Development of core competency indicators for emergency medicine residents based on the competency model: a Delphi and analytic hierarchy process study

BACKGROUND: Standardized residency training in emergency medicine is not well-defined in China. Establishing a core competency indicator system for emergency residency training is essential for standardizing and enhancing the quality of training and emergency care. OBJECTIVES: This study aimed to develop a core competency indicator system for emergency residency training in China, based on the competency iceberg model. METHODS: This study employed a multi-step approach, including a literature review, semi-structured expert interviews, to formulate a list of preliminary indicators. A two-round modified Delphi method was utilized to achieve consensus, with 19 emergency experts recruited from 11 tertiary hospitals across four regions of China. Consensus was determined using a 5-point Likert scale, with a mean importance score > 3.5, a coefficient of variation < 0.20, and a full-score proportion > 20% serving as criteria for indicator retention. RESULTS: All 19 invited experts completed both rounds of consultation, achieving a 100% valid response rate. The authority coefficient of the consultation was 0.895, and Kendall's W values ranged from 0.566 to 0.634 (p < 0.005), indicating strong expert consensus. The final indicator system includes 34 third-level indicators within 14 s-level indicators, categorized into 5 first-level dimensions: motivation, trait, self-concept, knowledge, and skill. CONCLUSIONS: This study represents an initial step towards establishing a contemporary competency-based training program for emergency residency training in China, providing a scientific reference for the standardization of emergency residency training.