Best Practices / Research Oral Abstract

Using Modified Nominal Group Technique in Developing a Competency-Based Curriculum (O004)

Bruce Bellande, PhD, FACME, CCMEP (DWA Healthcare Communications Group); Kevin Benson, MD (Sanford Clinic); Bruno Gallo, MD (University of Miami School of Medicine); Maged Hamza, MD (VCU Spine Center); John Huffman, MD (Holy Cross Hospital); Michael Saulino, MD (Moss Rehab Outpatient Network); Steven Siegel, MD (Metro Urology); Michael Turner, MD (Campbel Brain and Spine); Susan Bennett, PT, DPT, EdD, NCS, MSCS (University of Buffalo); Susan Heath, RN (San Francisco VA Medical Center); Myra Joseph, RN (University of Texas Health Science Center); Gail McGlothlen, RN-BC, MS, CNS (Napa Pain Institute); Mary Elizabeth Nelson, NP (Froedtert Hospital); Glenn Sulley, RN (OU Physicians Urology); Cynthia Reese (Medtronic) 

Additional Authors

Zev Winicur, PhD, DWA Healthcare Communications Group; Kathleen Cox, MA, DWA Healthcare Communications Group; David Charles, MD, Vanderbilt University; David Caraway, MD, PhD, TriState Center for Pain Relief; Suzanne Dawidowicz, MBA, Medtronic; Peter Scott, Medtronic; Jamie Boche, Medtronic; Andrea Larson, Medtronic

Funding Sources

Project funded by Medtronic.


Using a modified group technique streamlined the process of identifying competencies for use in developing a competency-based curriculum.


Although competency-based curricula have been identified as effective means of developing continuing competence in clinical practice, the process of identifying competencies is often cumbersome.To streamline the process, a short-term, modified Nominal Group Technique (NGT) was tested as a means of validating and stratifying clinical competencies identified from existing course content. The validated competencies were used to develop a competency-based curriculum to train clinicians in identification, surgical implantation and stimulation, risk mitigation, and postoperative management of patients undergoing neuromodulation device therapies.


Educational planners used evidence-based methodologies to review existing course content and derive competencies for FDA-approved uses of deep brain stimulation; intrathecal drug delivery systems, including baclofen; sacral nerve stimulation; and spinal cord stimulation. In three rounds of NGT, therapy-specific physician and midlevel provider panels reviewed the competencies to validate their accuracy, reliability, and relevance; identify whether they are core or therapy specific; assess their learner level (novice, intermediate-to-advanced, or master); and specify their sequence within clinical practice (preoperative, operative, postoperative, and postoperative with complications). Educational planners revised the competencies based on the panelists’ feedback and assisted the panelists in coming to consensus.


Panelists validated and delineated relevance, type, learner level, and sequencing for more than 400 competencies for physicians/fellows across all therapy areas and more than 300 for midlevel providers. The process took ten weeks.


The NGT method was successful in streamlining the process of identifying competencies, learner levels, and prerequisites for use in developing comprehensive, competency-based curricula for training in neuromodulation therapies.


Bruce Bellande, Zev Winicur, Kathleen Cox, Cynthia Reese, Suzanne Dawidowicz, Jamie Boche, Andrea Larson and Cynthia Reese have nothing to report. Peter Scott has stock in Medtronic. The rest are paid consultants of Medtronic