A limitation to using the Delphi technique is that results could be biased because of the composition of the expert panel itself(Keeney et al., 2011). Although participants in the current study were experts in managing patients with SWD or delirium in the inpatient clinical setting, simulation experts could have been included in this study. These experts could add input on the feasibility of implementing this competency checklist in a simulation setting. In addition, nurses and physicians were surveyed separately for the three Delphi rounds. The combined health care provider checklist could be further refined if nurses and physicians completed the same survey.