Obtaining consensus on core clinical skills for training in family medicine

Abstract

Background: Specialist registrar training in family medicine became a requirement in South Africa in August 2007. As part of the process of developing consensus on the content of training, heads of departments of family medicine agreed to a process for seeking national consensus on the skills required of a graduating family physician. A previously reported research project produced a set of skills lists that were used as the basis for this process.

Methods: The skills lists derived from the previous research were sent to all eight departments of family medicine in South Africa. The lists detailed (1) skills that should be performed independently at the end of training, (2) elective skills, (3) skills on which no consensus could be reached and (4) skills that should be performed under supervision during training. The departments were asked to discuss these skills and give consensus feedback on them, with the aim of narrowing down the lists to either (1) core or (2) elective skills.

Results: Seven of the eight departments participated. Good consensus (greater than 70%) was obtained on most skills, with confirmation of the lists of skills to be performed independently (core skills) and those that should be elective skills. Because consensus could not be obtained on reallocating many of the skills to be performed under supervision during training to either core or elective lists, it was decided to retain these as a third list of skills. The skills on which no consensus could be obtained in the prior research study were all allocated to the elective list as a result of this process.

Conclusions: The final skills lists represent the consensus of family medicine educators in South Africa and provide a basis for family medicine registrar training. They form one component of the outcomes required of graduating family physicians. A review of the lists will be required in time, as training programmes develop.