Consensus on Training and Assessment of Competence in Performing Chorionic Villus Sampling and Amniocentesis: An International Delphi Survey

Fetal Diagnosis and Therapy, vol. 48, pp. 720–737

Abstract

INTRODUCTION: The aim of this study was to obtain expert consensus on the content of a curriculum for learning chorionic villus sampling (CVS) and amniocentesis (AC) and the items of an assessment tool to evaluate CVS and AC competence. METHODS: We used a 3-round iterative Delphi process. A steering committee supervised all processes. Seven international collaborators were identified to expand the breadth of the study internationally. The collaborators invited fetal medicine experts to participate as panelists. In the first round, the panelists suggested content for a CVS/AC curriculum and an assessment tool. The steering committee organized and condensed the suggested items and presented them to the panelists in round 2. In the second round, the panelists rated and commented on the suggested items. The results were processed by the steering committee and presented to the panelists in the third round, where final consensus was obtained. Consensus was defined as support by more than 80% of the panelists for an item. RESULTS: Eighty-six experts agreed to participate in the study. The panelists represented 16 countries across 4 continents. The final list of curricular content included 12 theoretical and practical items. The final assessment tool included 11 items, systematically divided into 5 categories: pre-procedure, procedure, post-procedure, nontechnical skills, and overall performance. These items were provided with behavioral scale anchors to rate performance, and an entrustment scale was used for the final overall assessment. CONCLUSION: We established consensus among international fetal medicine experts on content to be included in a CVS/AC curriculum and on an assessment tool to evaluate CVS/AC skills. These results are important to help transition current training and assessment methods from a time- and volume-based approach to a competency-based approach which is a key step in improving patient safety and outcomes for the 2 most common invasive procedures in fetal medicine.

Authors 13

1. Vilma L. Johnsson

   Copenhagen University Hospital · Rigshospitalet

   Affiliation as printed

   Department of Fetal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

2. Martin G. Tolsgaard

   Copenhagen University Hospital · Rigshospitalet · Copenhagen Academy for Medical Education and Simulation · Capital Region of Denmark

   Affiliation as printed

   Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark, Copenhagen, Denmark

   Department of Fetal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

3. Jon Anthony Hyett

   Royal Prince Alfred Hospital

   Affiliation as printed

   Department of Women and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia

   Department of Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia

4. Ulrich Gembruch

   University of Bonn · University Hospital Bonn

   Affiliation as printed

   Department of Obstetrics and Prenatal Medicine, University Clinic Bonn, Bonn, Germany

5. Rory C. Windrim

   Mount Sinai Hospital

   Affiliation as printed

   Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada

   Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Mount Sinai Hospital, Toronto, ON, Canada

6. Asma A. Khalil

   St George's Hospital · St George's, University of London

   Affiliation as printed

   Fetal Medicine Unit, St George's University Hospitals, London, United Kingdom

   Fetal Medicine Unit, St George's University Hospitals, London, UK

7. Eleonor Tiblad

   Karolinska University Hospital

   Affiliation as printed

   Center for Fetal Medicine, Karolinska University Hospital, Huddinge, Sweden

8. Femke Slaghekke Aachen Department of Obstetrics and Fetal Medicine

   Leiden University Medical Center

   Affiliation as printed

   Department of Obstetrics and Fetal Medicine, Leiden University Medical Center, Leiden, The Netherlands

9. D. Paladini

   Istituto Giannina Gaslini

   Affiliation as printed

   Department of Fetal Medicine and Surgery, Gaslini Hospital, Genoa, Italy

10. Leizl Joy Nayahangan

    Copenhagen Academy for Medical Education and Simulation · Capital Region of Denmark

    Affiliation as printed

    Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark, Copenhagen, Denmark

11. Karin Sundberg

    Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Fetal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

12. Lone Nikoline Nørgaard

    Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Fetal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

13. Olav Bjørn Petersen

    University of Copenhagen · Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Department of Fetal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark