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Defining minimum expected competencies for orthopaedic surgery residency training in Chile: A national Delphi
Rodrigo Guiloff1,2,3, David Figueroa4,5, Ignacio Seitz4
1Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile. rguiloff@gmail.com.
Purpose:
To establish a national consensus on the minimum expected competencies that orthopaedic surgery residents in Chile should achieve by the end of training, providing a foundation for competency-based curriculum development in comparable training contexts.
Methods:
A multicentre modified Delphi study was conducted involving academic leaders from orthopaedic residency programmes across Chile. An initial round of open-ended questions among programme directors generated draft competency statements, which were refined through two subsequent rounds using a 5-point Likert scale. Consensus was predefined as ≥ 80% agreement (ratings of 4 or 5) with an interquartile range ≤ 1. Competencies were organised into six ACGME core competencies and one CanMEDS role.
Results:
Twenty-eight experts completed the final rounds. Consensus was achieved on 32 competency statements spanning patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, system-based practice, and scholar-research. Agreement was observed for non-procedural competencies and foundational surgical skills. In contrast, consensus was not reached regarding autonomy, even under supervision, for advanced surgical procedures, particularly arthroplasty and selected soft-tissue procedures. Qualitative feedback attributed disagreement to patient-safety considerations, procedural complexity, and differing views on the boundary between residency and fellowship-level competence.
Conclusions:
This national Delphi study establishes the first consensus-based definition of minimum expected competencies for orthopaedic surgery residency training in Chile. The resulting framework provides a shared reference aligned with international competency-based principles while remaining responsive to local training contexts, and is intended to inform educational development and accreditation discussions in similar training settings rather than mandate a uniform training model.
