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Journal of General Internal Medicine May 2023There is no consensus regarding values important for medical resident success, and current methods for selecting residents correlate poorly with success in residency. (Review)
Review
BACKGROUND
There is no consensus regarding values important for medical resident success, and current methods for selecting residents correlate poorly with success in residency.
OBJECTIVE
We developed and validated a set of values demonstrated by exemplary residents in the Internal Medicine-Pediatrics program at the University of Utah and used them to inform our resident selection process.
DESIGN
We utilized a modified Delphi method to identify and internally validate values of successful residents. We implemented these values into the interview evaluation rubric.
PARTICIPANTS
Four members of the Internal Medicine-Pediatrics residency program leadership and eleven current residents aided in value generation. Nine faculty from leadership positions in the residency programs of Internal Medicine-Pediatrics, Internal Medicine, and Pediatrics formed a local expert panel for validation.
APPROACH
We performed a literature review and engaged local stakeholders in a semi-structured group interview to generate 107 values. After consolidation based on redundancy, two iterative cycles of expert review using a modified Delphi approach, and alignment with the Accreditation Council for Graduate Medical Education core competencies, eleven values achieved expert agreement and were integrated into an interview rubric to aid in resident selection.
KEY RESULTS
We identified eleven values important for resident success: academic strength, intellectual curiosity, compassion, communication, work ethic, teamwork, leadership, self-awareness, DEI (diversity, equity, and inclusion), professionalism, and adaptability. The rank list from 2021 was found to correlate with a score based on values, but not Step 2 score, as it did in 2017.
CONCLUSIONS
We applied a modified Delphi method to generate eleven observable values present in the ideal Internal Medicine-Pediatric resident at one academic health center in the Intermountain West. Higher Step 2 scores no longer correlated with higher ranking when we used these values to inform our rank list.
Topics: Humans; Child; Internship and Residency; Education, Medical, Graduate; Internal Medicine; Accreditation
PubMed: 36344647
DOI: 10.1007/s11606-022-07857-y -
The Medical Journal of Malaysia Jul 2022The core competencies defined by the Accreditation Council for Graduate Medical Education merge under the 21st century skills. Technological advancements and...
The core competencies defined by the Accreditation Council for Graduate Medical Education merge under the 21st century skills. Technological advancements and globalisation have posed new requirements on all fronts. The 21st century skills are the 12 essential abilities for success in the internet age. Medical education has adapted the 21st century skills in all aspects. The 21st century skills are essential for producing relevant doctors in the age of internet and artificial intelligence. In this article, we present an example of teaching the anaesthesia basics by applying the 21st century skills.
Topics: Accreditation; Anesthesia; Artificial Intelligence; Clinical Competence; Education, Medical, Graduate; Humans
PubMed: 35902944
DOI: No ID Found -
Diagnosis (Berlin, Germany) Dec 2021Improving diagnosis-related education in the health professions has great potential to improve the quality and safety of diagnosis in practice. Twelve key diagnostic... (Review)
Review
OBJECTIVES
Improving diagnosis-related education in the health professions has great potential to improve the quality and safety of diagnosis in practice. Twelve key diagnostic competencies have been delineated through a previous initiative. The objective of this project was to identify the next steps necessary for these to be incorporated broadly in education and training across the health professions.
METHODS
We focused on medicine, nursing, and pharmacy as examples. A literature review was conducted to survey the state of diagnosis education in these fields, and a consensus group was convened to specify next steps, using formal approaches to rank suggestions.
RESULTS
The literature review confirmed initial but insufficient progress towards addressing diagnosis-related education. By consensus, we identified the next steps necessary to advance diagnosis education, and five required elements relevant to every profession: 1) Developing a shared, common language for diagnosis, 2) developing the necessary content, 3) developing assessment tools, 4) promoting faculty development, and 5) spreading awareness of the need to improve education in regard to diagnosis.
CONCLUSIONS
The primary stakeholders, representing education, certification, accreditation, and licensure, in each profession must now take action in their own areas to encourage, promote, and enable improved diagnosis, and move these recommendations forward.
Topics: Accreditation; Curriculum; Health Occupations; Humans
PubMed: 34881533
DOI: 10.1515/dx-2021-0103 -
Gaceta Sanitaria 2021The quality of health services has long received global attention. Consequently, safe and quality health services in hospitals have become the main hopes and goals of...
BACKGROUND
The quality of health services has long received global attention. Consequently, safe and quality health services in hospitals have become the main hopes and goals of the community, health workers, managers, owners, and regulators. A common external strategy used globally involves recognizing the applied quality management system, specifically certification and accreditation.
OBJECTIVE
Therefore, the purpose of this study is to determine the relationship between levels of quality perception and accreditation in hospitals based on several variables.
METHODS
A total of 13 hospitals were examined in this cross-sectional study, while a questionnaire consisting of 24 validated items was used for data collection. Subsequently, the analysis was performed by utilizing descriptive statistics and chi-square techniques.
RESULTS
From the results obtained, the patient assessment, drug use management, patient and family education, infection prevention and control, alongside facility management and safety variables, had a relationship with the level of hospital accreditation, while patient service did not.
CONCLUSIONS
Therefore, each hospital is expected to improve its service quality and accreditation.
Topics: Accreditation; Attitude of Health Personnel; Cross-Sectional Studies; Health Personnel; Hospitals; Humans
PubMed: 34929791
DOI: 10.1016/j.gaceta.2021.10.009 -
BMC Health Services Research Sep 2021Significant resources are spent on hospital accreditation worldwide. However, documentation of the effects of accreditation on processes, quality of care and outcomes in...
BACKGROUND
Significant resources are spent on hospital accreditation worldwide. However, documentation of the effects of accreditation on processes, quality of care and outcomes in healthcare remain scarce. This study aimed to examine changes in the delivery of patient care in accordance with clinical guidelines (recommended care) after first-time accreditation in a care setting not previously exposed to systematic quality improvement initiatives.
METHODS
We conducted a before and after study based on medical record reviews in connection with introducing first-time accreditation. We included patients with stroke/transient ischemic attack, bleeding gastric ulcer, diabetes, chronic obstructive pulmonary disease (COPD), childbirth, heart failure and hip fracture treated at public, non-psychiatric Faroese hospitals during 2012-2013 (before accreditation) or 2017-2018 (after accreditation). The intervention was the implementation of a modified second version of The Danish Healthcare Quality Program (DDKM) from 2014 to 2016 including an on-site accreditation survey in the Faroese hospitals. Recommended care was assessed using 63 disease specific patient level process performance measures in seven clinical conditions. We calculated the fulfillment and changes in the opportunity-based composite score and the all-or-none score.
RESULTS
We included 867 patient pathways (536 before and 331 after). After accreditation, the total opportunity-based composite score was marginally higher though the change did not reach statistical significance (adjusted percentage point difference (%): 4.4%; 95% CI: - 0.7 to 9.6). At disease level, patients with stroke/transient ischemic attack, bleeding gastric ulcer, COPD and childbirth received a higher proportion of recommended care after accreditation. No difference was found for heart failure and diabetes. Hip fracture received less recommended care after accreditation. The total all-or-none score, which is the probability of a patient receiving all recommended care, was significantly higher after accreditation (adjusted relative risk (RR): 2.32; 95% CI: 2.03 to 2.67). The improvement was particularly strong for patients with COPD (RR: 16.22; 95% CI: 14.54 to 18.10).
CONCLUSION
Hospitals were in general more likely to provide recommended care after first-time accreditation.
Topics: Accreditation; Denmark; Heart Failure; Hospitals, Public; Humans; Quality Improvement
PubMed: 34482842
DOI: 10.1186/s12913-021-06952-w -
Home Health Care Services Quarterly 2023While home health agencies (HHAs) can seek accreditation to recognize their quality of service, it is unknown whether agencies with accreditation perform better in...
While home health agencies (HHAs) can seek accreditation to recognize their quality of service, it is unknown whether agencies with accreditation perform better in providing care than those without accreditation. Using 5-year data from national data sources, the aims of this study were: 1) to depict characteristics of HHAs with and without accreditation; and 2) to examine the relationship between accreditation status and HHA performance on quality-of-care metrics. This study analyzed 7,697 agencies in the US and found that 1) agencies that were for-profit, urban, not-hospital-affiliated, single-branch, Medicare enrolled only, and without hospice program were more likely to have accreditation; and 2) overall, accredited agencies performed better on the three commonly used quality indicators, timely initiation of care, hospitalization, and emergency department visit, though not all the observed differences were substantial in absolute value. Our results provide unique empirical information to agencies considering seeking accreditation.
Topics: Aged; Humans; United States; Medicare; Cohort Studies; Home Care Agencies; Accreditation; Hospices; Quality of Health Care
PubMed: 36117455
DOI: 10.1080/01621424.2022.2123756 -
AJNR. American Journal of Neuroradiology Mar 2020
Topics: Accreditation; Education, Medical, Graduate; Fellowships and Scholarships; Humans; Radiologists; Radiology
PubMed: 32054619
DOI: 10.3174/ajnr.A6450 -
Family Medicine Mar 2022The Accreditation Council for Graduate Medical Education (ACGME) has implemented milestones for progression of residents. Career academic physicians would benefit from...
BACKGROUND AND OBJECTIVES
The Accreditation Council for Graduate Medical Education (ACGME) has implemented milestones for progression of residents. Career academic physicians would benefit from similar concrete guidance for scholarly activity and faculty development. After developing milestones across six recognized competencies among our family medicine academicians, we acknowledged the potential benefit of expanding the development of milestones throughout the academic medical center.
METHODS
Milestones that we previously developed were modified by departmental leaders within our institution reflecting levels of career development based on benchmarks in each field. These objective measures for guiding maturation of clinical and academic skill sets were then circulated to clinicians in five residency programs throughout our academic medical center for self-evaluation. We analyzed the completed surveys to determine if an association exists between years in academics and rank across each area of competency.
RESULTS
We received fifty-three responses from the 91 faculty invited. We noted a significant association in the competency of medical knowledge with progression from assistant to full professor, and we noted a trend toward significance in professionalism and progression from assistant to full professor. These objective measures of clinician development and competency suggest association with levels of academic career development by rank within the institution.
CONCLUSIONS
This rubric can be helpful for directing faculty development and faculty mentorship. These milestones are general enough that other physician specialties may be able to adopt them for their own needs.
Topics: Accreditation; Clinical Competence; Education, Medical, Graduate; Faculty, Medical; Humans; Internship and Residency; Physicians
PubMed: 35303302
DOI: 10.22454/FamMed.2022.700483 -
Medical Education Online Dec 2020Physician educators directing medical student programs face increasingly more complex challenges to ensure students receive appropriate preparation to care for patients....
BACKGROUND
Physician educators directing medical student programs face increasingly more complex challenges to ensure students receive appropriate preparation to care for patients. The Alliance for Clinical Education (ACE) defined expectations of and for clerkship directors in 2003. Since then, much has changed in medical education and health care.
METHODS
ACE conducted a panel discussion at the 2016 Association of American Medical Colleges Learn Serve Lead conference, soliciting input on these expectations and the changing roles of clerkship directors. Using workshops as a cross-sectional study design, participants reacted to roles and responsibilities of clerkship directors identified in the literature using an audience response system and completing worksheets.
RESULTS
The participants represented different disciplines of medicine and ranged from clerkship directors to deans of curriculum. Essential clerkship director qualifications identified by participants included: enthusiasm, experience teaching, and clinical expertise. Essential tasks included grading and assessment and attention to accreditation standards. Participants felt clerkship directors need adequate resources, including budget oversight, full-time clerkship support, and dedicated time to be the clerkship director. To whom clerkship directors report was mixed. Clerkship directors look to their chair for career advice, and they also report to the dean to ensure educational standards are being met. Expectations to meet accreditation standards and provide exemplary educational experiences can be difficult to achieve if clerkship directors' time and resources are limited.
CONCLUSIONS
Participant responses indicated the need for a strong partnership between department chairs and the dean's office so that clerkship directors can fulfill their responsibilities. Our results indicate a need to ensure clerkship directors have the time and resources necessary to manage clinical medical student education in an increasingly complex health care environment. Further studies need to be conducted to obtain more precise data on the true amount of time they are given to do that role.
Topics: Accreditation; Clinical Clerkship; Clinical Competence; Cross-Sectional Studies; Curriculum; Faculty, Medical; Female; Humans; Male; Motivation; Professional Role
PubMed: 31928206
DOI: 10.1080/10872981.2020.1714201 -
BMC Medical Education Sep 2020Social accountability in medical education has been defined as an obligation to direct education, research, and service activities toward the most important health... (Review)
Review
BACKGROUND
Social accountability in medical education has been defined as an obligation to direct education, research, and service activities toward the most important health concerns of communities, regions, and nations. Drawing from the results of a summit of international experts on postgraduate medical education and accreditation, we highlight the importance of local contexts in meeting societal aims and present different approaches to ensuring societal input into medical education systems around the globe.
MAIN TEXT
We describe four priorities for social responsiveness that postgraduate medical education needs to address in local and regional contexts: (1) optimizing the size, specialty mix, and geographic distribution of the physician workforce; (2) ensuring graduates' competence in meeting societal goals for health care, population health, and sustainability; (3) promoting a diverse physician workforce and equitable access to graduate medical education; and (4) ensuring a safe and supportive learning environment that promotes the professional development of physicians along with safe and effective patient care in settings where trainees participate in care. We relate these priorities to the values proposed by the World Health Organization for social accountability: relevance, quality, cost-effectiveness, and equity; discuss accreditation as a lever for change; and describe existing and evolving efforts to make postgraduate medical education socially responsive.
CONCLUSION
Achieving social responsiveness in a competency-based postgraduate medical education system requires accrediting organizations to ensure that learning emphasizes relevant competencies in postgraduate curricula and educational experiences, and that graduates possess desired attributes. At the same time, institutions sponsoring graduate medical education need to provide safe and effective patient care, along with a supportive learning and working environment.
Topics: Accreditation; Competency-Based Education; Curriculum; Education, Medical; Education, Medical, Graduate; Humans
PubMed: 32981520
DOI: 10.1186/s12909-020-02125-1