Health professions education as a discipline: Evidence based on Krishnan's framework.

Health professions education (HPE) emerged as a specific domain of higher education in the 1960s. The interim decades brought the development of advanced training in health professions education and the implementation of HPE offices at many institutions of healthcare and education across the world. Despite these advancements, organizations considering the establishment of HPE offices, or advanced HPE training programs are still challenged by approving authorities to demonstrate that HPE is a discipline and not simply a branch of higher education.

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.

A Value-Based Comparison of the Management of Ambulatory Respiratory Diseases in Walk-in Clinics, Primary Care Practices, and Emergency Departments: Protocol for a Multicenter Prospective Cohort Study.

Background: In Canada, 30%-60% of patients presenting to emergency departments are ambulatory. This category has been labeled as a source of emergency department overuse. Acting on the presumption that primary care practices and walk-in clinics offer equivalent care at a lower cost, governments have invested massively in improving access to these alternative settings in the hope that patients would present there instead when possible, thereby reducing the load on emergency departments.

Responsiveness to societal needs in postgraduate medical education: the role of accreditation.

Background: Social accountability in medical education has been defined as an obligation to direct education, research, and service activities toward the most important health concerns of communities, regions, and nations. Drawing from the results of a summit of international experts on postgraduate medical education and accreditation, we highlight the importance of local contexts in meeting societal aims and present different approaches to ensuring societal input into medical education systems around the globe.

Main Text: We describe four priorities for social responsiveness that postgraduate medical education needs to address in local and regional contexts: (1) optimizing the size, specialty mix, and geographic distribution of the physician workforce; (2) ensuring graduates' competence in meeting societal goals for health care, population health, and sustainability; (3) promoting a diverse physician workforce and equitable access to graduate medical education; and (4) ensuring a safe and supportive learning environment that promotes the professional development of physicians along with safe and effective patient care in settings where trainees participate in care.

The role of accreditation in 21st century health professions education: report of an International Consensus Group.

Background: Accreditation is considered an essential ingredient for an effective system of health professions education (HPE) globally. While accreditation systems exist in various forms worldwide, there has been little written about the contemporary enterprise of accreditation and even less about its role in improving health care outcomes. We set out to 1) identify a global, contemporary definition of accreditation in the health professions, 2) describe the relationship of educational accreditation to health care outcomes, 3) identify important questions and recurring issues in twenty-first century HPE accreditation, and 4) propose a framework of essential ingredients in present-day HPE accreditation.

The Relationship Between Accreditation Cycle and Licensing Examination Scores: A National Look.

Purpose: Accreditation aims to ensure all training programs meet agreed-upon standards of quality. The process is complex, resource intensive, and costly. Its benefits are difficult to assess because contextual confounds obscure comparisons between systems that do and do not include accreditation.

Measuring the continuous quality improvement orientation of medical education programs.

Purpose: There is a growing interest in applying continuous quality improvement (CQI) methodologies and tools to medical education contexts. One such tool, the "Are We Making Progress" questionnaire from the Malcolm Baldrige National Quality Award framework, adequately captures the dimensions critical for performance excellence and allows organizations to assess their performance and identify areas for improvement. Its results have been widely validated in business, education, and health care and might be applicable in medical education contexts.

Accreditation of Canadian Undergraduate Medical Education Programs: A Study of Measures of Effectiveness.

Purpose: Undergraduate medical education (UME) programs participate in accreditation with the belief that it contributes to improving UME quality and, ultimately, patient care. Linkages between accreditation and UME quality are incomplete. Previous studies focused on student performance on national examinations, medical school processes, medical school's organizational culture types, and degree of implementation of quality improvement activities as markers of the effectiveness of accreditation.

Resident Physician Wellness Curriculum: A Study of Efficacy and Satisfaction.

Background Recent literature highlights the alarming prevalence of burnout, depression, and illness during residency training; a trend that is also linked to suboptimal patient care. Dedicated wellness curricula may be one solution to this concerning issue. Purpose To determine the effect of a multi-faceted wellness curriculum during emergency medicine residency training on wellness scores and to assess resident satisfaction with the program.

Quality improvement in medical schools: vision meets culture.

Context: Medical schools face growing pressures to develop quality improvement (QI) strategies to ensure the continuous quality of their education. To best achieve quality, both organisational processes and culture need to be oriented towards quality. Quality processes already exist at medical schools, at least externally driven by accreditation.

Do organizational cultures of Canadian medical schools promote a quality culture?

Medical schools are expected to engage in ongoing reflection to maintain the quality of the education they deliver, that is, to cultivate a Quality Culture. Quality Culture integrates the culture of an organization with its structure and management processes. The culture of medical schools has not been previously studied.

Impact of interpersonal relations on learning and development of professional identity: A study of residents' perceptions.

Objectives: Informal learning includes all occurrences during one's life when learning is not deliberate. Prior research on informal learning in healthcare contexts examined learning happening outside of the formal curriculum, yet still in the workplace. This study explores residents' perceptions about extracurricular factors outside of the workplace that contribute to their learning and development of professional identity, whether interpersonal relations are recognised as such factors, and positive and negative impacts of interpersonal relations.

The impact of accreditation on medical schools' processes.

Objectives: Increased emphasis is being placed worldwide on accreditation of undergraduate medical education programmes, and costs of participation in accreditation continue to rise. The primary purposes of accreditation are to ensure the quality of medical education and to promote quality improvement. Student performance data as indicators of the impact of accreditation have important limitations.

Accreditation of Medical Education Programs: Moving From Student Outcomes to Continuous Quality Improvement Measures.

Accreditation of undergraduate medical education programs aims to ensure the quality of medical education and promote quality improvement, with the ultimate goal of providing optimal patient care. Direct linkages between accreditation and education quality are, however, difficult to establish. The literature examining the impact of accreditation predominantly focuses on student outcomes, such as performances on national examinations.

A National Faculty Development Needs Assessment in Emergency Medicine.

Objectives: Emergency physicians who work in academic settings enjoy an expanding number of roles beyond that of the skilled clinician. Faculty development (FD) encompasses the broad range of activities that institutions use to renew skill-sets and assist faculty members in these multiple roles. This study seeks to define the current FD needs and interests of Canadian academic emergency physicians (AEPs).

Emergency medicine residents' beliefs about contributing to an online collaborative slideshow.

Objective: Collaborative writing applications (CWAs), such as the Google DocsTM platform, can improve skill acquisition, knowledge retention, and collaboration in medical education. Using CWAs to support the training of residents offers many advantages, but stimulating them to contribute remains challenging. The purpose of this study was to identify emergency medicine (EM) residents' beliefs about their intention to contribute summaries of landmark articles to a Google DocsTM slideshow while studying for their Royal College of Physicians and Surgeons of Canada (RCPSC) certification exam.

Disrupting diagnostic reasoning: do interruptions, instructions, and experience affect the diagnostic accuracy and response time of residents and emergency physicians?

Purpose: Others have suggested that increased time pressure, sometimes caused by interruptions, may result in increased diagnostic errors. The authors previously found, however, that increased time pressure alone does not result in increased errors, but they did not test the effect of interruptions. It is unclear whether experience modulates the combined effects of time pressure and interruptions.

Comparative reliability of structured versus unstructured interviews in the admission process of a residency program.

Background: Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program.

Methods: In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process.

Too much of a good thing: management of diabetic ketoacidosis in adults.

A healthy 19-year-old man presents to your emergency department complaining of weakness and lethargy for the past 2 weeks. He sleeps 10 hours a day, yet remains tired. His appetite has been poor and he constantly feels thirsty.

Emergency medicine residents' beliefs about contributing to a Google Docs presentation: a survey protocol.

Background: Web 2.0 collaborative writing technologies have shown positive effects on medical education. One such technology, Google Docs(™), offers collaborative writing applications that improve healthcare students' sharing of information.

Reliability of a structured interview for admission to an emergency medicine residency program.

Background: Interviews are most important in resident selection. Structured interviews are more reliable than unstructured ones.

Purpose: We sought to measure the interrater reliability of a newly designed structured interview during the selection process to an Emergency Medicine residency program.