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

BACKGROUND: Quality of training is determined through programs' compliance with accreditation standards, often set for a number of years. However, perspectives on quality of training within these standards may differ from the clinicians' perspectives on quality of training. Knowledge on how standards relate to clinicians' perspectives on quality of training is currently lacking yet is expected to lead to improved accreditation design. METHODS: This qualitative study design was based on a case-study research approach. We analyzed accreditation standards and conducted 29 interviews with accreditors, clinical supervisors and trainees across Australia and the Netherlands about the quality and accreditation of specialist medical training programs. The perspectives were coded and either if applicable compared to national accreditation standards of both jurisdictions, or thematized to the way stakeholders encounter accreditation standards in practice. RESULTS: There were two evident matches and four mismatches between the perspectives of clinicians and the accreditation standards. The matches are: (1) accreditation is necessary (2) trainees are the best source for quality measures. The mismatches are: (3) fundamental training aspects that accreditation standards do not capture: the balance between training and service provision, and trainee empowerment (4) using standards lack dynamism and (5) quality improvement; driven by standards or intrinsic motivation of healthcare professionals. CONCLUSION: In our Australian and Dutch health education cases accreditation is an accepted phenomenon which may be improved by trainee empowerment, a dynamic updating process of standards and by flexibility in its use.

Medical school accreditation in China: a Sino-Australian collaboration.

In 2008, China established a medical school accreditation process based on international standards and guidelines. Twenty schools had been accredited by 2013 and it is intended to accredit all 137 schools by 2020. To achieve this ambitious aim, Chinese medical educators have entered into collaboration with their Australian counterparts, engendered by mutual membership of the Association for Medical Education in the Western Pacific Region, a regional division of the World Federation for Medical Education. The collaboration began in 2000 as informal discussions at regional meetings and has since developed three major components: workshops held throughout China for potential assessors and for medical schools undergoing accreditation; visits by Chinese accreditors to Australia to observe Australian Medical Council processes; and participation by Australian assessors in the accreditation of Chinese medical schools. The incremental steps that led to this unique bi-national venture are outlined in the context of other international developments in accreditation of medical education. Then, the preparation, piloting and implementation of accreditation standards and guidelines with Chinese specifications are described. Finally, the outcomes achieved thus far and the challenges remaining are discussed.

Reform in Australian medical schools: a collaborative approach to realising Indigenous health potential.

The Australian medical education system is at a critical juncture in relation to what and how it delivers for Aboriginal and Torres Strait Islander health. Since 2004, three key organisations concerned with medical education have worked to provide a toolkit for implementation of sustainable reform within medical schools. The aim is a medical workforce trained in Indigenous health, and more Aboriginal and Torres Strait Islander doctors, leading to better health for Australia's Indigenous peoples.