Building Consensus on the Point-of-Care Ultrasound Skills Required for Effective Healthcare Service Delivery at District Hospitals in South Africa: A Delphi Study

Pierre-Andre Mans (), Parimalaranie Yogeswaran and Oladele Vincent Adeniyi
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Pierre-Andre Mans: Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa
Parimalaranie Yogeswaran: Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
Oladele Vincent Adeniyi: Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa

IJERPH, 2023, vol. 20, issue 23, 1-15

Abstract: Background: Despite the widespread availability of ultrasound machines in South African district hospitals, there are no guidelines on the competency in point-of-care ultrasound (POCUS) use required by generalist doctors in this setting. This study aimed to define the required POCUS competencies by means of consensus via the Delphi method. Methods: An online Delphi process was initiated in June 2022, using the existing American Academy of Family Physicians’ ultrasound curriculum (84 skillsets) as the starting questionnaire. Panelists were selected across the country, including two from district hospitals in each province and two from each academic family medicine department in South Africa ( N = 36). In each iterative round, the participants were asked to identify which POCUS skillsets were essential, optional (region-specific), or non-essential for South African district hospitals. This process continued until consensus (>70% agreement) was achieved on all of the skillsets. Results: Consensus was achieved on 81 of the 84 skillsets after 5 iterative rounds (96.4%), with 3 skillsets that could not achieve consensus (defined as <5% change over more than 2 consecutive rounds). The final consensus identified 38 essential, 28 optional, and 15 non-essential POCUS skillsets for the South African district hospital context. Conclusions: The list of essential POCUS skillsets provided by this study highlights the predominance of obstetric- and trauma-based skillsets required for generalist healthcare workers in South African district hospitals. The findings will require priority setting and revalidation prior to their implementation across the country.

Keywords: curriculum; Delphi study; district hospitals; point-of-care ultrasound; South Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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