The Next GME Accreditation System — Rationale and Benefits

Accreditation Council for Graduate Medical Education, Chicago, USA.
New England Journal of Medicine (Impact Factor: 55.87). 02/2012; 366(11):1051-6. DOI: 10.1056/NEJMsr1200117
Source: PubMed


In 1999, the Accreditation Council for Graduate Medical Education (ACGME) introduced the six domains of clinical competency to the profession,(1) and in 2009, it began a multiyear process of restructuring its accreditation system to be based on educational outcomes in these competencies. The result of this effort is the Next Accreditation System (NAS), scheduled for phased implementation beginning in July 2013. The aims of the NAS are threefold: to enhance the ability of the peer-review system to prepare physicians for practice in the 21st century, to accelerate the ACGME's movement toward accreditation on the basis of educational outcomes, and to . . .

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    • "I do think there' s something to be said about in-person care for some specific cases but I do think it can certainly redistribute sort of vast inequity in the accessibility that' s sort of a geographic barrier more than anything else.[Faculty – 209]I think there' s a huge potential with telepsychiatry and collaborative care to be an advocate… to talk to the stakeholders… So I'd even emphasize the potential for health advocacy.[Resident – 106]Graduate Medical Education in the USA.[41]Within our own Canadian learning context, the telepsychiatry skills identified through this study map onto the Can- MEDS roles, particularly the roles of medical expert, communicator, collaborator, manager (changing in the 2015 framework to Leader), and health advocate.[ Table 1aligns the skills identified by our participants with the CanMEDS framework. "
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    ABSTRACT: Background A foundational assessment of learning needs is missing from previous reports of telepsychiatry curricula. We used an in-depth needs assessment to identify specific skills required for the practice of effective telepsychiatry, and provide an evidence base to guide the development of telepsychiatry curricula in postgraduate psychiatry training. Many of these skills set telepsychiatry apart from practice in traditional face-to-face clinical settings, or result from adaptations to clinical practice to meet the needs of a telepsychiatry interface in patient care. Methods We used a qualitative, modified grounded theory approach to gain insight into areas of importance for telepsychiatry training in postgraduate psychiatry residency. 16 interviews of faculty and residents (9 and 7 interviews, respectively), allowed participants to reflect on their experiences in telepsychiatry. Data were then thematically analyzed. Results Interview respondents identified important aspects of the context for telepsychiatry training; the skills required to competently practice telepsychiatry; and the desired teaching and learning methods for acquiring these skills. Specific domains of competency were identified: technical skills; assessment skills; relational skills and communication; collaborative and interprofessional skills; administrative skills; medico-legal skills; community psychiatry and community-specific knowledge; cultural psychiatry skills, including knowledge of Indigenous cultures; and, knowledge of health systems. The skills identified in this study map well to competency- based medical education frameworks. Conclusions Telepsychiatry is increasingly being adopted as a solution to health systems problems such as regional disparities in access to care, and it requires explicit competency development. Ensuring adequate and quality exposure to telepsychiatry during residency training could positively impact our health systems and health equity.
    Full-text · Article · Dec 2016 · BMC Medical Education
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    • "decision making about troop employment and to conduct training that is better targeted to actual need. In its emphasis on accountability, standardization, specific outcomes, and evidence , the Army's concept of training readiness is similar to that of medicine's competency-based assessment (Nasca et al. 2012;Brightwell & Grant 2013). Achieving training readiness in the Army reflects a complex interplay between organizational-level concerns (i.e. "
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    ABSTRACT: Background: The idea of competency-based education sounds great on paper. Who wouldn't argue for a standardized set of performance-based assessments to assure competency in graduating students and residents? Even so, conceptual concerns have already been raised about this new system and there is yet no evidence to refute their veracity. Aims: We argue that practical concerns deserve equal consideration, and present evidence strongly suggesting these concerns should be taken seriously. Method: Specifically, we share two historical examples that illustrate what happened in two disparate contexts (K-12 education and the Department of Defense [DOD]) when competency (or outcomes-based) assessment frameworks were implemented. We then examine how observation and assessment of clinical performance stands currently in medical schools and residencies, since these methodologies will be challenged to a greater degree by expansive lists of competencies and milestones. Results/conclusions: We conclude with suggestions as to a way forward, because clearly the assessment of competency and the ability to guarantee that graduates are ready for medical careers is of utmost importance. Hopefully the headlong rush to competencies, milestones, and core entrustable professional activities can be tempered before even more time, effort, frustration and resources are invested in an endeavor which history suggests will collapse under its own weight.
    Full-text · Article · Jan 2016 · Medical Teacher
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    • "Since the institution of the Accreditation Council for Graduate Medical Education (ACGME) in 1981, resident education has gone through a number of drastic changes. Resident education has improved substantially since that time, initially at the cost of mandating program requirements that seems to prevent program directors from providing individualized resident mentoring [1]. Eventually, the Next Accreditation System (NAS) was established in 2013, leading to a liberalization of resident education [2]. "

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