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The Acute Care Undergraduate TEaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom

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The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented. The aim of this study was to use consensus techniques to identify the core competencies in the care of acutely ill or arrested adult patients that medical students should possess at the point of graduation.


Healthcare professionals were invited to contribute suggestions for competencies to a website as part of a modified Delphi survey. The competency proposals were grouped into themes and rated by a nominal group comprised of physicians, nurses and students from the UK. The nominal group rated the importance of each competency using a 5-point Likert scale.


A total of 359 healthcare professionals contributed 2,629 competency suggestions during the Delphi survey. These were reduced to 88 representative themes covering: airway and oxygenation; breathing and ventilation; circulation; confusion and coma; drugs, therapeutics and protocols; clinical examination; monitoring and investigations; team-working, organisation and communication; patient and societal needs; trauma; equipment; pre-hospital care; infection and inflammation. The nominal group identified 71 essential and 16 optional competencies which students should possess at the point of graduation.


We propose these competencies form a core set for undergraduate training in resuscitation and acute care.

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We thank the contributors to the Delphi process, the nominal group members (Mrs. Catherine Baldock, Professor Matthew Cooke, Dr. Brian Cuthbertson, Dr. Sheena Hubble), Sara Harris, Administration Manager at the Resuscitation Council (UK) for administrative support and Bob Harris for developing the ACUTE website.

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Correspondence to Gavin D. Perkins.

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This study was supported by an unrestricted research grant from the Resuscitation Council (UK). The funding organisation hosted the website for phase 1 of the study and provided accommodation and travel costs for the nominal group meeting. The funding organisation did not contribute to the study design, analysis or interpretation of results or decision to submit for publication.

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Perkins, G.D., Barrett, H., Bullock, I. et al. The Acute Care Undergraduate TEaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom. Intensive Care Med 31, 1627–1633 (2005).

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