General Medicine · Medical Literature
Establishing international expert consensus on core competencies and best practices in osteopathic education: a modified Delphi study protocol
Abstract
Background Osteopathic education is typically delivered through accredited higher education institutions with curricula not only varying widely but also inconsistently aligned with contemporary evidence. This lack of standardisation creates challenges in accreditation, workforce mobility and public understanding of the osteopathic role. Objective The objective of this study aims to develop international expert consensus on core osteopathic capabilities through a structured Delphi process. Methods and analysis This protocol describes a three-round modified Delphi study involving international experts in osteopathic education. Participants will be purposively recruited from accredited osteopathic education programmes and professional networks and must have at least 5 years’ experience in osteopathic education, curriculum development or clinical supervision. A target sample of 40–60 experts will be sought. In round 1, participants will respond to open-ended questions exploring core competencies and educational priorities. Responses will be independently coded by two members of the research team using thematic analysis before being synthesised into consensus statements through investigator agreement. Rounds 2 and 3 will involve structured rating of these statements using a 4-point Likert scale with optional free-text comments to refine wording where appropriate. Descriptive statistics will be used to determine consensus, assess stability between rounds and guide item retention. Ethics and dissemination Ethics approval for this study was obtained from the RMIT University Human Research Ethics Committee, Australia (2025–29731-30793). Participation is voluntary and pseudo-anonymous, with informed consent obtained electronically. Findings will be disseminated through peer-reviewed publications, conference presentations and to professional bodies to support curriculum alignment, accreditation processes and international dialogue on capability development
Clinical relevance
Osteopathic education currently lacks international standardisation, with curricula varying widely across accredited institutions and inconsistently aligned with contemporary evidence — creating tangible barriers to accreditation equivalency, cross-border workforce mobility, and public understanding of the osteopathic scope of practice. This study addresses a critical gap by initiating the first structured international expert consensus process to define core osteopathic competencies and educational benchmarks. Clinicians, educators, and health system planners involved in interprofessional collaboration or credentialing of osteopathic practitioners should monitor these findings as they may directly inform workforce policy and scope-of-practice frameworks.
Key findings
1. Study design: A three-round modified Delphi protocol was registered and ethics-approved (RMIT University HREC, Australia, 2025–29731-30793), indicating methodological rigour appropriate for consensus-generating research in health professions education. 2. Target sample: 40–60 international experts will be purposively recruited from accredited osteopathic education programmes and professional networks, with a minimum eligibility threshold of 5 years' experience in osteopathic education, curriculum development, or clinical supervision. 3. Round 1 methodology: Open-ended qualitative questioning will be used to elicit expert perspectives on core competencies and educational priorities, with responses independently dual-coded using thematic analysis and synthesised into consensus statements via investigator agreement — reducing single-rater bias. 4. Rounds 2 and 3 methodology: Structured rating of synthesised statements will employ a 4-point Likert scale (no neutral midpoint, forcing directional response) with optional free-text refinement, and descriptive statistics will quantify consensus level, inter-round stability, and item retention thresholds. 5. Quantitative outcomes: Specific consensus thresholds (e.g., percentage agreement cut-offs) and pre-defined item retention criteria are not reported in this protocol abstract — a limitation of appraising a study protocol prior to data collection. 6. Dissemination scope: Findings are intended for peer-reviewed publication and direct engagement with professional bodies to support curriculum alignment and international accreditation dialogue — signalling intended real-world policy impact beyond academic publication.
Practice implications
Clinicians and health educators involved in osteopathic credentialing, interprofessional team composition, or postgraduate supervision should note that this consensus process may yield the first internationally validated competency framework for osteopathic practice, with direct implications for standardising entry-to-practice expectations across jurisdictions. Institutions involved in accreditation or workforce planning should engage with the dissemination outputs of this study — particularly any capability statements endorsed at consensus — to benchmark local curricula and inform scope-of-practice determinations. Note that as this is a published protocol rather than a completed trial, no efficacy, outcome, or patient-level data are yet available; clinical practice changes should await the full Delphi findings.