Development of a nationwide consensus curriculum of perioperative medicine: A modified Delphi method

Background: Although the Accreditation Council for Graduate Medical Education (ACGME) recognizes the importance of perioperative medicine and medicine consultation, there is no standardized perioperative medicine curriculum for internal medicine and primary care residents. Our objective was to design and implement a nationwide consensus curriculum of perioperative medicine for graduate medical education using a modified Delphi method. Material and methods: We adopted the five-step modified Delphi method: (1) Online survey to assess current curricula for perioperative medicine; (2) In-person meeting to decide on core topics and teaching methods; (3) focus group of 6 leaders in perioperative medicine to determine objectives, assessment tools, and draft syllabus; (4) 2nd round Delphi to draft curriculum; (5) In-person meeting to discuss and finalize curriculum. The finalized curriculum was piloted as a two-week senior internal medicine elective at an academic health science center. Results: The final consensus curriculum is based on the SHMConsults.com modules and consists of 8 objectives and 8 core topics. Assessment tools targets all levels of Miller's Pyramid and includes a pretest, multiple choice posttest, mini-CEX, and critique of written consultation note. Participants rated the curriculum high overall educational value with clear and effective modules and comprehensive and useful evaluation tools. After completing the curriculum, the participants demonstrated improved knowledge and competence for each core principle. Conclusions: This study used a modified Delphi method to develop a comprehensive curriculum for teaching perioperative medicine. The curriculum successfully increased learning competence in key skills in perioperative medicine. We hope to distribute the consensus curriculum to programs throughout the country.