• Rene de la Fuente, Eduardo Kattan, Jorge Munoz-Gama, Ignacio Puente, Matías Navarrete, Catalina Kychenthal, Ricardo Fuentes, Sebastian Bravo, Victor Galvez, and Marcos Sepúlveda.
• División de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
• Acta Anaesthesiol Scand. 2021 Feb 1; 65 (2): 244-256.

BackgroundDeconstructing a complex procedure improves skills learning, but no model has covered all relevant Percutaneous Dilatational Tracheostomy (PDT) procedural aspects. Moreover, the heterogeneity of techniques described may hinder trainees' competency acquisition. Our objective was to develop a PDT model for procedural training that includes a comprehensive step-by-step design.MethodsProcedural descriptions were retrieved after a structured search in medical databases. Activities were extracted and the adherence to McKinley's dimensions of procedural competence was analyzed. We developed a comprehensive PDT model, which was further validated through a Delphi-based consensus of Spanish-speaking international experts.ResultsThe 14 descriptions retrieved for analysis presented a median [interquartile range] of 18 [11-22] steps, covering 3 [2-4] of McKinley's dimensions. The Delphi panel's first model included all McKinley's dimensions, and was answered by 25 experts from nine countries, ending in the second round. The final model included 59 activities divided into six stages (51 from the initial model and eight proposed by experts) and performed by two operators (bronchoscopy and tracheostomy).ConclusionsWe have presented a PDT model that includes necessary competence dimensions to be considered complete. The model was validated by an experts' consensus, allowing to improve procedural training to promote safer patient care.© 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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