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Tempski P, Girotto LC, Brenelli S, Giamberardino DD, Martins MA. Accreditation of medical education in Brazil: an evaluation of seventy-six medical schools. BMC MEDICAL EDUCATION 2024; 24:656. [PMID: 38867222 PMCID: PMC11167757 DOI: 10.1186/s12909-024-05623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND We present the first results of the Accreditation System of Medical Schools (Sistema de Acreditação de Escolas Médicas - SAEME) in Brazil. METHODS We evaluated the results of the accreditation of medical schools from 2015 to 2023. The self-evaluation form of the SAEME is specific for medical education programs and has eighty domains, which results in final decisions that are sufficient or insufficient for each domain. We evaluated the results of the first seventy-six medical schools evaluated by the SAEME. RESULTS Fifty-five medical schools (72.4%) were accredited, and 21 (27.6%) were not. Seventy-two (94.7%) medical schools were considered sufficient in social accountability, 93.4% in integration with the family health program, 75.0% in faculty development programs and 78.9% in environmental sustainability. There was an emphasis on SAEME in student well-being, with seventeen domains in this area, and 71.7% of these domains were sufficient. The areas with the lowest levels of sufficiency were interprofessional education, mentoring programs, student assessment and weekly distribution of educational activities. CONCLUSION Medical schools in Brazil are strongly committed to social accountability, integration with the national health system, environmental sustainability and student well-being programs. SAEME is moving from episodic evaluations of medical schools to continuous quality improvement policies.
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Affiliation(s)
- Patricia Tempski
- Sistema de Acreditação de Escolas Médicas, Conselho Federal de Medicina, Brasilia, Brazil
- Centro de Desenvolvimento de Educação Médica da Faculdade de Medicina, da Universidade de São Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, 01246-903, Brazil
| | - Leticia C Girotto
- Sistema de Acreditação de Escolas Médicas, Conselho Federal de Medicina, Brasilia, Brazil
- Centro de Desenvolvimento de Educação Médica da Faculdade de Medicina, da Universidade de São Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, 01246-903, Brazil
| | - Sigisfredo Brenelli
- Sistema de Acreditação de Escolas Médicas, Conselho Federal de Medicina, Brasilia, Brazil
- Centro de Desenvolvimento de Educação Médica da Faculdade de Medicina, da Universidade de São Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, 01246-903, Brazil
| | - Donizeti D Giamberardino
- Sistema de Acreditação de Escolas Médicas, Conselho Federal de Medicina, Brasilia, Brazil
- Hospital Pequeno Príncipe, Curitiba, Brazil
| | - Milton A Martins
- Sistema de Acreditação de Escolas Médicas, Conselho Federal de Medicina, Brasilia, Brazil.
- Centro de Desenvolvimento de Educação Médica da Faculdade de Medicina, da Universidade de São Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, 01246-903, Brazil.
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Onyura B, Fisher AJ, Wu Q, Rajkumar S, Chapagain S, Nassuna J, Rojas D, Nirula L. To prove or improve? Examining how paradoxical tensions shape evaluation practices in accreditation contexts. MEDICAL EDUCATION 2024; 58:354-362. [PMID: 37726176 DOI: 10.1111/medu.15218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 08/18/2023] [Accepted: 08/26/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Although programme evaluation is increasingly routinised across the academic health sciences, there is scant research on the factors that shape the scope and quality of evaluation work in health professions education. Our research addresses this gap, by studying how the context in which evaluation is practised influences the type of evaluation that can be conducted. Focusing on the context of accreditation, we critically examine the types of paradoxical tensions that surface as evaluation-leads consider evaluation ideals or best practices in relation to contextual demands associated with accreditation seeking. METHODS Our methods were qualitative and situated within a critical realist paradigm. Study participants were 29 individuals with roles requiring responsibility and oversight on evaluation work. They worked across 4 regions, within 26 academic health science institutions. Data were collected using semi-structured interviews and analysed using framework and matrix analyses. RESULTS We identified three overarching themes: (i) absence of collective coherence about evaluation practice, (ii) disempowerment of expertise and (iii) tensions as routine practice. Examples of these latter tensions in evaluation work included (i) resourcing accreditation versus resourcing robust evaluation strategy (performing paradox), (ii) evaluation designs to secure accreditation versus design to spur renewal and transformation (performing-learning paradox) and (iii) public dissemination of evaluation findings versus restricted or selective access (publicising paradox). Sub-themes and illustrative data are presented. DISCUSSION Our study demonstrates how the high-stakes context of accreditation seeking surfaces tensions that can risk the quality and credibility of evaluation practices. To mitigate these risks, those who commission or execute evaluation work must be able to identify and reconcile these tensions. We propose strategies that may help optimise the quality of evaluation work alongside accreditation-seeking efforts. Critically, our research highlights the limitations of continually positioning evaluation purely as a method versus as a socio-technical practice that is highly vulnerable to contextual influences.
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Affiliation(s)
- Betty Onyura
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- The Wilson Centre, Toronto, Ontario, Canada
| | - Abigail J Fisher
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Faculty Development, Unity Health Toronto, Toronto, Ontario, Canada
- Ontario Institute for Studies in Education (OISE), University of Toronto, Toronto, Ontario, Canada
| | - Qian Wu
- Centre for Faculty Development, Unity Health Toronto, Toronto, Ontario, Canada
| | | | - Sarick Chapagain
- University of Toronto, Toronto, Ontario, Canada
- Department of Biology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | - David Rojas
- The Wilson Centre, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Latika Nirula
- Centre for Faculty Development, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Gaufberg E, Zimmermann C, Wong LM, Williams R, King B, King K, Paradise R. The Harvard Macy Institute Art Museum-based Health Professions Education Fellowship: Transformational faculty development through the arts. Int Rev Psychiatry 2023; 35:645-657. [PMID: 38461394 DOI: 10.1080/09540261.2023.2283596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/10/2023] [Indexed: 03/11/2024]
Abstract
Museum-based education for health professionals can lead to a variety of important learning outcomes within the domain of skills development, personal insight, perspective-taking and social advocacy. The Harvard Macy Institute's Art Museum-based Health Professions Education Fellowship was designed to develop faculty expertise in art museum-based practices, encourage scholarship, and cultivate a cohesive and supportive community of educators. The Fellowship was piloted from January to May 2019 with twelve interprofessional Fellows. Two in-person experiential sessions were held at Boston-area museums with intervening virtual learning. Fellows were introduced to a variety of approaches used in art museum-based education and developed a project for implementation at their home institution. A qualitative formative evaluation assessed immediate and 6-month post-Fellowship outcomes. Outcomes are reported in four categories: (1) Fellows' personal and professional development; (2) Institutional projects and curriculum development; (3) Community of practice and scholarly advancement of the field; and (4) Development of Fellowship model. A follow-up survey was performed four years after the conclusion of the pilot year, documenting Fellows' significant accomplishments in museum-based education, reflections on the Fellowship and thoughts on the future of the field.
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Affiliation(s)
- Elizabeth Gaufberg
- Medicine and Psychiatry, Harvard Medical School and Director of the Center for Professional and Academic Development, The Cambridge Health Alliance, Cambridge, MA, USA
| | - Corinne Zimmermann
- Museum Educator and Consultant, Corinne Zimmermann Consultancy, Watertown, MA, US
| | - Lisa M Wong
- Department of Pediatrics, Harvard Medical School, Boston, MA, US
| | - Ray Williams
- Director of Education and Academic Affairs, The Blanton Museum of Art, Austin, TX, USA
| | - Brandy King
- Health Sciences Librarian, Knowledge Linking, Wilmington, MA, USA
| | - Kristin King
- Research and Evaluation Project Manager, Institute for Community Health, Malden, MA, USA
| | - Ranjani Paradise
- Department of Evaluation, Institute for Community Health, Malden, MA, USA
- School of Medicine, Tufts University, Boston, MA, USA
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