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Journal of Advanced Nursing May 2013There is growing interest in realist synthesis as an alternative systematic review method. This approach offers the potential to expand the knowledge base in...
BACKGROUND
There is growing interest in realist synthesis as an alternative systematic review method. This approach offers the potential to expand the knowledge base in policy-relevant areas - for example, by explaining the success, failure or mixed fortunes of complex interventions. No previous publication standards exist for reporting realist syntheses. This standard was developed as part of the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project. The project's aim is to produce preliminary publication standards for realist systematic reviews.
DESIGN
A mixed method study synthesising data between 2011-2012 from a literature review, online Delphi panel and feedback from training, workshops and email list.
METHODS
We: (a) collated and summarized existing literature on the principles of good practice in realist syntheses; (b) considered the extent to which these principles had been followed by published syntheses, thereby identifying how rigour may be lost and how existing methods could be improved; (c) used a three-round online Delphi method with an interdisciplinary panel of national and international experts in evidence synthesis, realist research, policy and/or publishing to produce and iteratively refine a draft set of methodological steps and publication standards; (d) provided real-time support to ongoing realist syntheses and the open-access RAMESES online discussion list to capture problems and questions as they arose; and (e) synthesized expert input, evidence syntheses and real-time problem analysis into a definitive set of standards.
RESULTS
We identified 35 published realist syntheses, provided real-time support to 9 ongoing syntheses and captured questions raised in the RAMESES discussion list. Through analysis and discussion within the project team, we summarized the published literature and common questions and challenges into briefing materials for the Delphi panel, comprising 37 members. Within 3 rounds this panel had reached consensus on 19 key publication standards, with an overall response rate of 91%.
CONCLUSIONS
This project used multiple sources to develop and draw together evidence and expertise in realist synthesis. For each item we have included an explanation for why it is important and guidance on how it might be reported. Realist synthesis is a relatively new method for evidence synthesis and as experience and methodological developments occur, we anticipate that these standards will evolve to reflect further methodological developments. We hope that these standards will act as a resource that will contribute to improving the reporting of realist syntheses.
Topics: Delphi Technique; Publishing
PubMed: 23356726
DOI: 10.1111/jan.12095 -
Cirugia Pediatrica : Organo Oficial de... Apr 2024The course in Primary Care in Pediatric Trauma (ATIP in Spanish) has been taught in Spain since 1997, and there are currently 9 accredited training centers. Care of... (Review)
Review
INTRODUCTION
The course in Primary Care in Pediatric Trauma (ATIP in Spanish) has been taught in Spain since 1997, and there are currently 9 accredited training centers. Care of polytraumatized pediatric patients often takes place in an environment conducive to errors resulting from forgetfulness, which is why checklists - mnemonic tools widely used in industry and medicine - are particularly useful to avoid such errors. Although several checklists exist for pediatric trauma care, none have been developed within the setting of our course.
MATERIALS AND METHODS
The criteria for being selected as an expert in Primary Care in Pediatric Trauma were agreed upon with the scientific polytrauma committee of the Spanish Pediatric Surgery Society. The items that make up the checklist were obtained from a review of the literature and consultation with selected experts, using the Delphi Technique.
RESULTS
10 experts representing the 9 groups or training centers in Primary Care in Pediatric Trauma were selected, and a 28-item checklist was drawn up in accordance with their design recommendations.
CONCLUSIONS
With the consensus of all the groups, a checklist for the treatment of polytraumatized pediatric patients was drawn up using the Delphi Technique, an essential requirement for the dissemination of this checklist, which should be adapted and validated for use in each healthcare center.
Topics: Humans; Child; Checklist; Delphi Technique; Consensus; Multiple Trauma; Primary Health Care
PubMed: 38623796
DOI: 10.54847/cp.2024.02.12 -
BMJ Open Feb 2024Shoulder arthroplasty incidence is projected to continue its exponential growth and the resultant burden of monitoring patients with shoulder arthroplasty implants...
Can we develop consensus on long-term follow-up and surveillance of primary shoulder arthroplasty? A study protocol using a real-time Delphi technique among expert clinicians in the UK.
BACKGROUND
Shoulder arthroplasty incidence is projected to continue its exponential growth and the resultant burden of monitoring patients with shoulder arthroplasty implants creates significant pressure on orthopaedic services. Surveillance offers the opportunity to study implant longevity, detect failing implants and potentially perform revision at lower morbidity and cost. There is a paucity of evidence to support recommendations on long-term follow-up in shoulder arthroplasty. Prospective studies comparing long-term follow-up and structure are impractical from time, resource and cost perspectives. A real-time Delphi technique represents a mechanism by which experts involved in long-term follow-up of primary shoulder arthroplasty can formulate recommendations via a transparent, reproducible and efficient process. We outline the protocol for a real-time Delphi study seeking consensus on long-term follow-up and surveillance of primary shoulder arthroplasty .
METHODS
A real-time Delphi technique will be used. A planning committee will design the Delphi statements. A steering committee will supervise and monitor the real-time Delphi process. Participants will be asked to rate their agreement with statements using a 5-point Likert scale. The Delphi statements will be derived from review of published literature, and the strength of evidence available for each statement will be provided. We will offer participation to all surgeons and extended-scope practitioners who are current members of the British Elbow & Shoulder Society (BESS) and have clinical practice involving shoulder arthroplasty follow-up. The questionnaire will be active for 4 weeks and requires a minimum of 20 participants. Consensus agreement is defined as 70% of participants selecting at least a 4-point on a 5-point Likert scale.
DISCUSSION
We anticipate the outlined study will achieve consensus on long-term follow-up and surveillance of primary shoulder arthroplasty. We intend to use the expert consensus recommendations achieved, in addition to the limited applicable published evidence available, to produce BESS-affiliated guidelines on long-term follow-up and surveillance of primary shoulder arthroplasty.EthicsEthical approval is not required for the real-time Delphi study.We expect the results of this initiative will be published in a peer-reviewed, high-impact journal.
Topics: Humans; Delphi Technique; Follow-Up Studies; Arthroplasty, Replacement, Shoulder; Prospective Studies; United Kingdom
PubMed: 38401899
DOI: 10.1136/bmjopen-2023-081703 -
International Journal of Environmental... Jan 2022Consumers access health professionals with varying levels of diabetes-specific knowledge and training, often resulting in conflicting advice. Conflicting health messages...
Consumers access health professionals with varying levels of diabetes-specific knowledge and training, often resulting in conflicting advice. Conflicting health messages lead to consumer disengagement. The study aimed to identify capabilities required by health professionals to deliver diabetes education and care to develop a national consensus capability-based framework to guide their training. A 3-staged modified technique was used to gain agreement from a purposefully recruited panel of Australian diabetes experts from various disciplines and work settings. The Delphi technique consisted of (Stage I) a semi-structured consultation group and pre- pilot, (Stage II) a 2-phased online survey, and (Stage III) a semi-structured focus group and appraisal by health professional regulatory and training organisations. Descriptive statistics and central tendency measures calculated determined quantitative data characteristics and consensus. Content analysis using emergent coding was used for qualitative content. Eighty-four diabetes experts were recruited from nursing and midwifery ( = 60 [71%]), allied health ( = 17 [20%]), and pharmacy ( = 7 [9%]) disciplines. Participant responses identified 7 health professional practice levels requiring differences in diabetes training, 9 capability areas to support care, and 2 to 16 statements attained consensus for each capability-259 in total. Additionally, workforce solutions were identified to expand capacity for diabetes care. The rigorous consultation process led to the design and validation of a that addresses workforce enablers identified by the . It recognises diversity, creating shared understandings of diabetes across health professional disciplines. The findings will inform diabetes policy, practice, education, and research.
Topics: Australia; Delivery of Health Care; Delphi Technique; Diabetes Mellitus; Humans; Workforce
PubMed: 35055832
DOI: 10.3390/ijerph19021012 -
Nurse Education Today Feb 2023Transition education is a robust strategy to improve the core competency of newly graduated nurses and the quality of clinical nursing and ensure people's safety.... (Review)
Review
BACKGROUND
Transition education is a robust strategy to improve the core competency of newly graduated nurses and the quality of clinical nursing and ensure people's safety. Limited information about the learning objectives and educational content for newly graduated nurses in China was available.
OBJECTIVE
Construct the learning objectives and educational content for newly graduated nurses based on defined core competencies.
DESIGN
We used a literature review and the e-Delphi method to conduct this study.
SETTINGS
Ten tertiary teaching hospitals and six nursing schools in Zhejiang Province, China, were selected.
PARTICIPANTS
Experts (n = 21) were invited to the e-Delphi study.
METHODS
Based on seven competencies from the literature review and the research group discussions, we formed an initial set of objectives and specific educational content for newly graduated nurses. Subsequently, experts provided supportive and modification advice on the competencies, objectives, and specific content in the two Delphi rounds. The consensus percentage and the weight of each first-level, second-level, and third-level item were calculated.
RESULTS
Consensus was achieved on seven core competencies, 44 learning objectives, and 60 components of educational content. The positive coefficient of the two Delphi rounds was 100 %, the authority coefficient was 0.83 and 0.87, the proportion of experts who made suggestions was 71.40 %, the coefficient of variation (CV) was <0.25 (P < 0.05) except for two items and the Kendall coefficient (W) was 0.15-0.48 (P < 0.01).
CONCLUSION
The developed objectives and content framework provide a reference for implementing systematic and standardized education for newly graduated nurses.
Topics: Humans; Delphi Technique; Clinical Competence; Learning; Curriculum; Nurses
PubMed: 36657320
DOI: 10.1016/j.nedt.2023.105716 -
Health Expectations : An International... Dec 2022Psychological therapy assessments are a key point at which a person is accepted into a service or referred on. There is evidence of service users experiencing harm,...
BACKGROUND
Psychological therapy assessments are a key point at which a person is accepted into a service or referred on. There is evidence of service users experiencing harm, dropping out of services and potentially experiencing poor outcomes because of inadequate assessment practices. Approaches to assessment tend to be developed by individual services, with a lack of research identifying what makes a good assessment.
METHODS
This survivor-led study, based in England, aimed to generate guidelines for conducting trauma-informed psychological therapy assessments. The study was guided by a Service User Advisory Group and a Clinician Advisory Group. The study was conducted in three key stages: (i) identifying, modelling and drafting guideline content (ii) modified Delphi study and (iii) guideline finalization. Stage 1 was informed by literature reviews, qualitative research, data workshops with Advisory Groups and an expert consultation. Fifty-nine people with relevant experiences then participated in a single-stage modified Delphi (Stage 2). The guidelines were finalized through an analysis of Delphi open comments and a final expert consultation (Stage 3).
RESULTS
The guidelines evolved through each stage of the process, and all items were deemed important by >90% of Delphi participants. The final trauma-informed guidelines contain eight principles, including 'focus on relationships', 'from systems to people' and 'healing environments'.
CONCLUSIONS
Experiential knowledge was key in generating the guidelines and conceptualizing content, with a consequent focus on areas, such as recognizing power differentials, understanding oppression as trauma and the relational aspects of assessments. Future research should focus on guideline implementation and investigate whether this impacts service user dropout, engagement with therapy, and outcomes.
PATIENT OR PUBLIC CONTRIBUTION
This study is an example of survivor research, with several authors, including the study lead, identifying as survivors. We consider the ways in which our identities as survivor researchers impacted the study findings.
Topics: Humans; Delphi Technique; Psychotherapy; Qualitative Research; Mental Disorders; Survivors
PubMed: 36049032
DOI: 10.1111/hex.13585 -
Journal of Foot and Ankle Research Jul 2023The training of undergraduate and graduate-entry podiatry students in Australia and New Zealand includes practical sessions in a simulated and real-life clinical setting...
BACKGROUND
The training of undergraduate and graduate-entry podiatry students in Australia and New Zealand includes practical sessions in a simulated and real-life clinical setting and Work Integrated Learning (WIL) comprising professional clinical placements. Student performance during WIL is evaluated by their Clinical Educators using clinical competency tools. Having a standardised and validated clinical assessment tool for WIL in podiatry would facilitate consistency in assessment, promote standardisation between programs, and ensure that all podiatry students are assessed against a set of criteria over the course of their clinical programs to the point of threshold clinical competency. Therefore, the aim of this study was to develop a series of consensus-based statements via Delphi technique as the first step towards developing guidelines to direct the assessment of podiatry students during WIL.
METHODS
This study used a three-round modified Delphi consensus method. A panel of 25 stakeholders was sought. Specifically, representation from each of the universities in Australia and New Zealand who provide entry level programs, Clinical Educators, podiatry student representatives, new podiatry graduates and consumers (podiatrists hiring new graduates). The survey for Round 1 aimed for consensus and consisted of five open-ended questions. Questions one to three asked respondents to nominate what they considered were the important elements that needed to be assessed for podiatry students undertaking WIL for: Clinical performance/skills, Communication and Professional behaviour, Question 4 asked respondents to identify further/other elements of importance, whilst Question 5 asked a) how these elements should be evaluated and b) how should overall competency and ability to progress within the program be determined. Round 2 and 3 aimed to gather agreement and the questions were based on the responses from previous rounds.
RESULTS
Twenty-five participants agreed to participate, 17 females (68%) and eight males (32%). The panel consisted of 10 podiatry educators (40%), nine Clinical Educators (36%), two student representatives (8%), two new podiatry graduates (8%) and two consumers (8%). From the 25 recruited participants, 21 responded to Round one, 18 to Round two and 17 in Round three. At the conclusion of the Delphi survey, 55 statements had reached consensus or agreement.
CONCLUSIONS
This Delphi study is the first of its kind for the podiatry profession to develop consensus-based statements regarding the assessment of WIL. Fifty-five statements pertinent to the assessment of WIL were identified. This is an important first step toward the development of a consistent WIL assessment tool which may be applied across entry-level podiatry programs across Australia and New Zealand.
Topics: Male; Female; Humans; Clinical Competence; Consensus; Podiatry; Australia; Students; Delphi Technique
PubMed: 37468972
DOI: 10.1186/s13047-023-00639-7 -
Nursing Open Feb 2023To establish a sensitive, scientific and practical evaluation system for haemodialysis nursing and to provide a reference for the evaluation of haemodialysis nursing... (Review)
Review
AIMS
To establish a sensitive, scientific and practical evaluation system for haemodialysis nursing and to provide a reference for the evaluation of haemodialysis nursing quality.
DESIGN
Through a literature review and Delphi method.
METHOD
According to the literature review, a preliminary nursing-sensitive quality indicators for haemodialysis were established, and an expert survey questionnaire was designed. Finally, the evaluation system for the nursing-sensitive quality indicators was determined using the Delphi method.
RESULTS
Thirteen nursing-sensitive quality indicators for haemodialysis were finally constructed, including two structural indicators, three process indicators and eight outcome indicators. The effective recovery rate of the two rounds of expert survey questionnaires was 100%, the coefficient of judgement basis is 0.956, the coefficient of familiarity is 0.833, the coefficient of authority is 0.895, and the Kendall's harmony coefficients of the two rounds of expert consultation were 0.158 ~ 0.307 and 0.170 ~ 0.315, respectively, with statistical significance (p < .05).
CLINICAL RELEVANCE
In this study, the nursing-sensitive quality indicators for haemodialysis were developed by the Delphi method and included structural indicators, outcome indicators and process indicators, which made up for some deficiencies noted in previous studies. The authors have provided a more reliable and comprehensive basis for evaluating the quality and safety of haemodialysis nursing in the future.
Topics: Quality Indicators, Health Care; Delphi Technique; Renal Dialysis; Group Processes; Surveys and Questionnaires
PubMed: 36040112
DOI: 10.1002/nop2.1349 -
Transplantation Proceedings May 2017Lung transplantation is a well-established treatment for selected patients with advanced chronic respiratory insufficiency. Recognizing those patients with end-stage...
Lung transplantation is a well-established treatment for selected patients with advanced chronic respiratory insufficiency. Recognizing those patients with end-stage lung disease who might benefit from lung transplantation is a crucial task. Considering the presence of inadequate evidence-based practice, international and national scientific societies provided consensus opinions regarding the appropriate timing of listing. The Study Group for Thoracic Organs Transplantation (branch of the Italian Society for Organs Transplantation) promoted and realized a Delphi conference among the Italian lung transplantation centers to provide guidance to clinical practice based on international recommendations. The experts from the nine Italian centers completed two rounds of standardized questionnaires (answer rate, 100%): 42 statements received a consensus ≥80%. The selected statements presented in this article are intended to assist Italian clinicians in selecting patients for lung transplantation.
Topics: Delphi Technique; Humans; Italy; Lung Transplantation; Patient Selection
PubMed: 28457376
DOI: 10.1016/j.transproceed.2017.02.026 -
JAMA Network Open Jul 2022
Topics: Delphi Technique; Humans; Medication Errors
PubMed: 35904790
DOI: 10.1001/jamanetworkopen.2022.27817