How will the next accreditation system affect ophthalmology residency training?
| Autor: | George B. Bartley, Susan H. Day, Steven J. Gedde |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Medical education
medicine.medical_specialty Quality management Certification business.industry education Specialty Graduate medical education Internship and Residency Interpersonal communication Competency-Based Education Accreditation Patient safety Ophthalmology Education Medical Graduate medicine Humans business Competence (human resources) Residency training |
| Zdroj: | Ophthalmology. 120(12) |
| ISSN: | 1549-4713 |
| Popis: | Years ago, imagine a co-resident who demonstrated suboptimal surgical skills early in residency. In some programs, this person would have received extra attention to bring his or her performance up to a passable level of competence. In others, the resident would have been labeled (and treated) as a future medical ophthalmologist. No longer is such variability in education allowed. How has this change occurred? In the United States, the Accreditation Council for Graduate Medical Education (ACGME) has been accorded the right and responsibilities of overseeing the quality of residency training programs. If a program is accredited, this in essence is a signal to applicants that the education they receive will provide what the trainee needs. The ability to “sit” for a certifying board examination, administered by the American Board of Ophthalmology in our specialty, is linked to completion of residency training in either an ACGME-accredited program or a Canadian program accredited by its system. In the eyes of the ACGME, each trainee deserves an equivalent educational experience; hence, an accredited program cannot “label” a resident as being competent only for a restricted practice mode. And yet, this process-based model (i.e., spend 36 months in various rotations) lacked the assurance that all graduates had accumulated the proper skills and outcomes. Simply doing a minimum number of cases is not the same as demonstrating to educators that outcomes are satisfactory. In part, the shift from a process-based educational model to an outcomesand competency-based model has been fueled by public expectations. Emphasis on outcomes, patient safety, and quality improvement pervade much of societal demand for changes across all of medicine. These values have been carefully assessed and increasingly integrated into graduate medical education, including residency training in ophthalmology. The initial foray into outcomes measurement was the Outcomes Project, introduced in 1999. Evaluation of resident performance was required within a framework of 6 general domains of competence (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice). Although it catalyzed many improvements, the Outcomes Project fell short of its goal of creating a robust assessment system that would allow accreditation of training programs based on outcomes. In response, in 2009 the ACGME and specialty boards launched the Milestones Project, which has become an integral part of an extensive revision of graduate medical education termed the Next Accreditation System (NAS). |
| Databáze: | OpenAIRE |
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