Consistency and quality in written accreditation protocols for pediatrician training programs: a mixed-methods analysis of a global sample, and directions for improvement

Human Resources for Health

Research

Roseda E. Marshall¹  Jui-Yen Huang²  Katia C. Genadry³  Areej Hassan⁴  Christiana M. Russ⁵  Ayten Sergios⁶  Alexandra L. Coria⁷  Rashmi K. Kumar⁸ 

[1] AM Dogliotti College of Medicine, P.O Box 10-9020, Capitol Hill, 1000, Monrovia 10, West Africa, Liberia;Division of Adolescent Medicine, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Rd., Sanmin Dist., 80756, Kaohsiung City, Taiwan, ROC;Division of Emergency Medicine, Boston Children’s Hospital, 300 Longwood Avenue, 02115, Boston, MA, USA;Harvard Medical School, 25 Shattuck St, 02115, Boston, MA, USA;Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Avenue, 02115, Boston, MA, USA;Harvard Medical School, 25 Shattuck St, 02115, Boston, MA, USA;Intermediate Care Program, Boston Children’s Hospital, 300 Longwood Avenue, 02115, Boston, MA, USA;SUNY Downstate College of Medicine, 450 Clarkson Ave Suite J, 11203, Brooklyn, NY, USA;SUNY Downstate College of Medicine, 450 Clarkson Ave Suite J, 11203, Brooklyn, NY, USA;Department of Population Health, Maimonides Medical Center and Division of Hospital Medicine, Maimonides Children’s Hospital, 4802 10th Ave, 11219, Brooklyn, NY, USA;University of Nairobi, P.O Box 30197, GPO, Nairobi, Kenya;Kenyatta National Hospital, P.O Box 20723-00202, Nairobi, Kenya;

关键词: Accreditation;    Post-graduate medical education;    Medical education research;    International medical education;    Global pediatrics;   

DOI  :  10.1186/s12960-023-00852-2

 received in 2022-11-14, accepted in 2023-08-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe World Federation for Medical Education (WFME) defines accreditation as 'certification of the suitability of medical education programs, and of…competence…in the delivery of medical education.' Accreditation bodies function at national, regional and global levels. In 2015, WFME published quality standards for accreditation of postgraduate medical education (PGME). We compared accreditation of pediatric PGME programs to these standards to understand variability in accreditation and areas for improvement.MethodsWe examined 19 accreditation protocols representing all country income levels and world regions. For each, two raters assessed 36 WFME-defined accreditation sub-areas as present, partially present, or absent. When rating “partially present” or “absent”, raters noted the rationale for the rating. Using an inductive approach, authors qualitatively analyzed notes, generating themes in reasons for divergence from the benchmark.ResultsA median of 56% (IQR 43–77%) of WFME sub-areas were present in individual protocols; 22% (IQR 15–39%) were partially present; and 8.3% (IQR 5.5–21%) were absent. Inter-rater agreement was 74% (SD 11%). Sub-areas least addressed included number of trainees, educational expertise, and performance of qualified doctors. Qualitative themes of divergence included (1) variation in protocols related to heterogeneity in program structure; (2) limited engagement with stakeholders, especially regarding educational outcomes and community/health system needs; (3) a trainee-centered approach, including equity considerations, was not universal; and (4) less emphasis on quality of education, particularly faculty development in teaching.ConclusionsHeterogeneity in accreditation can be appropriate, considering cultural or regulatory context. However, we identified broadly applicable areas for improvement: ensuring equitable access to training, taking a trainee-centered approach, emphasizing quality of teaching, and ensuring diverse stakeholder feedback.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 8