Gersten Jonker

134   Chapter 6 Ethical considerations Our study adhered to the World Medical Association Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects [6]. The study was announced and discussed at a UEMS/EBA national representatives’ meeting of November 2015, which generated support for the project. Detailed information on the study was provided in a letter sent by email explaining the goals and design of the study, specifying confidentiality and the handling of data. Participation was voluntary. Participants’ informed consent was obtained by e-mail. Formal ethical review was not sought, as only publicly available information was collected from individuals, who, in their capacity as national delegates, were known to be knowledgeable insiders and to have easy access to this information. Procedure For the purpose of this study ‘certification process’ was defined as: the process of all steps in meeting requirements and in decision-making, that eventually leads to the completion of training and access to registration as medical specialist in anesthesiology. Each participant was asked to describe the certification process, or processes, in their country in a survey consisting of five questions with a constructed response format (three open questions and two short-answer questions), and four questions with a selected response format (one yes/no question and three questions with a list of options) (Table 1). Authors GJ and LM designed the survey questions after orientation on the topic by initial review of online available training documents, followed by discussion with and input from the other authors. No formal piloting of the survey was performed, although all authors approved the survey for clarity and feasibility. Participants could either answer the survey questions in a text file attached to the invitation e-mail or follow a link to an identical online survey (SurveyMonkey®). In addition, participants were asked to provide relevant supporting documents on postgraduate anesthesiology training such as training frameworks, national syllabi, policies and legislation. Email reminders and personal contact by telephone were used to increase the response rate.