Evaluation of continuous quality improvement in accreditation for medical education

BMC Medical Education

Linda N. Peterson¹  Nesibe Akdemir²  Fedde Scheele³  Craig M. Campbell⁴ 

[1] Committee on Accreditation of Canadian Medical Schools, Ottawa, Canada;OLVG Teaching Hospital, Amsterdam, the Netherlands;Amsterdam UMC, Amsterdam, the Netherlands;OLVG Teaching Hospital, Amsterdam, the Netherlands;Amsterdam UMC, Amsterdam, the Netherlands;Athena Institute for Transdisciplinary Research, Amsterdam, the Netherlands;Dutch Royal Medical Council, Chair Legislative College for Accreditation of Residency Training 2016–2019, Utrecht, the Netherlands;Royal College of Physicians and Surgeons of Canada, Ottawa, Canada;

关键词: Accountability;    Accreditation;    Continuous quality improvement;    Internal review;    Medical education;    Quality management;   

DOI  :  10.1186/s12909-020-02124-2

来源: Springer

【 摘 要 】

BackgroundAccreditation systems are based on a number of principles and purposes that vary across jurisdictions. Decision making about accreditation governance suffers from a paucity of evidence. This paper evaluates the pros and cons of continuous quality improvement (CQI) within educational institutions that have traditionally been accredited based on episodic evaluation by external reviewers.MethodsA naturalistic utility-focused evaluation was performed. Seven criteria, each relevant to government oversight, were used to evaluate the pros and cons of the use of CQI in three medical school accreditation systems across the continuum of medical education. The authors, all involved in the governance of accreditation, iteratively discussed CQI in their medical education contexts in light of the seven criteria until consensus was reached about general patterns.ResultsBecause institutional CQI makes use of early warning systems, it may enhance the reflective function of accreditation. In the three medical accreditation systems examined, external accreditors lacked the ability to respond quickly to local events or societal developments. There is a potential role for CQI in safeguarding the public interest. Moreover, the central governance structure of accreditation may benefit from decentralized CQI. However, CQI has weaknesses with respect to impartiality, independence, and public accountability, as well as with the ability to balance expectations with capacity.ConclusionCQI, as evaluated with the seven criteria of oversight, has pros and cons. Its use still depends on the balance between the expected positive effects—especially increased reflection and faster response to important issues—versus the potential impediments. A toxic culture that affects impartiality and independence, as well as the need to invest in bureaucratic systems may make in impractical for some institutions to undertake CQI.

【 授权许可】

CC BY