The digital health competencies in medical education framework an international consensus statement based on a Delphi study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Importance: Rapid digitalization of healthcare and a dearth of digital health education for medical
students and junior doctors worldwide, means there is an imperative for more training in this dynamic and
evolving field.
Objective: To develop an evidence-informed, consensus-guided, adaptable digital health competencies
framework for the design and development of digital health curriculum in medical institutions globally.
Evidence Review: A core group was assembled to oversee the development of the Digital hEalth
COmpetencies in meDical Education (DECODE) framework. First, an initial list was created based on
findings from a scoping review and expert consultations. A multidisciplinary and geographically diverse
panel of 211 experts from 79 countries and territories was convened for a two-round, modified Delphi
survey conducted between December 2022 and July 2023 with an a priori consensus level of 70%. The
framework structure, wordings, and learning outcomes with marginal percentage of agreement were
discussed and determined in a consensus meeting organized on 8 September 2024 and subsequent post-meeting qualitative feedback. In total, 211 experts participated in Round 1, 149 in Round 2, 12 in the
consensus meeting, and 58 in post-meeting feedback.
Findings: The DECODE framework uses three main terminologies, namely domain, competency, and
learning outcome. Competencies were grouped into four domains: Professionalism in Digital Health,
Patient and Population Digital Health, Health Information Systems, and Health Data Science. Each
competency is accompanied by a set of learning outcomes that are either mandatory or discretionary. The
final framework comprises 4 domains, 19 competencies, 33 mandatory and 145 discretionary learning
outcomes, with descriptions for each domain and competency. Six highlighted areas of considerations for
medical educators are the variations in nomenclature, the distinctiveness of digital health, the concept of
digital health literacy, curriculum space and implementation, the inclusion of discretionary learning
outcomes, and socioeconomic inequities in digital health education.
Conclusions and Relevance: This evidence-informed and consensus-guided framework will play an
important role in enabling medical institutions to better prepare future doctors for the ongoing digital
transformation in healthcare. Medical schools are encouraged to adopt and adapt this framework to align
with their needs, resources, and circumstances.
students and junior doctors worldwide, means there is an imperative for more training in this dynamic and
evolving field.
Objective: To develop an evidence-informed, consensus-guided, adaptable digital health competencies
framework for the design and development of digital health curriculum in medical institutions globally.
Evidence Review: A core group was assembled to oversee the development of the Digital hEalth
COmpetencies in meDical Education (DECODE) framework. First, an initial list was created based on
findings from a scoping review and expert consultations. A multidisciplinary and geographically diverse
panel of 211 experts from 79 countries and territories was convened for a two-round, modified Delphi
survey conducted between December 2022 and July 2023 with an a priori consensus level of 70%. The
framework structure, wordings, and learning outcomes with marginal percentage of agreement were
discussed and determined in a consensus meeting organized on 8 September 2024 and subsequent post-meeting qualitative feedback. In total, 211 experts participated in Round 1, 149 in Round 2, 12 in the
consensus meeting, and 58 in post-meeting feedback.
Findings: The DECODE framework uses three main terminologies, namely domain, competency, and
learning outcome. Competencies were grouped into four domains: Professionalism in Digital Health,
Patient and Population Digital Health, Health Information Systems, and Health Data Science. Each
competency is accompanied by a set of learning outcomes that are either mandatory or discretionary. The
final framework comprises 4 domains, 19 competencies, 33 mandatory and 145 discretionary learning
outcomes, with descriptions for each domain and competency. Six highlighted areas of considerations for
medical educators are the variations in nomenclature, the distinctiveness of digital health, the concept of
digital health literacy, curriculum space and implementation, the inclusion of discretionary learning
outcomes, and socioeconomic inequities in digital health education.
Conclusions and Relevance: This evidence-informed and consensus-guided framework will play an
important role in enabling medical institutions to better prepare future doctors for the ongoing digital
transformation in healthcare. Medical schools are encouraged to adopt and adapt this framework to align
with their needs, resources, and circumstances.
Date Issued
2025-01-31
Date Acceptance
2024-10-16
Citation
JAMA Network Open, 2025, 8 (1)
ISSN
2574-3805
Publisher
JAMA Network
Journal / Book Title
JAMA Network Open
Volume
8
Issue
1
Copyright Statement
© 2025 Car J et al. JAMA Network Open. Open Access. This is an open access article distributed under the terms of the CC-BY License.
License URL
Identifier
10.1001/jamanetworkopen.2024.53131
Publication Status
Published
Article Number
e2453131
Date Publish Online
2025-01-31