Core competencies in critical care for general medical practitioners in South Africa: A Delphi study

S D Maasdorp; F Paruk; K de Vasconcellos; C Grion; I Joubert; G M Joynt; N Kalafatis; S E Lapinsky; J Lipman; M L N G Malbrain; B Mrara; G A Richards; M G L Spruyt; E van der Merwe; J L Vincent; L J van der Merwe

doi:10.7196/SAJCC.2023.v39i3.1261

Core competencies in critical care for general medical practitioners in South Africa: A Delphi study

South Afr J Crit Care. 2023 Dec 13;39(3):e1261. doi: 10.7196/SAJCC.2023.v39i3.1261. eCollection 2023.

Authors

S D Maasdorp¹, F Paruk², K de Vasconcellos³, C Grion⁴, I Joubert⁵, G M Joynt⁶, N Kalafatis³, S E Lapinsky⁷, J Lipman⁸, M L N G Malbrain⁹, B Mrara¹⁰, G A Richards¹¹, M G L Spruyt¹², E van der Merwe¹³, J L Vincent¹⁴, L J van der Merwe¹⁵

Affiliations

¹ Division of Pulmonology and Critical Care, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
² Department of Critical Care, Faculty of Health Sciences, University of Pretoria, South Africa.
³ Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
⁴ Department of Clinical Medical, Hospital Universitári, Universidade Estadual de Londrina, Brazil.
⁵ Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
⁶ Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, China.
⁷ Department of Critical Care, Faculty of Medicine, University of Toronto, Canada.
⁸ Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, University of Queensland, Brisbane, Australia; and Nimes University Hospital, University of Montpellier, Nimes, France.
⁹ First Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Lublin, Poland.
¹⁰ Department of Anaesthesia, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa.
¹¹ Department of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹² Division of Critical Care, Department of Surgery, University of the Free State, Bloemfontein, South Africa.
¹³ Department of Critical Care, Livingstone Hospital, Gqeberha, South Africa.
¹⁴ Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Belgium.
¹⁵ Division of Health Sciences Education, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.

Abstract

Background: Despite a high burden of disease that requires critical care services, there are a limited number of intensivists in South Africa (SA). Medical practitioners at district and regional public sector hospitals frequently manage critically ill patients in the absence of intensivists, despite these medical practitioners having had minimal exposure to critical care during their undergraduate training.

Objectives: To identify core competencies in critical care for medical practitioners who provide critical care services at public sector hospitals in SA where intensivists are not available to direct patient management.

Methods: A preliminary list of core competencies in critical care was compiled. Thereafter, 13 national and international experts were requested to achieve consensus on a final list of core competencies that are required for critical care by medical practitioners, using a modified Delphi process.

Results: A final list of 153 core competencies in critical care was identified.

Conclusion: The core competencies identified by this study could assist in developing training programmes for medical practitioners to improve the quality of critical care services provided at district and regional hospitals in SA.

Contribution of the study: The study provides consensus on a list of core competencies in critical care that non-intensivist medical practitioners managing critically ill patients in healthcare settings in South Africa, especially where intensivists are not readily available, should have. The list can form the core content of training programmes aimed at improving critical care competence of general medical practitioners, and in this way hopefully improve the overall outcomes of critically ill patients in South Africa.

Keywords: Core competencies; Delphi; medical practitioners.