Identification of Essential Steps in Outlet Forceps-Assisted Vaginal Delivery: A Delphi Study.

OBJECTIVE: To achieve expert consensus using the Delphi methodology on the sub-steps considered essential in an outlet forceps-assisted vaginal delivery (FAVD). The purpose of this work is to help inform a framework for standardized training and objective assessment in the procedure. METHODS: A Delphi survey was conducted with an international panel of experts in FAVD. Using an online platform, experts rated sub-steps of FAVD on a 5-point Likert scale to indicate whether they considered them essential. Responses were returned to the panel until consensus was reached (Cronbach α ≥ 0.80) with an intraclass correlation coefficient ≥0.75. All sub-steps with a rate of agreement ≥80% are proposed to be included in a future evaluation instrument. RESULTS: After the first iteration of the Delphi procedure, a response rate of 42% was reached (n = 21); the second iteration was only sent to those who had participated in the initial iteration, reaching a response rate of 100%. Of 42 sub-steps rated in the first round, 24 (57.1%) achieved consensus, 8 (19%) were rejected, and 10 (23.8%) were re-rated in the second round. After 2 iterations, 28 sub-steps were agreed upon by the experts to be essential in FAVD. CONCLUSIONS: A panel of experts identified a total of 28 sub-steps essential to FAVD. This list could inform the development of an objective assessment framework and evaluation tool for this procedure. Further research should focus on the standardization, applicability, validation, and introduction of this tool in medical training, with a focus on real-life, high-fidelity simulation and online educational tools.

Correction to: Teaching health professionals how to tailor gender-affirming medicine protocols: A design thinking project.

The original version of this article unfortunately contained a mistake. The name of David Rojas Gualdron was presented incorrectly in the author list and in the conflict of interest. The corrected author list is given above. The original article has been ….

Teaching health professionals how to tailor gender-affirming medicine protocols: A design thinking project.

BACKGROUND: Content knowledge surrounding transgender (trans) medicine is currently lacking in the formal medical education curricula. Evidence indicates that the main protocols used to assess and refer trans patients for gender-affirming medicine are misunderstood by health professionals, and require flexible adaptation to achieve health equity and patient-centred care. APPROACH: A free online educational tool for gender-affirming medicine, The Path to Patient-Centred Care, was developed to teach learners how to adapt assessment protocols. Resource creation was supported by a knowledge translation grant that endorsed design thinking, a human-centred and solutions-focused framework recommended for use in curriculum development. EVALUATION: The Path to Patient-Centred Care provides learners with information related to key principles of patient-centred care in gender-affirming medicine, including a guide on how to adapt the main assessment protocols to achieve equitable care. The curriculum also includes narratives from trans patients and health professionals that focus on health equity, and a clinical vignette about a complex case, designed to foster critical thinking on medical ethics. Project future directions involve an implementation and evaluation pilot study with a diverse group of continuing professional development medical learners using a mixed-methods program evaluation design. REFLECTION: The use of design thinking to develop this resource exemplifies a novel approach to curriculum development. By using pedagogical strategies that foster critical reflection, this innovative online education tool strives to teach self-directed learners how to provide care that emphasizes trans people's self-determination and autonomy in medical decision-making.