Developing a national competency framework for pediatric hospital medicine in Canada using the Delphi method

Area of Science:

• Pediatric Hospital Medicine
• Medical Education
• Competency Frameworks

Background:

• Pediatric Hospital Medicine (PHM) has grown significantly in North America due to increasing pediatric inpatient complexity.
• The United States has a PHM Core Competencies framework, but Canada lacks a national standard.
• This absence creates ambiguity in defining the scope of practice and training for Canadian PHM.

Purpose of the Study:

• To define the scope of practice and essential competencies for Pediatric Hospital Medicine in Canada.

Main Methods:

• Delphi methodology was employed with a national panel of PHM experts.
• Experts iteratively rated competencies on a 5-point scale to determine priority.
• Consensus was defined as Cronbach's α ≥0.95, with ≥80% of panelists rating competencies ≥4 for inclusion.

Main Results:

• Two rounds of the Delphi process were needed to achieve consensus.
• Thirty-five panelists from 13 Canadian tertiary and 5 community hospitals participated.
• 109 PHM competencies were identified, spanning the seven CanMEDS roles.

Conclusions:

• This study establishes the first national competency framework for PHM in Canada.
• The identified competencies offer a guide for PHM fellowship program directors to develop curricula.
• These results can inform the creation of comprehensive national PHM fellowship curricula.