Table 2.
Competencies from Delphi round 2
| 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 |
a Items with overlapping subjects with other current third-year courses
bItems with median ≤ 3
cItems excluded due to potential misunderstanding of phrasing