Defining core procedure skills for Canadian family medicine training.

Objective: To create a list of core and enhanced procedures suitable for family medicine training.

Design: Mailed or e-mailed survey using a Delphi technique.

Setting: Randomly selected family physician practices across Canada.

Participants: Family physicians from urban, small-town, and rural practice locations and academic family physicians. All were experienced family physicians with from 3 to 36 years in practice.

Interventions: Participant physicians were asked to rate each of 158 procedures as to whether they would expect a graduate from a Canadian family practice training program to have learned and be capable of performing that procedure in their own community. In a second survey, participants were asked to verify the core and enhanced procedures lists produced from the first survey.

Main Outcome Measures: Physicians' opinions about a comprehensive list of skills.

Results: Twenty-two physicians responded to the first survey (92% response rate) and 14 to the second (58% response rate). Sixty-five core procedures and 15 enhanced procedures were identified in the surveys. More procedures were ranked on the core list and were performed by rural and small-town physicians than by urban physicians. Physicians' agreement with placement of procedures on the core list ranged from 55% to 100% and of procedures on the enhanced list from 50% to 64%. Fifty-five of the procedures on the core list had agreement from more than 70% of participants.

Conclusion: Procedure lists represent the opinions of Canadian family physicians about the importance of specific procedure skills for new family physicians in their communities. Procedure lists will be helpful for family medicine training programs to evaluate and refine their teaching of procedure skills.