Procedural sedation competencies: a review and multidisciplinary international consensus statement on knowledge, skills, training, and credentialing

Piet L Leroy; Baruch S Krauss; Luciane R Costa; Egidio Barbi; Michael G Irwin; Douglas W Carlson; Anthony Absalom; Gary Andolfatto; Mark G Roback; Franz E Babl; Keira P Mason; James Roelofse; Paulo S Costa; Steven M Green; International Committee for the Advancement of Procedural Sedation

doi:10.1016/j.bja.2024.07.036

Procedural sedation competencies: a review and multidisciplinary international consensus statement on knowledge, skills, training, and credentialing

Br J Anaesth. 2024 Sep 25:S0007-0912(24)00498-7. doi: 10.1016/j.bja.2024.07.036. Online ahead of print.

Authors

Affiliations

¹ Department of Pediatrics, Maastricht University Medical Centre and School of Health Professions Education, Maastricht University, Maastricht, The Netherlands. Electronic address: p.leroy@mumc.nl.
² Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
³ Department of Pediatric Dentistry, Federal University of Goias, Goiania, Goias, Brazil.
⁴ Department of Pediatrics, Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', Trieste, Italy.
⁵ Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
⁶ Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, IL, USA.
⁷ Department of Anaesthesia, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
⁸ University of British Columbia Department of Emergency Medicine, Lions Gate Hospital, North Vancouver, British Columbia, Canada.
⁹ Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
¹⁰ Departments of Paediatrics and Critical Care, University of Melbourne, Emergency Department, Royal Children's Hospital, Emergency Research, Murdoch Children's Research Institute, Parkville, WA, Australia.
¹¹ Department of Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
¹² Departments of Anaesthesia, University of the Western Cape, Stellenbosch University, Tygerberg, Republic of South Africa.
¹³ Department of Pediatrics, Federal University of Goias, Goiania, Goias, Brazil.
¹⁴ Department of Emergency Medicine, Loma Linda University, Loma Linda, CA, USA.

PMID: 39327154
DOI: 10.1016/j.bja.2024.07.036

Abstract

Procedural sedation is practised by a heterogeneous group of practitioners working in a wide array of settings. However, there are currently no accepted standards for the competencies a sedation practitioner should have, the content of sedation training programmes, and guidelines for credentialing. The multidisciplinary International Committee for the Advancement of Procedural Sedation sought to develop a consensus statement on the following: which competencies should medical or dental practitioners have for procedural sedation and how are they obtained, assessed, maintained, and privileged. Using the framework of Competency-Based Medical Education, the practice of procedural sedation was defined as a complex professional task requiring demonstrable integration of different competencies. For each question, the results of a literature review were synthetised into preliminary statements. Following an iterative Delphi review method, final consensus was reached. Using multispeciality consensus, we defined procedural sedation competence by identifying a set of core competencies in the domains of knowledge, skills, and attitudes across physical safety, effectiveness, psychological safety, and deliberate practice. In addition, we present a standardised framework for competency-based training and credentialing of procedural sedation practitioners.

Keywords: competencies; credentialing; entrustable professional activity; medical education; privileging; procedural sedation; quality and patient safety.