Contributed by Madelin Siedler, 2019/2020 U.S. GRADE Network Research Fellow
As an increasing number of organizations are developing
clinical guidelines, expectations for the quality and trustworthiness of these
guidelines are on the rise as well. Thus, there is an increased need for
guideline-producing organizations to identify, train, and hire or contract with
individuals who are adequately skilled in guideline development methods, and
for a clear delineation of the knowledge and skill sets required of these
individuals.
Recently, seven members of the U.S.
GRADE Network and GRADE Working Group co-published an article establishing a
framework of core competencies for individuals serving on guideline development
panels in a variety of roles, from panel content experts to methodologists. The
paper outlines the minimal knowledge, skills, and expertise that would allow an
individual to perform tasks adequately. The framework describes three major
domains of competency for guideline development: facilitating the development
of guideline structure and setup, making judgments about the quality or
certainty of evidence, and transforming evidence into recommendations.
Within each core competency, there
are multiple sub-competencies and various educational “milestones” which further
clarify the required skill. These milestones track to the five stages of
educational development established by the Dreyfus model: novice, advanced
beginner, competent, proficient, and expert. The authors note that the required
level of expertise related to these milestones will vary depending on the role
of the individual in developing the guideline. While some sub-competencies
related to rating of the certainty of evidence follow the GRADE approach
specifically, much of the competency-based framework can be applied universally
to other guideline development methodologies. The authors encourage future
research efforts to validate, assess, and refine the proposed milestones for
their widespread use in efforts to train the next generation of guideline
developers.
Sultan S, Morgan RL, Murad MH, Falck-Ytter Y, Dahm P, Schünemann HJ, Mustafa RA. A Theoretical Framework and Competency-Based Approach to Training in Guideline Development. Journal of general internal medicine. 2019 Nov 14:1-7.
Manuscript available here on publisher's site.
