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Academic Medicine : Journal of the... Dec 2019To summarize the state of evidence related to undergraduate medical education (UME) accreditation internationally, describe from whom and where the evidence has come,... (Review)
Review
PURPOSE
To summarize the state of evidence related to undergraduate medical education (UME) accreditation internationally, describe from whom and where the evidence has come, and identify opportunities for further investigation.
METHOD
The authors searched Embase, ERIC, PubMed, and Scopus from inception through January 31, 2018, without language restrictions, to identify peer-reviewed articles on UME accreditation. Articles were classified as scholarship if all Glassick's criteria were met and as nonscholarship if not all were met. Author, accrediting agency, and study characteristics were analyzed.
RESULTS
Database searching identified 1,379 nonduplicate citations, resulting in 203 unique, accessible articles for full-text review. Of these and with articles from hand searching added, 36 articles were classified as scholarship (30 as research) and 85 as nonscholarship. Of the 36 scholarship and 85 nonscholarship articles, respectively, 21 (58%) and 44 (52%) had an author from the United States or Canada, 8 (22%) and 11 (13%) had an author from a low- or middle-income country, and 16 (44%) and 43 (51%) had an author affiliated with a regulatory authority. Agencies from high-income countries were featured most often (scholarship: 28/60 [47%]; nonscholarship: 70/101 [69%]). Six (17%) scholarship articles reported receiving funding. All 30 research studies were cross-sectional or retrospective, 12 (40%) reported only analysis of accreditation documents, and 5 (17%) attempted to link accreditation with educational outcomes.
CONCLUSIONS
Limited evidence exists to support current UME accreditation practices or guide accreditation system creation or enhancement. More research is required to optimize UME accreditation systems' value for students, programs, and society.
Topics: Accreditation; Canada; Developed Countries; Developing Countries; Education, Medical, Undergraduate; Guidelines as Topic; United States
PubMed: 31274521
DOI: 10.1097/ACM.0000000000002857 -
Family Medicine Feb 2022The American Osteopathic Association (AOA) agreed to combine its graduate medical education programs with the Accreditation Council for Graduate Medical Education...
BACKGROUND AND OBJECTIVES
The American Osteopathic Association (AOA) agreed to combine its graduate medical education programs with the Accreditation Council for Graduate Medical Education (ACGME) between July 1, 2015 and June 30, 2020 in an initiative called the Single Accreditation System (SAS). The objective of our study was to identify the impact the SAS had on the ACGME, family medicine (FM), and implications for the future of FM.
METHODS
We collected and compiled data from the AOA, ACGME, and the National Residency Matching Program (NRMP). Analysis reveals the effects that the addition of former 122 AOA-accredited FM residencies had on the ACGME and FM programs.
RESULTS
Several osteopathic FM programs encountered challenges meeting ACGME accreditation standards. As of June 1, 2020, 89 of 122 accreditation applications received initial or continuing accreditation; the others had accreditation issues to resolve. The Osteopathic Recognition program emphasizing training in osteopathic principles and practices was a popular option in FM residencies. Fewer DOs serve as program directors in former AOA-accredited FM residencies.
CONCLUSIONS
The SAS has shifted the balance in the percentages of MDs, DOs, and international medical graduates (IMGs) in FM. Trends in FM show that as more DOs enter the NRMP the percent of MDs and IMGs decreases. In the future, it is projected that DOs will outnumber MDs and IMGs in ACGME FM residencies. The 51 new medical schools started between 2010 and 2020 will generate a test for the integration of their graduates into GME. Increased competition for FM residencies is expected.
Topics: Accreditation; Education, Medical, Graduate; Family Practice; Humans; Internship and Residency; Osteopathic Medicine; Osteopathic Physicians; United States
PubMed: 35143680
DOI: 10.22454/FamMed.2022.266260 -
Pathologie (Heidelberg, Germany) Sep 2022The precise performance of immunohistochemical and molecular examinations of diagnostic and predictive markers is essential for the further therapy of patients. Due to... (Review)
Review
The precise performance of immunohistochemical and molecular examinations of diagnostic and predictive markers is essential for the further therapy of patients. Due to the increasing number of biomarkers and their detection at the immunohistochemical and molecular level in patient tissue, the pathology has a direct influence on the therapy of patients, which increases the value of external quality assurance (EQA). In pathology, various forms are available for this purpose, such as proficiency tests. The standards of both the certification and accreditation procedures of pathology require regular participation in EQA and a statement on the EQA policy of the institutes. The quality of an EQA depends on the scientific concept, the adequate selection of material, the evaluation concept, and the communication of results.
Topics: Accreditation; Humans; Quality Assurance, Health Care
PubMed: 35948656
DOI: 10.1007/s00292-022-01102-3 -
Journal of Continuing Education in... Jan 2020In 2011, a task force sponsored by an organization that has Accreditation Board for Specialty Nurse Certification-accredited programs published a definition of...
In 2011, a task force sponsored by an organization that has Accreditation Board for Specialty Nurse Certification-accredited programs published a definition of continuing competence. Eight years later, the organization sponsored the work of another task force to revisit that definition, with the 2018-2019 task force broadening its focus beyond the U.S. borders and beyond nursing. After an extensive literature review, task force members collated their findings into four categories: Identifying Competencies, Validating Competencies, The International Perspective on Competency Assessment, and Competency in Disciplines Other Than Nursing. The task force identified perspectives on continuing competency and found that although licensing and credentialing organizations addressed the topic thoroughly, little attention was devoted to the perspectives of the public, individual clinicians, and recipients of clinicians' services. This article identifies that little consensus exists on definitions of competence and competency, international perspectives have much to offer, and theoretical frameworks for research on competence and competency are lacking. [J Contin Educ Nurs. 2020;51(1):15-24.].
Topics: Accreditation; Advisory Committees; Certification; Clinical Competence; Education, Nursing, Continuing; Educational Measurement; Humans; Internationality; Models, Educational
PubMed: 31895466
DOI: 10.3928/00220124-20191217-05 -
Healthcare Quarterly (Toronto, Ont.) Jul 2022Accreditation Canada is moving from a three-to-five-year assessment cycle to a continuous assessment program. As our organization shifted to a culture of continuous... (Review)
Review
Accreditation Canada is moving from a three-to-five-year assessment cycle to a continuous assessment program. As our organization shifted to a culture of continuous readiness, we aimed to develop a model that would support a seamless transition. To develop our model, we completed a literature review, environmental scan and an organizational needs assessment. Grounded in quality management theory, our continuous readiness model includes overarching supporting infrastructure and tasks, tools and initiatives to embed the principles of continuous readiness across the organization. Our model provides organizations with a practical, evidence-informed process to support a state of continuous readiness for accreditation.
Topics: Accreditation; Canada; Hospitals; Humans
PubMed: 36153682
DOI: 10.12927/hcq.2022.26891 -
Annals of Emergency Medicine Apr 2022The objectives of this study were to describe the reach and adoption of Geriatric Emergency Department Accreditation (GEDA) program and care processes instituted at...
STUDY OBJECTIVE
The objectives of this study were to describe the reach and adoption of Geriatric Emergency Department Accreditation (GEDA) program and care processes instituted at accredited geriatric emergency departments (EDs).
METHODS
We analyzed a cross-section of a cohort of US EDs that received GEDA from May 2018 to March 2021. We obtained data from the American College of Emergency Physicians and publicly available sources. Data included GEDA level, geographic location, urban/rural designation, and care processes instituted. Frequencies and proportions and median and interquartile ranges were used to summarize categorical and continuous data, respectively.
RESULTS
Over the study period, 225 US geriatric ED accreditations were issued and included in our analysis-14 Level 1, 21 Level 2, and 190 Level 3 geriatric EDs; 5 geriatric EDs reapplied and received higher-level accreditation after initial accreditation at a lower level. Only 9 geriatric EDs were in rural regions. There was significant heterogeneity in protocols enacted at geriatric EDs; minimizing urinary catheter use and fall prevention were the most common.
CONCLUSION
There has been rapid growth in geriatric EDs, driven by Level 3 accreditation. Most geriatric EDs are in urban areas, indicating the potential need for expansion beyond these areas. Future research evaluating the impact of GEDA on health care utilization and patient-oriented outcomes is needed.
Topics: Accreditation; Aged; Cohort Studies; Emergency Service, Hospital; Humans; Rural Population; United States
PubMed: 34389196
DOI: 10.1016/j.annemergmed.2021.06.013 -
Healthcare Quarterly (Toronto, Ont.) Jul 2022External, third-party evaluations are undertaken across every industry, including healthcare, to assess performance against an established set of standards. The...
External, third-party evaluations are undertaken across every industry, including healthcare, to assess performance against an established set of standards. The formality, rigour, timing and outcomes associated with these evaluations vary, and models throughout the world are evolving to meet changing needs. This is aligned with the historic shift from periodic pre-determined accreditations to healthcare organizations being "accreditation ready" every day. Accreditation Canada's continuous quality improvement model empowers and enables organizations to foster a culture and practice of continuous quality improvement.
Topics: Accreditation; Delivery of Health Care; Humans; Quality Improvement
PubMed: 36153683
DOI: 10.12927/hcq.2022.26890 -
BMC Medical Education Sep 2020Accreditation is a key feature of many medical education systems, helping to ensure that programs teach and assess learners according to applicable standards, provide... (Review)
Review
BACKGROUND
Accreditation is a key feature of many medical education systems, helping to ensure that programs teach and assess learners according to applicable standards, provide optimal learning environments, and produce professionals who are competent to practise in challenging and evolving health care systems. Although most medical education accreditation systems apply similar standards domains and process elements, there can be substantial variation among accreditation systems at the level of design and implementation. A discussion group at the 2013 World Summit on Outcomes-Based Accreditation examined best practices in health professional education accreditation systems and identified that the literature examining the effectiveness of different approaches to accreditation is scant. Although some frameworks for accreditation design do exist, they are often specific to one phase of the medical education continuum.
MAIN TEXT
This paper attempts to define a framework for the operational design of medical education accreditation that articulates design options as well as their contextual and practical implications. It assumes there is no single set of best practices in accreditation system development but, rather, an underlying set of design decisions. A "fit for purpose" approach aims to ensure that a system, policy, or program is designed and operationalized in a manner best suited to local needs and contexts. This approach is aligned with emerging models for education and international development that espouse decentralization.
CONCLUSION
The framework highlights that, rather than a single best practice, variation among accreditation systems is appropriate provided that is it tailored to the needs of local contexts. Our framework is intended to provide guidance to administrators, policy-makers, and educators regarding different approaches to medical education accreditation and their applicability and appropriateness in local contexts.
Topics: Accreditation; Delivery of Health Care; Education, Medical; Humans; Learning
PubMed: 32981517
DOI: 10.1186/s12909-020-02122-4 -
Journal of Oral and Maxillofacial... Feb 2020
Topics: Accreditation; Education, Medical, Graduate; Internship and Residency
PubMed: 31821782
DOI: 10.1016/j.joms.2019.11.020 -
BMC Medical Education Sep 2020The accreditation of medical educational programs is thought to be important in supporting program improvement, ensuring the quality of the education, and promoting... (Review)
Review
BACKGROUND
The accreditation of medical educational programs is thought to be important in supporting program improvement, ensuring the quality of the education, and promoting diversity, equity, and population health. It has long been recognized that accreditation systems will need to shift their focus from processes to outcomes, particularly those related to the end goals of medical education: the creation of broadly competent, confident professionals and the improvement of health for individuals and populations. An international group of experts in accreditation convened in 2013 to discuss this shift.
MAIN TEXT
Participants unequivocally supported the inclusion of more outcomes-based criteria in medical education accreditation, specifically those related to the societal accountability of the institutions in which the education occurs. Meaningful and feasible outcome metrics, however, are hard to identify. They are regionally variable, often temporally remote from the educational program, difficult to measure, and susceptible to confounding factors. The group identified the importance of health outcomes of the clinical milieu in which education takes place in influencing outcomes of its graduates. The ability to link clinical data with individual practice over time is becoming feasible with large repositories of assessment data linked to patient outcomes. This was seen as a key opportunity to provide more continuous oversight and monitoring of program impact. The discussants identified several risks that might arise should outcomes measures completely replace process issues. Some outcomes can be measured only by proxy process elements, and some learner experience issues may best be measured by such process elements: in brief, the "how" still matters.
CONCLUSIONS
Accrediting bodies are beginning to view the use of practice outcome measures as an important step toward better continuous educational quality improvement. The use of outcomes will present challenges in data collection, aggregation, and interpretation. Large datasets that capture clinical outcomes, experience of care, and health system performance may enable the assessment of multiple dimensions of program quality, assure the public that the social contract is being upheld, and allow identification of exemplary programs such that all may improve. There remains a need to retain some focus on process, particularly those related to the learner experience.
Topics: Accreditation; Education, Medical; Humans; Quality Improvement; Social Responsibility
PubMed: 32981523
DOI: 10.1186/s12909-020-02123-3