants across three centres identified eight thematic domains, including knowledge gaps, misconceptions, emergency response limitations, communication barriers, and resource constraints. This and the literature review informed the identification of 11 curriculum domains. Expert consensus through a two-round Delphi process (n = 42) finalised ten core domains and one introductory topic. An interdisciplinary panel formulated 58 competencies and 170 SMART learning objectives. The curriculum underwent preliminary field testing, and iterative refinements were made based on feedback from end users to enhance clarity, relevance, and applicability in school settings.

A telehealth-delivered, competency-based epilepsy curriculum was developed to address key knowledge and response gaps among school teachers. Informed by stakeholder input and expert consensus, it offers a scalable, evaluable model for improving school-based epilepsy care and may inform similar interventions for other chronic conditions.