A DELPHI STUDY TO DETERMINE THE KEY QUALITIES CONSULTANT HISTOPATHOLOGISTS USE TO DETERMINE DIAGNOSTIC COMPETENCY IN TRAINEES

Background There has been no clear description of what constitutes “diagnostic competence” in histopathology. We have published qualitative interview data exploring this concept that were used to devise a framework describing how consultants identify diagnostic competence in trainees. Objective A Delphi study was conducted to triangulate and determine the relative importance of the key qualities of trainees derived from the qualitative interviews. Methods Twelve participants were purposively chosen to form an expert panel of relevant stakeholders within the United Kingdom. Participants were asked to score and rank the items presented to them. Results A total of 22 out of 27 of the key qualities of trainees reached “consensus in,” suggesting that participants were able to agree that the majority of the items identified in the qualitative interviews were important to diagnostic competence. Five qualities reached “no consensus” and none reached “consensus out.” Participants did not suggest any additional qualities. Participants particularly valued qualities of reflection and professionalism and trainees who understood the process of reaching a diagnosis and how their pathological report could impact patient care. This culminated in entrusting work to trainees. Conclusions This study has triangulated findings from qualitative interviews and shows that consultants value a wide variety of qualities when determining trainees’ diagnostic competence. The judgment is complex and should be assessed longitudinally. Consultants can then assess consistency of both approach to diagnosis and trainee behavior. Curricula should focus on what trainees do in the workplace rather than demonstration of individual competencies.