What Is the Role of Accreditation in Achieving Medical School Diversity?

Diversity standards in medical education accreditation do not guarantee diversity but do stimulate schools' activities to recruit and retain diverse students and faculty. The Liaison Committee on Medical Education's (LCME's) accreditation standard addressing medical school diversity neither mandates which categories of diversity medical schools must use nor defines quantitative outcomes they should achieve. Rather, each medical school is required to (1) identify diversity categories that motivate its mission and reflect its environment and (2) use those categories to implement programs to promote diverse representation of students and faculty. When the LCME assesses each medical school's compliance with these requirements, it considers single point-in-time diversity numbers, trends in student and faculty diversity, and outcomes of programs implemented by the school to promote diversity in the categories it identifies as key to its mission.

Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination.

Nutrition plays an important role in health promotion and disease prevention and treatment across the lifespan. Physicians and other healthcare professionals are expected to counsel patients about nutrition, but recent surveys report minimal to no improvements in medical nutrition education in US medical schools. A workshop sponsored by the National Heart, Lung, and Blood Institute addressed this gap in knowledge by convening experts in clinical and academic health professional schools. Representatives from the National Board of Medical Examiners, the Accreditation Council for Graduate Medical Education, the Liaison Committee on Medical Education, and the American Society for Nutrition provided relevant presentations. Reported is an overview of lessons learned from nutrition education efforts in medical schools and health professional schools including interprofessional domains and competency-based nutrition education. Proposed is a framework for coordinating activities of various entities using a public-private partnership platform. Recommendations for nutrition research and accreditation are provided.

Which LCME Accreditation Expectations Support Quality and Safety in Global Health Immersion Experiences for Medical Students?

Almost all allopathic medical schools in the United States allow students to participate in global health immersion experiences. The Liaison Committee on Medical Education accreditation requirements specify that students' home institutions are responsible for overseeing learning experiences, assessing and mitigating risk, ensuring appropriate supervision, and offering instruction about what to expect, ethically and culturally, in a learning setting. Students should also have opportunities to debrief about their experiences.

Consistency in decision-making between survey teams and the decision-making body in a professional education program accrediting agency.

This article was migrated. The article was marked as recommended. Credibility of an education program accreditor is dependent on consistency in decision-making among program reviews. The use of peer-review accreditation survey teams is a potential source of inconsistency in the review of individual programs, especially so when the agency employs non-prescriptive accreditation standards. The accrediting agency that is the subject of this study utilized multiple steps to ensure consistency in the recommendations from peer survey teams. Analysis of the agreement between survey team recommendations and final decisions by the decision-making body revealed a coefficient of agreement of 0.927, indicated a high degree of agreement. The results suggest the accrediting agency's processes are effective in ensuring that peer review survey teams are applying the accreditation standards consistently between peer teams and the accrediting agency.

The Role of Accreditation in Supporting Educational Quality During Difficult Circumstances.

This article was migrated. The article was marked as recommended. Accreditation aims to ensure that generally-accepted standards of educational program quality are being met. The Liaison Committee on Medical Education (LCME), the accrediting body for medical education programs leading to the MD degree, has a process to address circumstances at medical schools arising from acute emergency situations. This involves consultation with faculty and administration at the affected school and collection of data related to compliance with accreditation standards through written reports and on-site visits. The actions of both the medical schools in New Orleans and the LCME following Hurricane Katrina in 2005 illustrate this process. While the need to respond to requests for information from an accrediting body places additional burdens on a medical school's faculty and administration during an emergency, such oversight also ensures that the medical education program continues to meet standards. This provides assurance of educational quality to school personnel and students, as well as to the school's publics. Accreditation agencies should consider how their standards and processes support a timely and flexible response to disaster situations that occur at accredited schools.

Are family practice residents able to interpret electrocardiograms?

BACKGROUND: Teaching electrocardiogram (ECG) interpretation is a recommended component of the family practice residency curriculum. Published information concerning the ECG interpretation ability of residents is sparse. This study sought to ascertain the baseline knowledge of family practice residents' ECG interpretation skills and extent of improvement after one year of training. METHODS: A 15 ECG examination was administered to 38 PG-1 and 14 upper level residents at 5 residency programs at the beginning of the academic year and to residents at the authors' program at the end of the academic year. Pre-test scores among the five programs were compared using an analysis of variance (ANOVA). Pre-test and post-test scores were compared using a paired randomization test. RESULTS: No difference was found between average scores from each site, or between the beginning and end of the academic year. Residents were more likely to misinterpret items such as myocardial infarction, myocardial ischemia, and atrial fibrillation. CONCLUSIONS: Residents in family practice have considerable deficiencies in ECG interpretation skills. Further studies are needed to determine effective ECG teaching curricula.

Facilitating academic institutional change: redefining scholarship.

BACKGROUND AND OBJECTIVES: Academic institutions are typically resistant to change. Redefining scholarship is an important issue for academic health care institutions. This study examines the change process at institutions that have attempted to change the definition of scholarship. METHODS: Five medical schools were identified that had recently redesigned their promotion and tenure systems based on expanded definitions of scholarship. Interviews were conducted with a key leader in this effort. The interviews were designed to identify the forces and barriers involved in change, activities designed to secure faculty "buy-in, "factors needed to sustain change, and advice that would help others who might be considering such an effort at their academic health centers. We organized the results of the interviews within a change leadership and management model. RESULTS: The responses to the survey questions fit well into the change model. Many of the responses were felt to be applicable to multiple stages of the change model. CONCLUSIONS: The leaders of change from the study institutions, either by intention or intuition, identified key factors of their change process that fit well with the study model. Change leaders should include plans that follow an established model for institutional change in their strategy to change the definition of scholarship at their institution.

Longitudinal and horizontal integration of nutrition science into medical school curricula.

The overall goal of our Nutrition Academic Award (NAA) medical nutrition program at Mercer University School of Medicine is to develop, implement and evaluate a medical education curriculum in nutrition and other aspects of cardiovascular disease (CVD) prevention and patient management with emphasis on the training of primary care physicians for medically underserved populations. The curriculum is 1) vertically integrated throughout all 4 y of undergraduate medical education, including basic science, clinical skills, community science and clinical clerkships as well as residency training; 2) horizontally integrated to include allied healthcare training in dietetics, nursing, exercise physiology and public health; and 3) designed as transportable modules adaptable to the curricula of other medical schools. The specific aims of our program are 1) to enhance our existing basic science problem-based Biomedical Problems Program with respect to CVD prevention through development of additional curriculum in nutrition/diet/exercise and at-risk subpopulations; 2) to integrate into our Clinical Skills Program objectives for medical history taking, conducting patient exams, diet/lifestyle counseling and referrals to appropriate allied healthcare professionals that are specific to CVD prevention; 3) to enhance CVD components in the Community Science population-based medicine curriculum, stressing the health-field concept model, community needs assessment, evidence-based medicine and primary care issues in rural and medically underserved populations; 4) to enhance the CVD prevention and patient management component in existing 3rd- and 4th-y clinical clerkships with respect to nutrition/diet/exercise and socioeconomic issues, behavior modification and networking with allied health professionals; and 5) to integrate a nutrition/behavior change component into Graduate Residency Training in CVD prevention.

Does physician weight affect perception of health advice?

BACKGROUND: Obesity is considered a growing health threat in the United States. Although physicians have an important role in counseling their patients for obesity prevention and treatment, physicians themselves are often overweight. There are few data regarding how physician body weight might affect patient receptiveness to obesity counseling. METHODS: A 43-item survey instrument was developed that consisted of three scales related to physician characteristics, health locus of control, and perceptions on receiving health advice from overweight physicians. The survey was administered to 226 patients in five physician offices. Two of the physicians were classified as obese using BMI calculations, and three were nonobese. The responses from the surveys were grouped into those from obese and nonobese physicians. RESULTS: Significant differences were found for patient receptiveness to counseling for treatment of illness (P = 0.038) and health advice (P = 0.049), with the patients of nonobese physicians indicating greater confidence scores. The difference for weight and fitness counseling did not reach significance (P = 0.075). Analysis revealed that patient BMI was not a significant covariate nor were items related to physician characteristics in general or health locus of control. CONCLUSIONS: Patients seeking care from nonobese physicians indicated greater confidence in general health counseling and treatment of illness than patients seeing obese physicians. It is not known if this can be translated into increased success in obesity prevention and treatment.

Patterns of Lyme disease diagnosis and treatment by family physicians in a southeastern state.

This study examined how often physicians in Georgia diagnose and treat Lyme disease as well as the criteria they use to reach a diagnosis of Lyme disease. A survey was sent to 1,331 family physicians in Georgia concerning how many cases of Lyme disease the physicians diagnosed, and the criteria used to make the diagnosis, during the preceding 12 months. Of 710 responses, 167 physicians treated 316 cases of Lyme disease without a firm diagnosis. In addition, 125 physicians diagnosed 262 cases of Lyme disease, 130 without serologic testing and 132 with serologic testing. Family Physicians in Georgia diagnose Lyme disease at a rate 40 times greater than the surveillance case rate reported in Georgia.