Clinicians' perspectives on quality: do they match accreditation standards?

Exploring Motivations and Barriers To Accreditation Adoption Among Physician Assistant and Nurse Practitioner Emergency Medicine and Orthopedic Surgery Residency and Fellowship Programs

Although there has been a rapid increase in the number of physician assistant (PA) and nurse practitioner postgraduate residency/fellowship specialty training programs in the United States, voluntary accreditation of these programs is a relatively new phenomenon. There is little research examining which factors may be predictors of accreditation adoption among PA and nurse practitioner (NP) postgraduate programs. Therefore, the primary aim of this study was to investigate which motivating factors influence postgraduate programs choice on whether to pursue accreditation. Methodology A descriptive cross-sectional survey consisting of 10 questions was distributed to 56 postgraduate emergency medicine and orthopedic surgery PA, NP, and joint PA/NP residency/fellowship programs via email between November 2022 and February 2023. Descriptive statistics were performed. Results Nineteen postgraduate programs responded to the survey. Two programs submitted incomplete surveys where less than 50% of the total items were completed. The partially completed surveys were omitted from the data analysis. The final response rate was 30% (17/56). Among the responded programs, 47% (8/17) offer dual PA and NP training, and 53% (9/17) are PA only. Although 88% (15/17) of postgraduate programs have discussed accreditation funding with their sponsoring institution only 76% are planning to do so or are in the process of pursuing accreditation. The two most common reasons for pursuing accreditation are program validation and assessment of educational quality 59% (10/17) and competition for applicants 24% (4/17). However, Magnet hospital designation, requirement of the sponsoring institution, or demand from employers were not determining factors of whether to pursue accreditation or not. Reasons for not pursuing accreditation included high costs of accreditation 18% (3/17), lack of perceived value of accreditation 6% (1/17), and lack of protected time to pursue accreditation 6% (1/17). Conclusion Although literature is still lacking on the effectiveness and impact of PA and NP postgraduate program accreditation, the findings of this rare study indicate that postgraduate programs are motivated to pursue accreditation. It is important for accreditors to communicate the utility of program-level accreditation and other value-added benefits to programs and their sponsoring institutions. Further work is necessary to better understand the value of external validation, specific drivers for validation, and barriers that influence accreditation adoption among these postgraduate programs.

Accreditation as a driver of interprofessional education: the Canadian experience

BACKGROUND

The purpose of this study was to (1) explore evidence provided by Canadian health and social care (HASC) academic programs in meeting their profession-specific interprofessional education (IPE)-relevant accreditation standards; (2) share successes, exemplars, and challenges experienced by HASC academic programs in meeting their IPE-relevant accreditation standards; and (3) articulate the impacts of IPE-relevant accreditation standards on enabling interprofessional learning to the global HASC academic community.

METHODS

Profession-specific (bilingual, if requested) surveys were developed and emailed to the Deans/Academic Program Directors of eligible academic programs with a request to forward to the individual who oversees IPE accreditation. Responses were collated collectively and by profession. Open-ended responses associated with our first objective were deductively categorized to align with the five Accreditation of Interprofessional Health Education (AIPHE) standards domains. Responses to our additional questions associated with our second and third objectives were inductively categorized into themes.

RESULTS/DISCUSSION

Of the 270 HASC academic programs surveyed, 30% (n = 24) partially or completely responded to our questions. Of the 106 IPE-relevant standards where evidence was provided, 62% (n = 66) focused on the Educational Program, 88% of which (n = 58) were either met or partially met, and 47% (n = 31) of which focused on practice-based IPE. Respondents cited various exemplars and challenges in meeting IPE-relevant standards.

CONCLUSIONS

The overall sentiment was that IPE accreditation was a significant driver of the IPE curriculum and its continuous improvement. The array of exemplars described in this paper may be of relevance in advancing IPE implementation and accreditation across Canada and perhaps, more importantly, in countries where these processes are yet emerging.