Table 2 Competencies from Delphi round 2
From: A Delphi consensus study for teaching “Basic Trauma Management” to third-year medical students
Coding | Item | Median (IQR) | Agreement (%) | Result |
|---|---|---|---|---|
Triage | Know how to conduct preclinical triage | 3.5 (2.75–4) | 50.0 | |
Know how to conduct In-hospital triage | 4 (2–4) | 61.1 | ||
Demonstration of triage in a workshop | 4 (2.75–4.25) | 61.1 | ||
Do triage | 3 (2.75–4) | 38.9 | bExcluded | |
Structured approach | Describe the ABCDE algorithm to assess a trauma patient | 5 | 100 | Consensus |
Perform a secondary survey | 4 (3–5) | 72.2 | ||
Be able to describe the ABCDE sequence of trauma | 5 (4–5) | 100 | Consensus | |
Do a primary survey according to the ABCDE approach | 5 | 100 | Consensus | |
Have a structured approach to the patient | 5 | 100 | Consensus | |
Treat only what needs to be treated, fast | 4 (4–5) | 88.8 | ||
Why the ABCDE is important: “To treat first what kills first” | 5 | 100 | Consensus | |
Which problems to identify in primary and secondary survey | 5 (4–5) | 83.4 | Consensus | |
Management general | Diagnose and treat life-threatening conditions | 5 (3.75–5) | 77.8 | Consensus |
Treat hemorrhagic shock | 5 (4–5) | 88.9 | Consensus | |
Teach/refresh the BLS | 5 (4–5) | 83.4 | Consensus | |
Treatment of massive bleeding | 4,5 (4–5) | 88.9 | ||
Diagnostic tools in trauma management | 3 (3–4) | 44.4 | bExcluded | |
Trauma cinematics | 3.5 (2,75–5) | 50 | bExcluded | |
Be able to discuss the reason why ATLS is structured the way it is, with its benefits and pitfalls | 4 (3–5) | 72.2 | ||
Be able to stop the bleeding | 5 (4–5) | 100 | Consensus | |
What to do as first responder | 4 (3–5) | 72.2 | ||
Process of treatment of trauma patients from triage to definitive care | 3 (2–4) | 33.4 | bExcluded | |
The AMPLE | 4 (3–5) | 88.9 | ||
Use oxygen correctly | 5 (3.75–5) | 77.8 | Consensus | |
Assessment of vital signs | 5 (4–5) | 100 | Consensus | |
Technical skill | Basic knowledge of immobilization techniques | 5 (4–5) | 88.9 | Consensus |
Indications, contra-indications, advantages and disadvantages of immobilization techniques | 4 (3.75–4) | 77.8 | ||
Immobilization skills | 4 (3.75–5) | 77.7 | ||
Demonstrate and use material for the management of trauma patients | 4 (3–5) | 72.2 | ||
Thorax drain insertion demonstration | 3 (1.75–3.25) | 22.2 | bExcluded | |
Pelvic sling use | 5 (3.75–5) | 77.8 | Consensus | |
Airway management | 4 (2.75–5) | 61.1 | aExcluded | |
At the end of the course, students should be able to perform a simulated scenario | 4 (4–5) | 94.5 | ||
Perform bag-mask ventilation | 4 (3.75–5) | 77.7 | ||
Perform the airway management specific to trauma (MILS) | 4 (2–4) | 55.1 | ||
Perform HWS immobilization | 5 (4–5) | 88.9 | Consensus | |
Demonstrate the immobilization of a conscious trauma victim including extrication collar and pelvic binder | 4 (4–5) | 83.3 | ||
Demonstrate immobilization techniques and consequences for clinical work | 4 (3–5) | 72.2 | ||
Adequate handling of the spine, check that no danger threatens, since a paralysis is a problem | 66.6 | cExcluded | ||
Immobilization with extrication collar | 4 (4–5) | 94.4 | ||
Immobilization with vacuum mattress | 4 (4–4.25) | 83.3 | ||
Use of the scoop stretcher | 4 (3–4) | 61.1 | ||
Use of the spine board | 4 (3–4) | 72.3 | ||
Perform a log-roll | 4 (4–5) | 94.5 | ||
Perform an E-FAST | 3 (1–4) | 38.9 | bExcluded | |
Management specific | Tourniquet use | 4 (3–4.25) | 66.6 | |
Assessment of minor musculoskeletal trauma | 3 (2–4) | 27.8 | bExcluded | |
Assessment of traumatic brain injury | 4 (3–5) | 72.2 | ||
Wound care | 3 (2–4) | 44.4 | bExcluded | |
Aspects not included in ATLS, like coagulation aspects of trauma, use of painkillers | 3 (2–4) | 38.9 | bExcluded | |
Be able to discuss the pathophysiological changes in hypovolemic patients (why look at lactate and pH, not hemoglobin?). | 4 (3–4.25) | 66.6 | ||
Know the basics of diagnosis and treatment of different kinds of trauma (e.g., head, abdomen, thoracic, spinal, extremities) | 4 (3–5) | 66.7 | ||
To correlate trauma cinematics with potential lesions | 4 (3–4) | 61.1 | ||
Wound care | 3 (2–4) | 27.1 | bExcluded | |
Manage massive bleeding and perform the needle decompression of tension pneumothorax, because it saves lives | 4 (2–5) | 61.1 | cExcluded | |
Perform sutures | 1.5 (1–3) | 16.7 | bExcluded | |
Discuss the limitations of trauma care for the elderly | 3 (2–4) | 38.9 | bExcluded | |
Organization and reporting of the trauma scene | 3 (2–4) | 72.2 | bExcluded | |
Transport | Transport to adequate hospital | 4 (3–5) | 61.1 | |
Stay and play vs scoop and run | 4 (3–5) | 72.2 | ||
Safely transport a trauma patient | 4 (2–4) | 55.5 | ||
Human factor | Teach non-technical skills (leadership, membership, situational awareness) | 4 (3–5) | 61.1 | |
Teach about decision-making | 4 (3–5) | 66.6 | ||
Empowerment of students in the classroom | 4 (3–4) | 66.7 | ||
Teach about teamwork | 4 (4–5) | 83.4 | ||
Establish clear communication | 4 (3.75–5) | 77.7 | ||
Work as a team member | 4 (3.75–5) | 77.7 | ||
Be able to call for help properly | 4 (3.75–5) | 88.9 | ||
Coordination of different professional groups in an emergency | 3 (2–3.5) | 72.2 | bExcluded | |
Have communication skills | 5 (4–5) | 88.9 | Consensus | |
Correctly communicate in a handover | 4 (3–5) | 66.6 | ||
Coordinate team members | 3.5 (3–4) | 50.0 | ||
Be able to lead a trauma situation | 3 (2–3.25) | 22.3 | bExcluded | |
Be a good team player | 4.5 (4–5) | 88.9 | ||
Learn to prioritize | 4.5 (4–5) | 94.0 | ||
Be aware of own limitations | 5 (4–5) | 100 | Consensus | |
Be able to communicate clearly | 5 (4–5) | 94.4 | Consensus | |
Be capable of decision-making | 4 (3–4.25) | 72.2 | ||
Stay calm | 4 (3.75–5) | 77.7 | ||
Speak up | 4 (4–5) | 83.3 | ||
Security | Maintain safety of self, team, and patient | 5 (3.75–5) | 77.8 | Consensus |
Call for help properly and assess your security | 5 (4–5) | 94.5 | Consensus | |
Secure the place and self | 5 (4–5) | 83.4 | Consensus | |
Be able to assess your own security in the emergency location | 5 (4–5) | 88.9 | Consensus | |
Knowledge | The script of the BTM course Bern | 4 (3–4.25) | 72.2 | cExcluded |