Did the students' satisfaction rates at Avalon University School of Medicine correlate with the occurrence of accreditation site visits?

INTRODUCTION: Accreditation of medical education programs can be observed from different perspectives. Regulatory/accreditation agencies consider it vital to assure a certain level of quality. Other stakeholders may perceive the accreditation process as a negative experience, draining resources, and efforts. Although accreditation may improve the program's governance and administration, its direct or indirect impact on students must be further investigated. This study explores the relationship between the occurrence of accreditation site visits and student satisfaction rates at Avalon University School of Medicine. METHODS: A comparison study was conducted with retrospective satisfaction data from two accreditation cycles at AUSOM. We used the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) student surveys for data collection, and data from 2017, 2019, and 2022 were used. The response rate was 70% (n = 71), 72% (n = 47), and 60% (n = 56) for basic science students and 80% (n = 111), 82% (n = 115), and 70% (n = 76) for clinical students in 2017, 2019, and 2022, respectively. The survey for basic sciences students included 37 questions/items, and the survey for clinical students included 39 questions/items. The responses for the questionnaire were on the five-point Likert scale. The retrospective data were evaluated using the unpaired Wilcoxon-rank sum test. RESULTS: The ratings for the basic science students' survey increased from 2017 to 2019 (first accreditation cycle) only for 11 items/questions and they were increased from 2019 to 2022 for all items/questions. The ratings for clinical science students' surveys increased from 2017 to 2019 (the first accreditation cycle) for all items/questions with a statistically significant p-value. They increased for 28 questions/items from 2019 to 2022, and two items (availability and adequacy of career counseling) showed statistically significant p-values. CONCLUSIONS: The pre-accreditation preparation and the self-evaluation process while correcting the program's deficiencies are essential triggers for the quality improvement process associated with accreditation.

Integrated curriculum and the change process in undergraduate medical education.

INTRODUCTION: This study is aimed at explaining the change process followed for the implementation of the new curriculum at Avalon University School of Medicine and its evaluation. BACKGROUND: Self-evaluation at Avalon University School of Medicine identified the need for a change in the curriculum. The main reasons for the change are isolated disciplines and overcrowded curriculum leading to less self-study time for students. The new curriculum is aimed to have an integrated curriculum and to avoid redundancies. The new curriculum is designed, implemented, and evaluation of the same is in place. Evaluation methods and materials: After implementation, quantitative (results from exams) and semi-quantitative (self-administered questionnaire) evaluation methods are being used to evaluate the new curriculum. Feedback is also taken by having discussions with teachers and students to find out what they like and where modifications are needed. In this article, we are presenting the results of course evaluations (semi-quantitative methods) for two courses. The course evaluations were taken from the sample class size of 30 students. RESULTS AND DISCUSSION: The course evaluations demonstrated an improvement. The main reason for the improvement is due to collaborative efforts of the faculty members from different disciplines in teaching, assessments, and providing feedback to the students. CONCLUSIONS: The well-approached change process is required for the successful implementation of the new curriculum. The idea of ownership among all stakeholders is required for a well-managed change process.

Cross-Border Accreditation in the Caribbean: A Potential Threat to the Integrity of the Accreditation Process?

According to the World Directory of Medical Schools, the Caribbean region hosts around 100 medical schools, leading to variations in education programs and student performance. Accreditation is crucial for maintaining educational standards. The proliferation of accrediting agencies recognized by the World Federation of Medical Education (WFME) has led to cross-border accreditation practices and market-driven competition. Concerns about the integrity of accreditation processes in the Caribbean region have raised questions about educational quality and global implications. Establishing a framework and scrutiny of the WFME regarding cross-border accreditation is essential to preserve educational standards and prevent global implications. ECFMG's intervention is urgently needed to investigate and restore the integrity of medical school accreditation in the Caribbean, setting a precedent for global accreditation standards.

The impact of accreditation on continuous quality improvement process in undergraduate medical education programs: A scoping review.

Background: Accreditation in medical education has existed for more than 100 years, yet the impact of accreditation remains inconclusive. Some studies have shown the effects of accreditation on student outcomes and educational processes at medical schools. However, evidence showing the impact of accreditation on continuous quality improvement of undergraduate medical education programs is still in its infancy. This scoping review explores the impact of accreditation on continuous quality improvement (CQI). Methods: This scoping review followed the methodology of the Preferred Reporting Items of Systematic Reviews and the Meta-Analysis extension for scoping reviews (PRISMA-ScR) checklist outlined by Arksey and O'Malley (2005). Databases, including PubMed, Medline, ERIC, CINHAL, and Google Scholar, were searched to find articles from 2000 to 2022 related to the accreditation of undergraduate medical education programs and continuous quality improvement. Results: A total of 35 full-text articles were reviewed, and ten articles met our inclusion criteria. The review of the full-text articles yielded four themes: Accreditation and its standards in general, Accreditation and its impact on student outcomes, Accreditation and its impact on medical school's educational processes, Accreditation and CQI. However, the literature evidence suggesting the impact of accreditation on CQI is minimal. The quality assurance approach is based on meeting the standards of accreditation. The quality improvement approach is based on striving for excellence. Literature suggests a requirement to move from student outcomes to CQI measures. CQI requires everyone in the organization to take responsibility and accountability, considering quality as the result of every single step or process and leaders supporting improvements in data collection and data analysis for quality improvement. Conclusions: The literature on accreditation and CQI are limited in number. More research studies are required to enhance undergraduate medical education accreditation practices' value to medical students, educators, academic leaders, programs, and the public. It was recommended that medical schools embrace the culture and vision perpetuated by the CQI process.

Medical Education Electives Can Promote Teaching and Research Interests Among Medical Students.

Introduction: Although all residents routinely teach medical students, not all residents are involved in teaching or trained in teaching during undergraduate medical school, as accreditation bodies do not mandate the promotion of teaching skills to undergraduate medical students. With relatively inadequate formal training and residents' intrinsic time constraints, tactically incorporating formal medical education elective experiences in medical school curricula is understandable. This study explores if medical education electives at Avalon University School of Medicine (AUSOM) can enhance medical students' interest in teaching and research. Methods: The medical education elective at AUSOM was developed to give interested medical students an elective experience. The course modules include accreditation/regulation, curriculum development, learning theories, assessments, and research methodology. Students can choose any one of the modules. We offered the medical education elective to twenty-five students in the year 2021. All of them gave feedback at the end of the elective. The data was analyzed qualitatively through framework analysis, which includes familiarization, generating initial codes, searching for themes, reviewing, and defining and naming themes. Results: Different themes emerged, enhancing the interest in academic medicine, understanding research methodologies, supporting learners, and awareness of learning theories. Conclusion: Doing medical education electives at AUSOM enhanced students' interest in teaching, and students reported that they could understand research methodologies, especially those related to medical education. Medical students should have opportunities for electives in medical education, and more research is required to evaluate the effectiveness of medical education electives across medical schools.

Is Emergency Remote (Online) Teaching in the First Two Years of Medical School During the COVID-19 Pandemic Serving the Purpose?

Purpose: COVID-19 pandemic and closure of campuses have required a significant and rapid shift in teaching and training methods across health professions education, including remote teaching replacing face-to-face teaching. This study aims to investigate if emergency remote teaching implemented in the first two years of the medical school at Avalon University School of Medicine served the purpose during the COVID-19 pandemic. The effectiveness of emergency remote teaching and on-campus teaching were compared using course evaluations (students' feedback) and students' performance in assessments. Methods: This is a concurrent mixed research method. The quantitative data collected are course evaluations and students' performance in assessments between the two semesters September 2019 (on-campus teaching) and May 2020 (emergency remote teaching). There are three semesters in the first year and two semesters in the second year of the medical program. Each semester has around 10-20 students at any given time. Quantitative data were analyzed for p-values and statistical significance using a t-test. The qualitative data were analyzed using thematic analysis. Results: Results have shown no statistically significant difference (p<0.05) between two semesters (between on-campus teaching and emergency remote teaching) for course evaluations. Even if there is any difference, the mean values were better in May 2020 semester with emergency remote teaching. There was no statistically significant difference (p<0.05) even on students' performance in assessments between two semesters (between on-campus teaching and emergency remote teaching) except for two courses. The thematic analysis of interviews revealed the advantages and disadvantages of online teaching. Conclusion: Emergency remote teaching served the purpose in the first two years of medical school during the COVID-19 pandemic. The advantages of online teaching are flexibility and comfort, and students can save time. The disadvantages are technical challenges, students lacking motivation, lack of personal interaction, and limitations on lab and hands-on experiences.

Impact of accreditation on Caribbean medical schools' processes.

BACKGROUND: Caribbean graduates contribute significantly to the US healthcare workforce. The accreditation requirements of local governments vary from one Caribbean island to another island. The Educational Commission for Foreign Medical Graduates (ECFMG) requirement that all future applicants be graduates from accredited medical schools drove Caribbean medical schools to seek accreditation. Accreditation has been found to significantly impact the educational processes of Canadian medical schools. Our study aims at investigating Caribbean medical school leaders' perceptions of the impact of accreditation on their school's processes. METHODS: This qualitative study and data analysis were done using a framework analysis. Academic leaders and faculty members from three different types of Caribbean medical schools (accredited, denied-accreditation schools, never applied for accreditation) were interviewed using semi-structured interviews. RESULTS: A total of 12 participants from six different Caribbean medical schools participated in the interview process. Themes of processes influenced by accreditation at Caribbean medical schools were similar to those found in the Canadian context and align with best practices of Continuous Quality Improvement (CQI). CONCLUSIONS: Caribbean medical schools are changing their educational processes as a result of accreditation requirements. Some processes are not maintained in a continuous manner, raising questions about the development of a true CQI culture.

CONTEXTE: Les diplômés des Caraïbes contribuent de manière significative au personnel de santé Américain. Les exigences des gouvernements Caraïbes en matière d'agrément varient d'une île à l'autre. L'Educational Commission for Foreign Medical Graduates, ECFMG (Commission de l'éducation pour les diplômés en médecine étrangers), exige que les candidats soient diplômés de facultés de médecine agréées, ce qui a incité les facultés de médecine des Caraïbes à solliciter l'agrément. Il a été démontré que l'agrément affectait de manière importante les processus éducatifs des écoles de médecine canadiennes. Notre étude vise à examiner les perceptions des directions des facultés de médecine des Caraïbes quant aux répercussions de l'agrément sur leurs processus. MÉTHODES: La présente étude qualitative et l'analyse des données ont été réalisées selon la méthodologie du cadre logique. Les responsables universitaires et les membres du corps professoral de facultés de médecine des Caraïbes se trouvant dans trois cas de figure différents (facultés agrées, facultés auxquelles l'agrément a été refusé et facultés n'ayant jamais sollicité l'agrément) ont été interrogés par le biais d'entretiens semi-structurées. RÉSULTATS: Douze participants de six facultés de médecine de la région des Caraïbes ont participé aux entretiens. Des thèmes similaires se dégagent en ce qui concerne les processus influencés par l'agrément dans les facultés de médecine caribéennes et canadiennes, en particulier l'adoption des pratiques exemplaires en matière d'amélioration continue de la qualité (ACQ). CONCLUSIONS: Les facultés de médecine des Caraïbes modifient leurs processus éducatifs afin de remplir les exigences d'agrément. Certains processus ne sont pas maintenus de manière continue, ce qui soulève des interrogations quant à l'implantation d'une véritable culture de l'ACQ.