Determination of Adult Critical Care Physician Core Knowledge and Skills: Results of a Multidisciplinary, Modified Delphi Process

Abstract

Objectives: In the United States, training for physicians who manage critically ill adult patients (intensivists) evolved through parallel subspecialty critical care medicine (CCM) pathways with significant commonality. The Society of Critical Care Medicine Adult Critical Care Physician Core Knowledge and Skills Task Force aimed to delineate the common core knowledge and skills required of all intensivists. Design: A master list of content areas and procedural skills was compiled from all CCM subspecialty program requirements and blueprints of the certification examinations. Using a modified Delphi approach, participants were asked to categorize the knowledge items as “advanced knowledge is essential,” “general, but not advanced, knowledge is essential,” or “knowledge is not essential.” Procedures were categorized as “intensivist performs routinely,” “intensivist only performs in an emergency,” or “intensivist knows” about the procedure. Setting: Representatives from CCM stakeholder organizations, including accreditation and certification organizations, critical care societies, and program directors’ societies, were invited to participate. SUBJECTS: Members of the Adult Critical Care Physician Core Knowledge and Skills Task Force of the Society of Critical Care Medicine. Interventions: For the first two rounds of the modified Delphi process, Research Electronic Data Capture was used. For the third and fourth rounds, the process was completed through online meetings with Zoom (Zoom Video Corporations, San Jose, CA) utilizing Zoom’s polling feature. Measurements and Main Results: A total of 541 items were determined to be essential, with 145 requiring advanced knowledge and 323 requiring general knowledge. For 73 items, consensus regarding advanced vs. general could not be achieved, but they remained essential. Only eight items were felt to be nonessential. Of the 16 procedures, most were categorized as “intensivist performs.” Conclusions: The large number of items included in the list of essential knowledge and skills demonstrates the complexity of modern CCM. Utilization of a common framework across the subspecialties of CCM could lead to greater harmonization among the fellowship program requirements and certification examinations.

Affiliated Institutions

• Harvard University US
• Temple University US
• University of California, Los Angeles US
• Inova Fairfax Hospital US
• University of Virginia US
• Shriners Hospitals for Children - Northern California US
• University of Alabama at Birmingham US
• Indiana University – Purdue University Indianapolis US
• Emory University US
• University of California, Davis US
• California State University, Fresno US
• University of Toledo US
• Duke University US
• MaineHealth US
• Cleveland Clinic US
• Massachusetts General Hospital US
• University of Maryland, Baltimore US
• University of Pittsburgh US
• University of Iowa US
• Medical College of Wisconsin US
• University of Florida US
• Columbia University US
• University of Michigan US
• John H. Stroger, Jr. Hospital of Cook County US
• University of Southern California US
• Cooper University Hospital US
• University of California, San Francisco US
• Washington University in St. Louis US
• Mayo Clinic in Arizona US
• WellSpan Health US
• Society of Critical Care Medicine US
• Wilmington University US

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