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LEARNING IN PRACTICE: Abdelaziz Alahlafi and Susan Burge What should undergraduate medical students know about psoriasis? Involving patients in curriculum development: modified Delphi technique BMJ 2005; 330: 633-636 [Abstract] [Full text]

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Novel and realistic Design

subramanian mahadevan   (24 March 2005)

Methodological Shortcomings

Paul McCoubrie   (17 May 2005)

Novel and realistic Design 24 March 2005
subramanian mahadevan, Professor Pondicherry Send response to journal: Re: Novel and realistic Design	The authors have come out with a novel and realistic way of designing a curriculum for medical students based on the "felt-needs of the clients". Patients with chronic diseases will not be hurt by "poorly thoughtout and throwaway responses" by the trainees. The authors have shown a way to be followed. Competing interests: None declared
Methodological Shortcomings 17 May 2005
Paul McCoubrie, Consultant Radiologist North Bristol NHS Trust Send response to journal: Re: Methodological Shortcomings	Alahlafi & Burge (1) are to be congratulated on their use of the Delphi technique to attempt to gain a consensus on what medical students should know about psoriasis. In particular, their involvement of patients is to be applauded. The Delphi technique has several key characteristics that distinguish it from other group decision-making processes (2). One of these is iteration with controlled feedback. The iterative process summarizes, averages and recycles views of the panel members yet it allows complex problems to be discussed. Through iteration, the expert panel is encouraged to refine their opinions thereby converging on a consensus. The authors of this study performed a small pilot study but failed to perform any further iteration and feedback. Without this key step, unfortunately, they have violated a fundamental underpinning part of the method. This is commonplace and often due to ignorance of the method (3). As a result, the authors have not performed a modified Delphi study, merely a cross-sectional, questionnaire-based survey. This fundamental error should have been picked up a the review stage. A retraction or or least a published erratum should follow. Refs 1) Alahlafi A & Burge S. What should undergraduate medical students know about psoriasis? Involving patients in curriculum development: modified Delphi technique. BMJ 2005; 330: 633-636. 2) Jones JMG & Hunter D. Qualitative research: consensus methods for medical and health services research. BMJ 1995; 311: 376-380. 3) Crisp J et al. Its all in a name. When is a "Delphi study" not a Delphi study? Aus J Adv Nurs 1999; 26(3): 32-37. Competing interests: None declared