Table 2 Final set of core competencies required for critical care specialists and the supporting rate for each item
From: Consensus development of core competencies in intensive and critical care medicine training in China
Theme | Competency statement | Online survey (%) | Agreement (%)a | ||
|---|---|---|---|---|---|
Round one | Round two | Round three | |||
1. Resuscitation and initial management of acutely ill patient | 1.1 Assesses and provides initial management of the trauma patient | 95.0 | 100 | ||
1.2 Manages cardiopulmonary resuscitation | 99.0 | 100 | |||
1.3 Manages postresuscitation brain protection | 99.0 | 100 | |||
1.4 Provides advanced life support for postresuscitation patient | 99.7 | 100 | |||
2. Diagnosis, assessment, investigation, monitoring, and data interpretation | 2.1 Obtains medical history and performs accurate physical examination | 99.0 | 100 | ||
2.2 Orders timely and appropriate laboratory investigations | 99.2 | 100 | |||
2.3 Orders timely and appropriate image investigations | 98.5 | 100 | |||
2.4 Integrates clinical findings with laboratory investigations to form a differential diagnosis | 97.5 | 92 | 100 | ||
2.5 Describes and assesses patient with severity-of-illness score: APACHE, SAPS | 96.2 | 100 | |||
2.6 Describes and assesses patient with multiorgan dysfunction score: SOFA, MODS | 90.7 | 100 | |||
2.7 Describes monitoring and interpretation of respiratory mechanics | 97.2 | 100 | |||
2.8 Interprets arterial blood gas analysis | 95.5 | 92 | 100 | ||
2.9 Performs electrocardiography and interprets the results | 88.4 | 100 | |||
2.10 Interprets chest radiographs | 89.7 | 100 | |||
2.11 Interprets CT image | 75.1 | 92 | 100 | ||
3. Disease management | 3.1 Describes implications of chronic and comorbid disease in the acutely ill patient | 96.7 | 85 | 100 | |
3.2 Recognizes and manages different types of shock | 99.7 | 100 | |||
3.3 Assesses and manages life-threatening arrhythmia | 99.7 | 100 | |||
3.4 Recognized and manages left ventricular failure and/or acute pulmonary edema | 99.7 | 100 | |||
3.5 Recognizes and manages right heart failure | 97.2 | 100 | |||
3.6 Assesses and manages myocardial infarction and acute coronary syndrome | 97.5 | 100 | |||
3.7 Recognizes and manages rupture of aneurysm (bleeding and cardiac tamponade) | 91.5 | 100 | |||
3.8 Recognizes and manages hypertension crisis | 98.7 | 100 | |||
3.9 Describes physiological changes of cardiovascular system under acute condition | 98.2 | 100 | |||
3.10 Assesses and manages acute and chronic respiratory failure | 99.5 | 100 | |||
3.11 Assesses and manages acute exacerbation of chronic obstructive pulmonary disease | 98.7 | 100 | |||
3.12 Assesses and manages status asthmaticus | 99.5 | 100 | |||
3.13 Assesses and manages smoke inhalation, airway burns | 96.0 | 100 | |||
3.14 Assesses and manages upper airway obstruction (due to infection or foreign body) | 97.0 | 100 | |||
3.15 Recognizes (diagnosis and grading) and manages ARDS | 99.7 | 100 | |||
3.16 Manages life-threatening hemoptysis | 97.2 | 100 | |||
3.17 Describes effects of positioning on respiratory physiology | 95.5 | 92 | 100 | ||
3.18 Recognizes (diagnosis and grading) and manages acute kidney injury | 99.0 | 100 | |||
3.19 Manages critically ill patients with chronic renal failure | 97.7 | 100 | |||
3.20 Manages patients with coma | 100.0 | 100 | |||
3.21 Assesses and manages patients with drug overdose and intoxication | 96.2 | 92 | 100 | ||
3.22 Assesses and manages cerebral vascular accident | 97.5 | 92 | 100 | ||
3.23 Manages status epilepticus | 97.7 | 92 | 100 | ||
3.24 Recognizes and manages intracranial infection | 98.0 | 92 | 100 | ||
3.25 Assesses and manages patient with increased intracranial pressure | 98.5 | 92 | 100 | ||
3.26 Assesses and manages spine injury | 91.5 | 85 | 92 | 100 | |
3.27 Recognizes and manages adrenal crisis | 95.2 | 100 | |||
3.28 Recognizes and manages diabetes insipidus | 92.5 | 100 | |||
3.29 Recognizes and manages diabetic ketoacidosis | 99.5 | 100 | |||
3.30 Recognizes and manages sepsis, severe sepsis, and septic shock | 100.0 | 100 | |||
3.31 Assesses and manages multiorgan dysfunction syndrome | 99.7 | 100 | |||
3.32 Assesses and manages severe community acquired infection (e.g., severe community-acquired pneumonia) | 98.7 | 100 | |||
3.33 Recognizes and manages nosocomial infection | 99.0 | 100 | |||
3.34 Assesses and manages fever in critically ill patient | 96.0 | 100 | |||
3.35 Describes antimicrobial resistance | 99.7 | 100 | |||
3.36 Recognizes intra-abdominal infection and gastrointestinal leakage | 96.5 | 100 | |||
3.37 Manages coagulopathy | 99.0 | 100 | |||
3.38 Manages hemolytic disorders | 89.7 | 92 | 92 | 100 | |
3.39 Assesses and manages thromboembolic disease (including pulmonary embolism) | 99.2 | 100 | |||
3.40 Manages disseminated intravascular coagulation | 98.5 | 92 | 100 | ||
3.41 Manages traumatic coagulopathy | 95.7 | 92 | 92 | 100 | |
3.42 Assesses and manages gastrointestinal bleeding | 98.7 | 100 | |||
3.43 Assesses and manages patient with liver failure | 97.7 | 100 | |||
3.44 Assesses and manages pancreatitis | 99.2 | 100 | |||
3.45 Assesses and manages abdominal compartment syndrome | 97.2 | 100 | |||
3.46 Assesses and manages acute illness in pregnancy | 93.0 | 100 | |||
4. Therapeutic interventions/organ system support in single or multiple organ failure | 4.1 Assesses and manages fluid and electrolyte disorders | 99.7 | 100 | ||
4.2 Assesses and manages acid–base disorders | 98.7 | 100 | |||
4.3 Describes and provides parenteral nutrition support | 99.0 | 100 | |||
4.4 Describes and provides enteral nutrition support | 98.7 | 100 | |||
4.5 Provides nutrition support for patient with severe acute pancreatitis | 97.0 | 92 | 100 | ||
4.6 Provides nutrition support for patient with renal failure | 97.0 | 92 | 92 | 100 | |
4.7 Provides nutrition support for patient with liver failure | 96.7 | 92 | 100 | ||
4.8 Provides nutrition support for patient with sepsis and septic shock | 98.5 | 92 | 100 | ||
4.9 Provides nutrition support for postgastrointestinal surgery patient | 94.7 | 92 | 92 | 100 | |
4.10 Assesses and manages pain in critically ill patients | 98.5 | 100 | |||
4.11 Describes principle and assessment of sedation | 99.5 | 100 | |||
4.12 Provides assessment, prevention, and treatment of delirium | 96.7 | 100 | |||
4.13 Describes indication and choice of neuromuscular blockade | 92.5 | 92 | 92 | 100 | |
4.14 Manages fluid therapy | 99.7 | 100 | |||
4.15 Manages vasoactive/inotropic medication therapy | 100.0 | 100 | |||
4.16 Describes principles of drug dose adjustment in renal failure | 98.7 | 100 | |||
4.17 Describes principles of continuous renal replacement therapy | 99.0 | 100 | |||
4.18 Explains and appraises management of severe sepsis and septic shock | 99.7 | 100 | |||
4.19 Describes principle of antimicrobial agent selection and dosing in critically ill patients | 100.0 | 100 | |||
4.20 Describes principle of anticoagulation; anti-fibrinolytic therapy | 98.0 | 100 | |||
4.21 Describes principle of blood component transfusion | 99.2 | 100 | |||
4.22 Describes stress ulcer prophylaxis | 99.2 | 92 | 100 | ||
5. Practical procedures | 5.1 Performs bedside ultrasound to localize pleural effusion and ascites | 73.6 | 100 | ||
5.2 Maintains an open airway in the nonintubated patient | 98.5 | 100 | |||
5.3 Performs bag-mask ventilation | 98.5 | 100 | |||
5.4 Performs tracheal intubation | 97.7 | 100 | |||
5.5 Performs tracheal aspiration | 95.5 | 100 | |||
5.6 Manages pneumothorax | 84.2 | 100 | |||
5.7 Administers oxygen therapy | 98.2 | 100 | |||
5.8 Manages noninvasive and invasive mechanical ventilation: indication, rational, complication, and weaning | 98.0 | 100 | |||
5.9 Explains and performs recruitment maneuver: principle and practice | 95.2 | 100 | |||
5.10 Performs arterial puncture and cannulation | 96.5 | 100 | |||
5.11 Performs central venous catheter insertion | 97.7 | 100 | |||
5.12 Performs and interprets cardiac output and hemodynamic monitor | 93.7 | 100 | |||
5.13 Performs cardioversion and defibrillation | 97.7 | 100 | |||
5.14 Performs lumber puncture | 87.9 | 100 | |||
5.15 Performs nasogastric tube placement | 83.7 | 100 | |||
5.16 Performs abdominal paracentesis | 96.2 | 100 | |||
5.17 Performs and interprets intra-abdominal pressure monitor | 86.9 | 100 | |||
5.18 Manages continuous renal replacement therapy | 91.5 | 100 | |||
5.19 Performs urinary catheterization | 82.9 | 92 | 100 | ||
6. Perioperative care | 6.1 Performs preoperative cardiopulmonary evaluation of high-risk patient | 92.7 | 92 | 100 | |
6.2 Manages postoperative assessment and care of high-risk surgical patient | 98.2 | 100 | |||
6.3 Manages the preoperative and postoperative care of the trauma patient | 94.2 | 77 | 77 | 100 | |
7. Comfort, recovery, and end-of-life care | 7.1 Describes and applies practice to minimizes the physical and psychosocial consequences of critical illness for patients and families | 98.5 | 100 | ||
7.2 Manages the safe and timely discharge of patients from the ICU | 98.5 | 100 | |||
7.3 Communicates the continuing care requirements of patients at ICU discharge to healthcare professionals, patients, and relatives | 96.2 | 100 | |||
8. Transport | 8.1 Assesses patient before transport | 99.0 | 100 | ||
8.2 Prepares equipment for transport | 98.0 | 100 | |||
8.3 Performs intrahospital transport | 97.5 | 100 | |||
9. Patient safety and system management | 9.1 Complies with infection control measures | 99.0 | 100 | ||
9.2 Identifies environmental hazards and promotes safety for patients and staff | 97.2 | 92 | 100 | ||
9.3 Organizes a case conference | 98.0 | 100 | |||
9.4 Critically appraises and applies guidelines, protocols, and care bundles | 97.7 | 92 | 100 | ||
10. Professionalism | 10.1 Formulates clinical decisions with respect for ethical and legal principles | 95.0 | 100 | ||
10.2 Involves patients (or their surrogates if applicable) in decisions about care and treatment (including informed consent and end-of-life care) | 91.0 | 92 | 85 | 100 | |
10.3 Demonstrates respect of cultural and religious beliefs and an awareness of their impact on decision-making | 94.0 | 92 | 100 | ||
10.4 Promotes effective team working | 97.2 | 100 | |||
10.5 Communicates effectively with patients and relatives | 97.7 | 100 | |||
10.6 Communicates effectively with members of the healthcare team | 97.7 | 100 | |||
10.7 Maintains accurate medical records and documentation | 98.0 | 100 | |||
10.8 Respects privacy, dignity, confidentiality, and legal constraints on the use of patient data | 97.2 | 100 | |||
10.9 Takes responsibility for safe patient care | 97.7 | 100 | |||
10.10 Ensures continuity of care through effective handover of clinical information | 97.7 | 100 | |||
10.11 Seeks learning opportunities and integrates new knowledge into clinical practice | 97.7 | 100 | |||
10.12 Describes and explains the managerial and administrative responsibilities of the ICM specialist | 97.2 | 100 | |||
11. Certification | 11.1 Basic life support | 99.0 | 100 | ||
11.2 Advanced cardiac life support | 98.2 | 100 | |||