Nesibe Akdemir1,2, Romana Malik3,4, Theanne Walters5, Stanley Hamstra6,7,8, Fedde Scheele9,3,4. 1. School of Medical Sciences, VU Medical Center, Amsterdam, The Netherlands. N.c.akdemir@gmail.com. 2. Department of Medical Education, OLVG Hospital, Amsterdam, The Netherlands. N.c.akdemir@gmail.com. 3. Department of Medical Education, OLVG Hospital, Amsterdam, The Netherlands. 4. Athena Institute for Transdisciplinary Research, Vrije Universiteit, Amsterdam, The Netherlands. 5. Australian Medical Council, Canberra, Australia. 6. Milestones Research and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, IL, United States of America. 7. Faculty of Education, University of Ottawa, Ottawa, ON, Canada. 8. Department of Medical Education, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America. 9. School of Medical Sciences, VU Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Quality of training is determined through programs' compliance with accreditation standards, often set for a number of years. However, perspectives on quality of training within these standards may differ from the clinicians' perspectives on quality of training. Knowledge on how standards relate to clinicians' perspectives on quality of training is currently lacking yet is expected to lead to improved accreditation design. METHODS: This qualitative study design was based on a case-study research approach. We analyzed accreditation standards and conducted 29 interviews with accreditors, clinical supervisors and trainees across Australia and the Netherlands about the quality and accreditation of specialist medical training programs. The perspectives were coded and either if applicable compared to national accreditation standards of both jurisdictions, or thematized to the way stakeholders encounter accreditation standards in practice. RESULTS: There were two evident matches and four mismatches between the perspectives of clinicians and the accreditation standards. The matches are: (1) accreditation is necessary (2) trainees are the best source for quality measures. The mismatches are: (3) fundamental training aspects that accreditation standards do not capture: the balance between training and service provision, and trainee empowerment (4) using standards lack dynamism and (5) quality improvement; driven by standards or intrinsic motivation of healthcare professionals. CONCLUSION: In our Australian and Dutch health education cases accreditation is an accepted phenomenon which may be improved by trainee empowerment, a dynamic updating process of standards and by flexibility in its use.
BACKGROUND: Quality of training is determined through programs' compliance with accreditation standards, often set for a number of years. However, perspectives on quality of training within these standards may differ from the clinicians' perspectives on quality of training. Knowledge on how standards relate to clinicians' perspectives on quality of training is currently lacking yet is expected to lead to improved accreditation design. METHODS: This qualitative study design was based on a case-study research approach. We analyzed accreditation standards and conducted 29 interviews with accreditors, clinical supervisors and trainees across Australia and the Netherlands about the quality and accreditation of specialist medical training programs. The perspectives were coded and either if applicable compared to national accreditation standards of both jurisdictions, or thematized to the way stakeholders encounter accreditation standards in practice. RESULTS: There were two evident matches and four mismatches between the perspectives of clinicians and the accreditation standards. The matches are: (1) accreditation is necessary (2) trainees are the best source for quality measures. The mismatches are: (3) fundamental training aspects that accreditation standards do not capture: the balance between training and service provision, and trainee empowerment (4) using standards lack dynamism and (5) quality improvement; driven by standards or intrinsic motivation of healthcare professionals. CONCLUSION: In our Australian and Dutch health education cases accreditation is an accepted phenomenon which may be improved by trainee empowerment, a dynamic updating process of standards and by flexibility in its use.
Entities:
Keywords:
Accreditation; Medical education; Quality improvement; Quality of training; Regulation
Authors: Mohammad B Azzam; Marie-Andrée Girard; Cynthia Andrews; Hope Bilinski; Denise M Connelly; John H V Gilbert; Christie Newton; Ruby E Grymonpre Journal: Hum Resour Health Date: 2022-08-26