The Positive Effects of Accreditation on Graduate Medical Education Programs in Singapore

RE-AIM evaluation of accreditation process in Turkey

BACKGROUND

Effects of accreditation on various areas of medical education were studied in literature. However, data about comprehensive evaluation of accreditation activities is limited. This paper aims to present how an accreditation agency self-evaluates its own accreditation activities.

METHODS

Association for Evaluation and Accreditation of Medical Education Programs (TEPDAD) is an accreditation agency in Turkey. RE-AIM evaluation framework was used to evaluate TEPDAD's activities. The accreditation processes were evaluated through indicators set for each of five RE-AIM evaluation framework dimensions (reach, effectiveness, adoption, implementation and maintenance). Data for evaluation for each dimension were gathered from the documents available in TEPDAD website and archives. Qualitative and quantitative analysis methods were used when necessary to investigate the degree of achievement for each indicator.

RESULTS

Seventy-five (83%) of 90 medical schools meeting the application criteria are registered in the accreditation system. Effectiveness analyses revealed that medical education programs improved in eight areas (education program, student representation, documentation, assessment, infrastructure/facilities, faculty development, educational management). Accreditation processes were well adopted by medical schools and TEPDAD volunteers. The number of medical education programs registered in the accreditation system has gradually increased over years. For the accreditation implementation process, medical schools and TEPDAD evaluators provided positive feedback. Medical schools and TEPDAD invested efforts to maintain the accreditation process over time and changing conditions. All of the previously accredited schools have applied for reaccreditation for the second or third cycles to maintain their status. TEPDAD has maintained its recognition status by national and international authorities by several times. The accreditation standards have been continuously reviewed and renewed when necessary. The organizational structure of TEPDAD has been changed in time considering feedback and past experiences. TEPDAD also arranges meetings to promote and maintain its activities.

CONCLUSIONS

TEPDAD has achieved significant success in terms of reaching majority of the Turkish medical schools, leading to prominent developments in medical education programs without any significant problems related to process, procedures and maintenance. There are still areas of improvement for TEPDAD such as reaching all targeted schools and guiding medical schools to improve quality in diverse elements of medical education programs.

Assessing the impact of adopting a competency-based medical education framework and ACGME-I accreditation on educational outcomes in a family medicine residency program in Abu Dhabi Emirate, United Arab Emirates

Background

Competency-Based Medical Education (CBME) is now mandated by many graduate and undergraduate accreditation standards. Evaluating CBME is essential for quantifying its impact, finding supporting evidence for the efforts invested in accreditation processes, and determining future steps. The Ambulatory Healthcare Services (AHS) family medicine residency program has been accredited by the Accreditation Council of Graduate Medical Education-International (ACGME-I) since 2013. This study aims to report the Abu Dhabi program's experience in implementing CBME and accreditation.

Objectives

Compare the two residents' cohorts' performance pre-and post-ACGME-I accreditation.Study the bi-annually reported milestones as a graduating residents' performance prognostic tool.

Methods

All residents in the program from 2008 to 2019 were included. They are called Cohort one-the intake from 2008 to 2012, before the ACGME accreditation, and Cohort two-the intake from 2013 to 2019, after the ACGME accreditation, with the milestones used. The mandatory annual in-training exam was used as an indication of the change in competency between the two cohorts. Among Cohort two ACGME-I, the biannual milestones data were studied to find the correlation between residents' early and graduating milestones.

Results

A total of 112 residents were included: 36 in Cohort one and 76 in Cohort two. In Cohort one, before the ACGME accreditation, no significant associations were identified between residents' graduation in-training exam and their early performance indicators, while in Cohort two, there were significant correlations between almost all performance metrics. Early milestones are correlated with the graduation in-training exam score. Linear regression confirmed this relationship after controlling the residents' undergraduate Grade Point Average (GPA). Competency development continues to improve even after residents complete training at Post Graduate Year, PGY4, as residents' achievement in PGY5 continues to improve.

Conclusion

Improved achievement of residents after the introduction of the ACGME-I accreditation is evident. Additionally, the correlation between the graduation in-training exam and graduation milestones, with earlier milestones, suggests a possible use of early milestones in predicting outcomes.