Patricia B Neumann1, Nada Radi2, Tamara Lynn Gerdis2, Clee Tonkin2, Chenaye Wright2, K Jane Chalmers3,4, Irena Nurkic2. 1. Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, SA, 5000, Australia. trish.neumann@unisa.edu.au. 2. Curtin School of Allied Health, Curtin University, Perth, WA, 6845, Australia. 3. School of Health Sciences, Western Sydney University, Campbelltown, NSW, 2560, Australia. 4. IIMPACT in Health Research, Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, SA, 5000, Australia.
Abstract
INTRODUCTION AND HYPOTHESIS: Vaginal support pessaries are intravaginal devices designed to relieve symptoms of pelvic organ prolapse, but they can cause serious medical complications if not managed well. Physiotherapists are well placed to manage pessaries, but there are no guidelines on the training required for competency in pessary management (PM). METHODS: A scoping review of current literature on PM training was conducted to develop draft competency standards, which were reviewed by a multidisciplinary focus group. Using e-Delphi methodology, a multidisciplinary and multinational expert panel then refined the standards. Three rounds of e-Delphi online surveys were conducted, with individual participant feedback and one videoconference to discuss items that did not reach consensus. Consensus was set at 80% agreement and stability measured using kappa coefficient. RESULTS: Pessary training competency standards, developed by 29 experts, covered three key domains including: (1) prerequisite knowledge and understanding; (2) entrustable professional activities; (3) pessary-specific standards under ten key roles. Consensus was reached on all 73 (100%) competency standards and stability demonstrated for 95.9% of standards. There was no attrition of expert panel participants through the e-Delphi rounds. CONCLUSIONS: This e-Delphi study provides the first, robust recommendations on training standards for physiotherapists in PM. These competency standards will provide clinicians with a self-assessment tool, and educators and training institutions with a benchmark in training for PM, which should improve options and reduce risk for women with prolapse being managed with a pessary.
INTRODUCTION AND HYPOTHESIS: Vaginal support pessaries are intravaginal devices designed to relieve symptoms of pelvic organ prolapse, but they can cause serious medical complications if not managed well. Physiotherapists are well placed to manage pessaries, but there are no guidelines on the training required for competency in pessary management (PM). METHODS: A scoping review of current literature on PM training was conducted to develop draft competency standards, which were reviewed by a multidisciplinary focus group. Using e-Delphi methodology, a multidisciplinary and multinational expert panel then refined the standards. Three rounds of e-Delphi online surveys were conducted, with individual participant feedback and one videoconference to discuss items that did not reach consensus. Consensus was set at 80% agreement and stability measured using kappa coefficient. RESULTS: Pessary training competency standards, developed by 29 experts, covered three key domains including: (1) prerequisite knowledge and understanding; (2) entrustable professional activities; (3) pessary-specific standards under ten key roles. Consensus was reached on all 73 (100%) competency standards and stability demonstrated for 95.9% of standards. There was no attrition of expert panel participants through the e-Delphi rounds. CONCLUSIONS: This e-Delphi study provides the first, robust recommendations on training standards for physiotherapists in PM. These competency standards will provide clinicians with a self-assessment tool, and educators and training institutions with a benchmark in training for PM, which should improve options and reduce risk for women with prolapse being managed with a pessary.
Authors: Bernard T Haylen; Christopher F Maher; Matthew D Barber; Sérgio Camargo; Vani Dandolu; Alex Digesu; Howard B Goldman; Martin Huser; Alfredo L Milani; Paul A Moran; Gabriel N Schaer; Mariëlla I J Withagen Journal: Neurourol Urodyn Date: 2016-01-07 Impact factor: 2.696
Authors: Anne-Lotte W M Coolen; Stephanie Troost; Ben Willem J Mol; Jan- Paul W R Roovers; Marlies Y Bongers Journal: Int Urogynecol J Date: 2017-06-09 Impact factor: 2.894