Development strategy for educational standards

The European task force, supported by the ERS School, applied a specific methodology consisting of facilitated group discussions, a modified Delphi consensus-building process and plenary meetings, to develop and produce a series of core documents setting out the agreed European consensus recommendations for each HERMES phase.

Syllabus phase: ‘what’

This phase aims to develop generally accepted European syllabi representing the content of the required knowledge (what respiratory specialists should know for their initial training in general respiratory medicine, and subsequently the additional knowledge required for those who choose to undertake more advanced training in a specific subspecialty area).

Curriculum phase: ‘how’

This phase aims to develop generally accepted recommendations for a full European curriculum, providing an overview of the entire content of the educational programme, not only what respiratory specialists should know, but also how competencies in respiratory medicine should be taught, learned and assessed. In addition, this phase also includes development of detailed recommended curriculum training modules, expressing objectives in terms of the knowledge, skills, and behaviour and attitudes required to complete each module.

In addition to the syllabus, other parts of the curriculum such as assessment and accreditation are also developed in greater detail in separate phases of the project as set out below.

Assessments phase

In the assessments phase, European assessment methods are developed. The first of these was the introduction of a voluntary knowledge-based examination in adult respiratory medicine with multiple-choice questions (MCQs), developed and run in close cooperation with the Institute of Medical Education in Bern, Switzerland, to assure high-quality professional educational standards. The examination is based on the examination blueprint – which comprises weighted examination topics from the 2006 syllabus – and is composed of 90 MCQs which must be answered in 3 hours. Only successful candidates who are already qualified as national respiratory specialists are eligible to receive the ERS Diploma in Adult Respiratory Medicine, as a recognised European qualification to mark their high quality and commitment to high-level knowledge. The examination is also used for regular revalidation, and is open to trainee specialists to test their knowledge. Following the success of the adult examination, a paediatric version has also been introduced.

More recently, the ERS School and HERMES task forces have seen the need to move beyond MCQ examinations based solely on the assessment of knowledge. Task forces are now investigating direct observation of procedural skills (DOPS) and other assessment methods for subspecialty areas of respiratory medicine.

Accreditation of training centres phase

The accreditation phase will enable European training centres in respiratory specialties to apply for ERS/EBAP accreditation. The purpose of accreditation within the HERMES initiative is to ensure that training centre networks whose educational programmes in respiratory specialties reach the required level of excellence are certified as such.

Development of this project phase requires two key steps:

1) Documented minimum criteria for a training centre.
2) Detailed processes and supporting documentation to  determine whether the prerequisites are met.

The second step refers to the accreditation process itself and is based on the well-established accreditation practice of site visitation.

Network of supporting initiatives

The successful implementation of the HERMES educational standards in respiratory medicine is dependent not only on the core activities but also on a network of supporting initiatives, including preparation courses for the examination, educational resources, and e-learning activities for example (figure 2).

See the entire Specialist clinical training (HERMES) chapter