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Development of a multinational, multidisciplinary competency framework for physiotherapy training in pessary management: an E-Delphi study

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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.

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Acknowledgements

The authors would like to thank the e-Delphi expert panel for their valued contributions and commitment to this project and Ms. Angela Jacques for her assistance in statistical analysis.

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Authors and Affiliations

  1. Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, SA, 5000, Australia

    Patricia B. Neumann

  2. Curtin School of Allied Health, Curtin University, Perth, WA, 6845, Australia

    Nada Radi, Tamara Lynn Gerdis, Clee Tonkin, Chenaye Wright & Irena Nurkic

  3. School of Health Sciences, Western Sydney University, Campbelltown, NSW, 2560, Australia

    K. Jane Chalmers

  4. IIMPACT in Health Research, Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, SA, 5000, Australia

    K. Jane Chalmers

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  1. Patricia B. Neumann
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  2. Nada Radi
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  4. Clee Tonkin
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  5. Chenaye Wright
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Contributions

• PB Neumann: Conception and design, analysis and interpretation of data, revision for intellectual content, final approval of completed article

• N Radi: Project development, data collection and analysis, manuscript writing/editing.

• TL Gerdis: Project development, ethics application, data collection, manuscript writing/editing.

• C Tonkin: Project development, scoping review, data collection, manuscript writing/editing.

• C Wright: Project development, scoping review, data collection and analysis, manuscript writing/editing.

• KJ Chalmers: Design, analysis and interpretation of data, revision for intellectual content, final approval of completed article.

• I Nurkic: Conception and design, analysis and interpretation of data, revision for intellectual content, final approval of completed article.

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Correspondence to Patricia B. Neumann.

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Appendices

Appendix 1

Table 5. Scoping review search strategy
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Appendix 2

Scoping review PRISMA flowchart

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Neumann, P.B., Radi, N., Gerdis, T.L. et al. Development of a multinational, multidisciplinary competency framework for physiotherapy training in pessary management: an E-Delphi study. Int Urogynecol J 33, 253–265 (2022). https://doi.org/10.1007/s00192-021-04843-6

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  • DOI: https://doi.org/10.1007/s00192-021-04843-6

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