DOI: 10.1093/bjs/znag087.055 ISSN: 0007-1323

SP 4.09 Integrating Evidence-Based Medicine in the General Surgery Curriculum; A Modified Delphi Study

Evripidis Tokidis, Saba Balasubramaninan, Pirashanthie Vivekananda-Schmidt

Abstract

Aims

Recent research has highlighted inconsistent teaching and application of Evidence-Based Medicine (EBM) within general surgery education. Existing international EBM competency frameworks are not tailored to the specific requirements of surgical training, and no specialty-specific curriculum currently exists. This study aims to establish stakeholder agreement on core components of an EBM curriculum in general surgery and explore potential implementation strategies.

Methods

This modified Delphi study was conducted electronically with surgical educators involved in postgraduate general surgery training. Participants rated their agreement to 21 statements using a five-point Likert scale and provided commentary. Consensus was predefined as ≥70% agreement. Quantitative findings were summarised using percentage agreement, medians, and interquartile ranges; commentary was retained verbatim after Round 1 and analysed thematically after Round 2 when the study concluded.

Results

Thirty-six and twenty panellists completed Rounds 1 and 2 respectively. Strong consensus was reached on key EBM competencies—including question formulation, evidence retrieval, critical appraisal, and application of evidence in clinical decisions—and on preferred teaching approaches. Qualitative feedback emphasised the value of EBM while identifying feasibility, supervisory capacity, and resource constraints. A single statement proposing assessment of EBM through existing Workplace-Based Assessments did not reach consensus across two rounds; response stability, supported by panel diversity and a 50% retention rate informed the decision not to proceed to a third round.

Conclusion

The study establishes consensus on core EBM competencies for general surgery. These findings provide a foundation for curriculum development and highlight areas such as assessment that require further refinement before implementation.

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