Core sepsis-related competencies for medical students: an international consensus by Delphi technique

doi:10.1186/s12909-024-05525-9

. 2024 Jun 11;24(1):653.

doi: 10.1186/s12909-024-05525-9.

Core sepsis-related competencies for medical students: an international consensus by Delphi technique

Elanor Lian Mary Gomersall^{1

2}, Lowell Ling³, Konrad Reinhart⁴, Victoria Bion⁵, Abeselom Ekesh⁶, Christiana Adu-Takyi⁷, Luciano Cesar Pontes Azevedo⁸, Paulin Ruhato Banguti⁹, Jonathan Cohen¹⁰, Janet Victoria Diaz¹¹, Bin Du¹², David M Goldfarb¹³, Luis Antonio Gorordo-Delsol¹⁴, Colin Alexander Graham¹⁵, Ricardo Iramain¹⁶, Shevin T Jacob¹⁷, Zsuzsoka Kecskes¹⁸, Niranjan Kissoon¹⁹, Jeffrey Lipman^{20

21}, Ganbold Lundeg²², Kathryn Maitland^{23

24}, Kamal Osman Mergani²⁵, Christopher Moschides²⁶, Miriam Nakalembe²⁷, Ikenna Kingsley Ndu²⁸, Jolene Oon²⁹, Trina Sale³⁰, Ashis Shresthra³¹, Simon Stockley³², Daniel Talmor³³, Audrey Bree Tse³⁴, Anand Zachariah³⁵, Gavin Matthew Joynt³⁶

Affiliations

¹ Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. elanorgomersall@gmail.com.
² Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China. elanorgomersall@gmail.com.
³ Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China. lowell.ling@cuhk.edu.hk.
⁴ Charité Universitätsmedizin, Berlin, 13353, Germany.
⁵ Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK.
⁶ Department of Internal Medicine, Saint Paul Hospital, Millennium Medical College, Addis Ababa, Ethiopia.
⁷ Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁸ Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
⁹ Department of Anesthesia, Critical Care and Emergency Medicine, University of Rwanda, Kigali, Rwanda.
¹⁰ Department of Medicine, Brighton and Sussex Medical School, Brighton, UK.
¹¹ World Health Organization, Avenue de Appia 20, Geneva, 1202, Switzerland.
¹² Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China.
¹³ Department of Pathology and Laboratory Medicine, University of British Columbia, BC Children's Hospital, Vancouver, Canada.
¹⁴ Emergency Medicine and Critical Care Medicine, Adults Intensive Care Unit, Hospital Juárez de México, Mexico City, México.
¹⁵ Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁶ Emergency Department,, Hospital de Clinicas, Asunción, Paraguay.
¹⁷ Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.
¹⁸ ANU Medical School, Canberra Hospital, Woden, Australia.
¹⁹ Department of Pediatrics, University of British Columbia, Vancouver, Canada.
²⁰ Royal Brisbane and Womens Hospital and The University of Queensland, Brisbane, QLD, Australia.
²¹ Nimes University Hospital, University of Montpellier, Nimes, France.
²² Department of Critical Care and Anaesthesiology, School of Medicine, Mongolian National University of Medical Sciences, Ulaan Batar, Mongolia.
²³ Department of Medicine, St Mary's Campus, Imperial College London, Norfolk Place, London, UK.
²⁴ KEMRI Wellcome Trust Research Programme, Kilifi, Kenya.
²⁵ Adult Critical Care Medicine Department, Military Hospital, Khartoum, Sudan.
²⁶ Dunvegan Medical Centre, 48 Dunvegan Avenue, Edenvale, Gauging, South Africa.
²⁷ Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.
²⁸ Department of Paediatrics, College of Medicine, Enugu State University of Science and Technology, Park Lane, Enugu, Nigeria.
²⁹ Division of Infectious Diseases, Department of Medicine, National University Hospital Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
³⁰ Emergency Department, National Referral Hospital, Honiara, Solomon Islands.
³¹ Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Patan, Nepal.
³² Eaglescliffe Health Centre, Sunningdale Drive, Eaglescliffe, Stockton-on-Tees, UK.
³³ Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
³⁴ Department of Emergency Medicine, John Muir Health, Walnut Creek/ Concord, CA, USA.
³⁵ Department of Medicine, Christian Medical College, Vellore, India.
³⁶ Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.

PMID: 38862952
PMCID: PMC11167876
DOI: 10.1186/s12909-024-05525-9

Core sepsis-related competencies for medical students: an international consensus by Delphi technique

Elanor Lian Mary Gomersall et al. BMC Med Educ. 2024.

. 2024 Jun 11;24(1):653.

doi: 10.1186/s12909-024-05525-9.

Authors

Affiliations

¹ Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. elanorgomersall@gmail.com.
² Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China. elanorgomersall@gmail.com.
³ Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China. lowell.ling@cuhk.edu.hk.
⁴ Charité Universitätsmedizin, Berlin, 13353, Germany.
⁵ Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK.
⁶ Department of Internal Medicine, Saint Paul Hospital, Millennium Medical College, Addis Ababa, Ethiopia.
⁷ Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁸ Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
⁹ Department of Anesthesia, Critical Care and Emergency Medicine, University of Rwanda, Kigali, Rwanda.
¹⁰ Department of Medicine, Brighton and Sussex Medical School, Brighton, UK.
¹¹ World Health Organization, Avenue de Appia 20, Geneva, 1202, Switzerland.
¹² Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China.
¹³ Department of Pathology and Laboratory Medicine, University of British Columbia, BC Children's Hospital, Vancouver, Canada.
¹⁴ Emergency Medicine and Critical Care Medicine, Adults Intensive Care Unit, Hospital Juárez de México, Mexico City, México.
¹⁵ Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁶ Emergency Department,, Hospital de Clinicas, Asunción, Paraguay.
¹⁷ Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.
¹⁸ ANU Medical School, Canberra Hospital, Woden, Australia.
¹⁹ Department of Pediatrics, University of British Columbia, Vancouver, Canada.
²⁰ Royal Brisbane and Womens Hospital and The University of Queensland, Brisbane, QLD, Australia.
²¹ Nimes University Hospital, University of Montpellier, Nimes, France.
²² Department of Critical Care and Anaesthesiology, School of Medicine, Mongolian National University of Medical Sciences, Ulaan Batar, Mongolia.
²³ Department of Medicine, St Mary's Campus, Imperial College London, Norfolk Place, London, UK.
²⁴ KEMRI Wellcome Trust Research Programme, Kilifi, Kenya.
²⁵ Adult Critical Care Medicine Department, Military Hospital, Khartoum, Sudan.
²⁶ Dunvegan Medical Centre, 48 Dunvegan Avenue, Edenvale, Gauging, South Africa.
²⁷ Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.
²⁸ Department of Paediatrics, College of Medicine, Enugu State University of Science and Technology, Park Lane, Enugu, Nigeria.
²⁹ Division of Infectious Diseases, Department of Medicine, National University Hospital Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
³⁰ Emergency Department, National Referral Hospital, Honiara, Solomon Islands.
³¹ Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Patan, Nepal.
³² Eaglescliffe Health Centre, Sunningdale Drive, Eaglescliffe, Stockton-on-Tees, UK.
³³ Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
³⁴ Department of Emergency Medicine, John Muir Health, Walnut Creek/ Concord, CA, USA.
³⁵ Department of Medicine, Christian Medical College, Vellore, India.
³⁶ Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.

PMID: 38862952
PMCID: PMC11167876
DOI: 10.1186/s12909-024-05525-9

Abstract

Background: Sepsis is a life-threatening condition which may arise from infection in any organ system and requires early recognition and management. Healthcare professionals working in any specialty may need to manage patients with sepsis. Educating medical students about this condition may be an effective way to ensure all future doctors have sufficient ability to diagnose and treat septic patients. However, there is currently no consensus on what competencies medical students should achieve regarding sepsis recognition and treatment. This study aims to outline what sepsis-related competencies medical students should achieve by the end of their medical student training in both high or upper-middle incomes countries/regions and in low or lower-middle income countries/regions.

Methods: Two separate panels from high or upper-middle income and low or lower-middle income countries/regions participated in a Delphi method to suggest and rank sepsis competencies for medical students. Each panel consisted of 13-18 key stakeholders of medical education and doctors in specialties where sepsis is a common problem (both specialists and trainees). Panelists came from all continents, except Antarctica.

Results: The panels reached consensus on 38 essential sepsis competencies in low or lower-middle income countries/regions and 33 in high or upper-middle incomes countries/regions. These include competencies such as definition of sepsis and septic shock and urgency of antibiotic treatment. In the low or lower-middle income countries/regions group, consensus was also achieved for competencies ranked as very important, and was achieved in 4/5 competencies rated as moderately important. In the high or upper-middle incomes countries/regions group, consensus was achieved in 41/57 competencies rated as very important but only 6/11 competencies rated as moderately important.

Conclusion: Medical schools should consider developing curricula to address essential competencies, as a minimum, but also consider addressing competencies rated as very or moderately important.

Keywords: Competency; Curriculum; Education; Medical students; Septic shock; Severe sepsis.

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Conflict of interest statement

The authors declare no competing interests.

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Knowledge, practice and attitudes of healthcare students to sepsis management in Jamaica.
Roye-Green KJ, Vickers I, Priestley S, Walker J, Willis R. Roye-Green KJ, et al. BMC Med Educ. 2025 Apr 17;25(1):565. doi: 10.1186/s12909-025-07122-w. BMC Med Educ. 2025. PMID: 40247330 Free PMC article.

References

1. Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211. doi: 10.1016/S0140-6736(19)32989-7. - DOI - PMC - PubMed
1. da Silva Ramos FJ, de Freitas FGR, Machado FR. Sepsis in patients hospitalized with coronavirus disease 2019: how often and how severe? Curr Opin Crit Care. 2021;27(5):474–4792. doi: 10.1097/MCC.0000000000000861. - DOI - PMC - PubMed
1. Reinhart K, Daniels R, Kissoon N, et al. Recognizing sepsis as a global health priority - a WHO resolution. N Engl J Med. 2017;377(5):414–417. doi: 10.1056/NEJMp1707170. - DOI - PubMed
1. WHO Sepsis Technical Expert Meeting - Meeting Report. Geneva: World Health Organization; 2018.
1. Ryan MS, Blood AD, Park YS, et al. Competency-based frameworks in medical school education programs: a thematic analysis of the academic medicine snapshots. Acad Med. 2022;97(11S):63–70. doi: 10.1097/ACM.0000000000004912. - DOI - PubMed

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[1] Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211. doi: 10.1016/S0140-6736(19)32989-7. - DOI - PMC - PubMed

[2] Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211. doi: 10.1016/S0140-6736(19)32989-7. - DOI - PMC - PubMed

[3] da Silva Ramos FJ, de Freitas FGR, Machado FR. Sepsis in patients hospitalized with coronavirus disease 2019: how often and how severe? Curr Opin Crit Care. 2021;27(5):474–4792. doi: 10.1097/MCC.0000000000000861. - DOI - PMC - PubMed

[4] da Silva Ramos FJ, de Freitas FGR, Machado FR. Sepsis in patients hospitalized with coronavirus disease 2019: how often and how severe? Curr Opin Crit Care. 2021;27(5):474–4792. doi: 10.1097/MCC.0000000000000861. - DOI - PMC - PubMed

[5] Reinhart K, Daniels R, Kissoon N, et al. Recognizing sepsis as a global health priority - a WHO resolution. N Engl J Med. 2017;377(5):414–417. doi: 10.1056/NEJMp1707170. - DOI - PubMed

[6] Reinhart K, Daniels R, Kissoon N, et al. Recognizing sepsis as a global health priority - a WHO resolution. N Engl J Med. 2017;377(5):414–417. doi: 10.1056/NEJMp1707170. - DOI - PubMed

[7] WHO Sepsis Technical Expert Meeting - Meeting Report. Geneva: World Health Organization; 2018.

[8] WHO Sepsis Technical Expert Meeting - Meeting Report. Geneva: World Health Organization; 2018.

[9] Ryan MS, Blood AD, Park YS, et al. Competency-based frameworks in medical school education programs: a thematic analysis of the academic medicine snapshots. Acad Med. 2022;97(11S):63–70. doi: 10.1097/ACM.0000000000004912. - DOI - PubMed

[10] Ryan MS, Blood AD, Park YS, et al. Competency-based frameworks in medical school education programs: a thematic analysis of the academic medicine snapshots. Acad Med. 2022;97(11S):63–70. doi: 10.1097/ACM.0000000000004912. - DOI - PubMed

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Core sepsis-related competencies for medical students: an international consensus by Delphi technique

Affiliations

Core sepsis-related competencies for medical students: an international consensus by Delphi technique

Authors

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Conflict of interest statement

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