{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:39:46Z","timestamp":1792409986209,"version":"4.4.0"},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"8","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brazilian Medical Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: To develop Part II of the National Consensus Catalogue of essential psychomotor competencies and establish the minimum expected competence levels for graduating medical students across 11 clinical and diagnostic support specialties in Brazil using a modified Delphi process.  METHODS: This national consensus-development study used a two-phase, two-round modified Delphi process coordinated by the Brazilian Medical Association. Preliminary specialty-specific catalogues were developed between February and June 2025 by Scientific Committees from 11 specialty societies, which also proposed the minimum expected competence level for each psychomotor competency statement. Round 1 of the modified Delphi process was conducted from August to December 2025, and Round 2 was conducted from February to June 2026. Board-certified physicians evaluated each competency-competence level combination using a five-point Likert scale. Consensus was predefined as \u226575% agreement. Statements achieving &lt;60% agreement were excluded after Round 1, whereas those achieving 60.0\u201374.9% agreement were revised and reassessed in Round 2. Additional competency statements proposed during Round 1 were evaluated in Round 2.  RESULTS: A total of 667 physicians participated in Round 1, and 499 completed Round 2. The preliminary catalogues comprised 346 psychomotor competency statements; 240 (69.4%) achieved consensus and 106 (30.6%) were excluded. Participants proposed 38 additional statements, of which 36 (94.7%) achieved consensus in Round 2. The Part II catalogue comprised 276 specialty-specific psychomotor competency statements, corresponding to 229 unique psychomotor competencies after harmonization. Most competency statements were classified as perform independently (n=195), followed by perform under supervision (n=62) and master the technique (n=19).  CONCLUSION: This modified Delphi study established Part II of the National Consensus Catalogue of essential psychomotor competencies and minimum expected competence levels for graduating medical students, encompassing 11 clinical and diagnostic support specialties in Brazil.<\/jats:p>","DOI":"10.1590\/1806-9282.20261142","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:42:53Z","timestamp":1792406573000},"source":"Crossref","is-referenced-by-count":0,"title":["National Consensus Catalogue of Psychomotor Competencies for Brazilian Medical Graduates: a modified Delphi Study \u2013 Part II"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1710-0318","authenticated-orcid":false,"given":"Adriana Gibo","family":"Padanosque","sequence":"first","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1861-1312","authenticated-orcid":false,"given":"Jos\u00e9 Eduardo Lutaif","family":"Dolci","sequence":"additional","affiliation":[{"name":"Santa Casa de S\u00e3o Paulo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7796-6386","authenticated-orcid":false,"given":"C\u00e9sar Eduardo","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina do ABC","place":["Santo Andr\u00e9, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4376-2059","authenticated-orcid":false,"given":"Ant\u00f4nio Jos\u00e9","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Santa Casa de S\u00e3o Paulo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4547-7926","authenticated-orcid":false,"given":"Lucas de Oliveira","family":"Sassi","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7913-0585","authenticated-orcid":false,"given":"Francisco Sandro","family":"Menezes-Rodrigues","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7490-4999","authenticated-orcid":false,"given":"Jos\u00e9 Mario","family":"Podanosque","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0450-4963","authenticated-orcid":false,"given":"Fernando Sabia","family":"Tallo","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"sup1","key":"ref1","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1080\/0142159X.2024.2351215","article-title":"Competency-based medical education guidelines are context-based: lessons from national guidelines in five countries","volume":"46","author":"Matsuyama Y","year":"2024","journal-title":"Med Teach"},{"issue":"5","key":"ref2","first-page":"Doc68","article-title":"National Competence-Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM): process description over the last 15 years","volume":"43","author":"Jennebach J","year":"2026","journal-title":"GMS J Med Educ"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1186\/s12909-025-07342-0","article-title":"Implementation of United Arab Emirates competency framework for medical education in undergraduate medical curriculum","volume":"25","author":"Kar SS","year":"2025","journal-title":"BMC Med Educ"},{"issue":"2","key":"ref4","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1080\/0142159X.2023.2232097","article-title":"Competency-based medical education: the spark to ignite healthcare\u2019s escape fire","volume":"46","author":"Schumacher DJ","year":"2024","journal-title":"Med Teach"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1186\/s12909-025-07694-7","article-title":"Building the 8-star doctor: a modified Delphi study to define, teach, and assess health professions education for undergraduate medical students","volume":"25","author":"Khan SJ","year":"2025","journal-title":"BMC Med Educ"},{"issue":"1","key":"ref6","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1186\/s12909-024-05553-5","article-title":"Defining a set of teaching EPAs tailored to an undergraduate medical curriculum using a modified Delphi approach","volume":"24","author":"Peters H","year":"2024","journal-title":"BMC Med Educ"},{"key":"ref7","series-title":"C\u00e2mara de Educa\u00e7\u00e3o Superior","volume-title":"Minist\u00e9rio da Educa\u00e7\u00e3o. Conselho Nacional de Educa\u00e7\u00e3o","year":"2014"},{"issue":"8","key":"ref8","doi-asserted-by":"crossref","first-page":"e0304651","DOI":"10.1371\/journal.pone.0304651","article-title":"Delphi studies in social and health sciences: recommendations for an interdisciplinary standardized reporting (DELPHISTAR). Results of a Delphi study","volume":"19","author":"Niederberger M","year":"2024","journal-title":"PLoS One"},{"issue":"1","key":"ref9","doi-asserted-by":"crossref","first-page":"e1004326","DOI":"10.1371\/journal.pmed.1004326","article-title":"ACCORD (ACcurate Consensus Reporting Document): a reporting guideline for consensus methods in biomedicine developed via a modified Delphi","volume":"21","author":"Gattrell WT","year":"2024","journal-title":"PLoS Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"23821205251327363","DOI":"10.1177\/23821205251327363","article-title":"Identifying essential procedural skills for medical students: a modified Delphi technique","volume":"12","author":"Kodikara K","year":"2025","journal-title":"J Med Educ Curric Dev"},{"issue":"8","key":"ref11","doi-asserted-by":"crossref","first-page":"638","DOI":"10.3109\/0142159X.2010.501190","article-title":"Competency-based medical education: theory to practice","volume":"32","author":"Frank JR","year":"2010","journal-title":"Med Teach"},{"issue":"6","key":"ref12","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1080\/0142159X.2017.1315066","article-title":"Toward a shared language for competency-based medical education","volume":"39","author":"Englander R","year":"2017","journal-title":"Med Teach"},{"issue":"1","key":"ref13","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/s12909-024-05082-1","article-title":"Mapping an undergraduate medical education curriculum against national and international palliative care reference learning objectives","volume":"24","author":"Murphy R","year":"2024","journal-title":"BMC Med Educ"},{"issue":"3","key":"ref14","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s40670-022-01558-1","article-title":"An exemplar milestone framework for scaffolding a competency-based medical school curriculum","volume":"32","author":"Laird-Fick HS","year":"2022","journal-title":"Med Sci Educ"},{"issue":"5","key":"ref15","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3109\/0142159X.2011.565831","article-title":"Performance in assessment: consensus statement and recommendations from the Ottawa conference","volume":"33","author":"Boursicot K","year":"2011","journal-title":"Med Teach"},{"issue":"12","key":"ref16","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/j.1365-2929.2005.02341.x","article-title":"Entrustability of professional activities and competency-based training","volume":"39","author":"ten Cate O","year":"2005","journal-title":"Med Educ"},{"issue":"2","key":"ref17","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/ACM.0000000000003800","article-title":"Entrustment decision making: extending Miller\u2019s pyramid","volume":"96","author":"Cate OT","year":"2021","journal-title":"Acad Med"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/medu.14580","article-title":"Autonomy and developing physicians: reimagining supervision using self-determination theory","volume":"56","author":"Sawatsky AP","year":"2022","journal-title":"Med Educ"},{"issue":"6","key":"ref19","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1080\/0142159X.2017.1315067","article-title":"A call to action: the controversy of and rationale for competency-based medical education","volume":"39","author":"Holmboe ES","year":"2017","journal-title":"Med Teach"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/1478-4491-10-43","article-title":"The promise of competency-based education in the health professions for improving global health","volume":"10","author":"Gruppen LD","year":"2012","journal-title":"Hum Resour Health"},{"issue":"1","key":"ref21","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/medu.12839","article-title":"The promise, perils, problems and progress of competency-based medical education","volume":"50","author":"Touchie C","year":"2016","journal-title":"Med Educ"},{"issue":"11","key":"ref22","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1111\/j.1553-2712.2008.00227.x","article-title":"Deliberate practice and acquisition of expert performance: a general overview","volume":"15","author":"Ericsson KA","year":"2008","journal-title":"Acad Emerg Med"},{"issue":"10","key":"ref23","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1590\/1806-9282.66.10.1409","article-title":"Comparison of three methods for teaching mechanical ventilation in an emergency setting to sixth-year medical students: a randomized trial","volume":"66","author":"Tallo FS","year":"2020","journal-title":"Rev Assoc Med Bras (1992)"},{"issue":"27","key":"ref24","doi-asserted-by":"crossref","first-page":"e38813","DOI":"10.1097\/MD.0000000000038813","article-title":"The impact of simulation-based training in medical education: a review","volume":"103","author":"Elendu C","year":"2024","journal-title":"Medicine (Baltimore)"},{"issue":"9","key":"ref25","doi-asserted-by":"crossref","first-page":"601","DOI":"10.6061\/clinics\/2014(09)05","article-title":"An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil","volume":"69","author":"Tallo FS","year":"2014","journal-title":"Clinics (Sao Paulo)"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302026000802221&tlng=en","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302026000802221&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:42:57Z","timestamp":1792406577000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302026000802221&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":25,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0104-42302026000802221"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20261142","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20261142"}}