The core competencies required by toxicology students in order to function effectively in a poisons information centre : a Delphi study

Marks, Carine Johanna (2020-03)

Thesis (MMed)--Stellenbosch University, 2020.

Thesis

ENGLISH ABSTRACT: The training of medical toxicologists in South Africa is inadequate. In developing countries, where accidental and intentional poisonings are problematic, a need exists for tuition in medical toxicology. Stellenbosch University (SU) developed a blended learning Post Graduate Diploma in Medical Toxicology (PGDip Tox) to bridge this knowledge gap. Prior to the development of the PGDip Tox, key learning outcomes were not well-defined and a need still existed to investigate the core competencies required by toxicology graduates to effectively operate in a poisons information centre. The purpose of this study was to contribute to the wider discipline of Medical Toxicology by clearly outlining the core competencies that underpin a medical toxicology curriculum. To reach consensus on what medical toxicology graduates must know (knowledge), what they must be able to do (skills) and what dispositions they must display (attitude), a structured communication survey was developed. With the survey, the Delphi technique was used and it included a set of carefully selected questions that were drawn from various sources. The questionnaire was distributed to participants that had a medical background as well as extensive knowledge in medical toxicology, and who were highly respected by colleagues nationally and internationally. In three iterative rounds, participants rated the relative importance of individual topics and suggested new ideas. Consensus was reached when a topic on the competency list was rated 70% or more. Forty-eight panellists (n=48) were invited to participate in the survey. A total of 134 competencies were selected for the three rounds. In the end, consensus was reached on 118 (88%) items. Panel members agreed that 113 (96%) of these items should be incorporated into a medical toxicology curriculum, and that five (4%) should be excluded. All panellists (100%) agreed that it is important for medical toxicology graduates to: 1.be able to effectively use information technology to access, evaluate and interprettoxicology information 2.know where to look first when managing a poisoning query (databases, books, journalsetc.) 3.be able to communicate effectively (verbally and in writing) with healthcare providersin a manner that they understand 4. be able to identify limitations of knowledge within themselves (e.g. when to refer an enquiry). In summary, while knowledge forms the foundation of the toxicology service, the ultimate cornerstone of a poisons information service is communication. It is important for the medical toxicology curriculum to include a training package aimed at teaching toxicology students the skill of communication. Self-regulatory teaching should also be incorporated into the curriculum as to ensure that graduates have a better understanding of their responsibility towards patients and peers. When planning a new, or changing an existing course, a developer should not start with the curriculum design and measurable educational objectives, but instead use a consensus-based learning outcomes model. Establishing the core competencies in terms of knowledge, skills and attitude, will direct the choice of curriculum content and educational objectives. In conclusion, the outcomes of this study can be used in future studies to assess medical toxicology curricula and to investigate if there is an alignment and synergy between goals of the educator, the needs of the students, the curriculum, the learning milieu, the teaching strategies, and the assessment procedures. Health care workers should consider the incorporation of meaningful outcomes into all future education programmes.

AFRIKAANSE OPSOMMING: Die opleiding van Mediese Toksikoloë in Suid-Afrika en ander ontwikkelende lande is onvoldoende en daar is ‘n behoefte vir onderrig in die behandeling van vergiftigings. Om die rede is n gemengde leermodel, ‘n Nagraadse Diploma in Mediese Toksikologie, deur Stellenbosch Universiteit ontwikkel. Ongelukkig was die leeruitkomste nie voorheen duidelik geidentifiseer en gedefinieer met die ontwikkeling van die kursus nie. Die literatuur beklemtoon die belangrikheid van kernbevoegdhede in gesondheidswerkers. Dit is dus belangrik, om die nodige bevoegdhede vir suksesvolle mediese toksikoloë wat in gifinligtingsentrums werk, te bepaal. Die studie is gebasseer op ‘n gestruktureerde kommunikasieopname wat ontwikkel is om te bepaal wat pas gekwalifiseerde mediese toksikoloë moet weet (kennis), moet kan doen (vaardighede) en wat hulle ingesteldheid daarteenoor (houding) moet wees. Die doel van die opname was om konsensus te bereik oor die kernbevoegdhede wat mediese toksikoloë moet besit. Die studie dra sodoende by tot die breër spesialiteit van Mediese Toksikologie. Hierdie studie het die Delphi-tegniek gebruik wat n stel sorgvuldige geselekteerde vrae bevat wat uit verskillende bronne geneem is. Die vraelys is versprei aan deelnemers met n mediese agtergrond en met ‘n uitgebreide kennis in mediese toksikologie. Hulle kennis in die verband word nasionaal en internasionaal deur kollegas gerespekteer. In drie herhalende rondtes het deelnemers die belangrikheid van individuele onderwerpe beoordeel. Nuwe onderwerpe kon ook voorgestel word. Konsensus is bereik as n onderwerp 70% of meer op die bevoegdheidslys bereik het. Ag-en-veertig paneellede is uitgenooi om aan die opname deel te neem. Altesaam 134 bevoegdhede is vir die drie rondtes gekies. Konsensus is bereik in 118 (88%) van die bevoegdhede. Volgens paneellede behoort 113 (96%) van die bevoegdhede in ‘n kurrikulum vir Mediese Toksikologie opgeneem te word. Vyf (4%) van die bevoegdhede is uitgesluit. Volgens deelnemers (100%) is die volgende belangrik vir gegradueerders in mediese toksikologie: 1. Inligtingtegnologie moet effektief gebruik kan word om sodoende inligting oor toksikologie te bekom, te evalueer en te interpreter. 2. Dit is nodig om te weet watter bronne om te gebruik om ‘n vergiftigings-navraag te hanteer, byvoorbeeld watter boeke, databasisse, joernale en ander relevante bronne kan gebruik word. 3. Dit is nodig om effektief (mondeling en skriftelik) te kan kommunikeer met ander gesondheidsorgwerkers op ‘n manier wat vir hulle verstaanbaar is. 4. Hulle moet hulle eie beperkinge ken en byvoorbeeld weet wanneer om ‘n navraag te verwys na n meer senior persoon. Alhoewel kennis die basis vorm van die toksikologie diens, is die hoeksteen van die diens kommunikasie. Daarom is dit belangrik dat die kurrikulum vir Mediese Toksikologie ‘n opleidingspakket insluit wat kommunikasie-vaardigheid aanspreek. ‘n Verdere komponent van die kurrikulum is selfregulerende leer. Dit sal gegradueerders ‘n beter begrip gee van hulle verantwoordelikhede teenoor pasiënte sowel as teenoor medewerkers. Die studie beveel aan dat ‘n konsensus-gebaseerde leeruitkomste model gebruik moet word in die beplanning van nuwe ‘n kurrikulum, of wanneer ‘n bestaande kursus verander moet word. Kernbevoeghede ten opsigte van kennis, vaardighede en houding behoort die opvoedkundige inhoud van die kurrikulum te bepaal. Die uitkomste van die studie kan in toekomstige studies gebruik word om die kurrikulum vir Mediese Toksikologie te evalueer. Uitkomste kan ook gebruik word om die sinergie tussen die doelstellings van die opvoeder, behoefte van die student, kurrikulum, leeromgewing, onderrigstrategieë en asseseringsprosedures te ondersoek. Gesondheidsorgwerkers moet die insluiting van betekenisvolle uitkomste in alle toekomstige opleidingsprogamme oorweeg.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/107801
This item appears in the following collections: