Defining the key competencies in radiation protection for endovascular procedures : a multispecialty Delphi consensus study

Objectives: Radiation protection training courses currently focus on broad knowledge topics which may not always be relevant in daily practice. The goal of this study is to determine the key competencies in radiation protection that every endovascular team member should possess and apply routinely, through multispecialty clinical-content expert consensus. Design: Consensus was obtained through a two-round modified Delphi methodology. Methods: The expert panel consisted of European vascular surgeons, interventional radiologists and interventional cardiologists/angiologists experienced in endovascular procedures. An initial list of statements, covering knowledge skills, technical skills and attitudes was created, based on a literature search. Additional statements could be suggested by the experts in the first Delphi round. Each of the statements had to be rated on a 5-point Likert scale. A statement was considered to be a key competency when the internal consistency was larger than alpha = 0.80 and at least 80% of the experts agreed (rating 4/5) or strongly agreed (rating 5/5) with the statement. Questionnaires were emailed to panel members using the Surveymonkey service. Results: Forty-one out of sixty-five (63.1%) invited experts agreed to participated in the study. The response rate was 38/41(92.6%) in the first round and 36/41(87.8%) in the second round. The 71 primary statements were supplemented with 9 items suggested by the panel. Results showed excellent consensus among responders (Cronbach’s alpha = 0.937 first round; 0.958 second round). Experts achieved a consensus that 30/33 knowledge skills (90.9%), 23/27 technical skills (82.1%) and 15/20 attitudes (75.0%) should be considered as key competencies. Conclusions: A multispecialty European endovascular expert panel reached consensus about the key competencies in radiation protection. These results may serve to create practical and relevant radiation protection training courses in the future, enhancing radiation safety for both patients and the entire endovascular team