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Embracing Accreditation

Embracing Accreditation. Disclosure. Objectives. Be able to describe the benefits of accreditation standards and processes to Northern and rural community settings. Be able to describe the importance of their own participation in accreditation.

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Embracing Accreditation

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  1. Embracing Accreditation

  2. Disclosure

  3. Objectives

  4. Be able to describe the benefits of accreditation standards and processes to Northern and rural community settings. • Be able to describe the importance of their own participation in accreditation. • Reflect on and discuss the relationships among educational best practices, accreditation standards, excellent clinical care and the health of the people of Northern Ontario.

  5. How do accreditation standards arise? • Best educational practices • Patients’ needs • Previously identified problems • Advocacy • Specialty committees

  6. Best Educational Practices B3.3 The program must be organized such that residents are given increasing professional responsibility, according to their level of training, ability/competence, and experience. B 4.5.3 There must also be facilities to allow such learning activities as direct observation of clinical skills and delivery of the academic program, as well as places that offer privacy for confidential discussions.

  7. Best Educational Practices B5.1.2 There must be a structured academic curriculum which …….should include teaching and learning with a patient-centered focus as well as skills training, seminars, reflective exercises, directed reading, journal clubs, and research conferences. B 6.2.2   Clinical skills must be assessed by direct observation and must be documented

  8. Best Educational Practices B1.3.8 The residency program committee must undertake an ongoing review of the program to evaluate the quality of the educational experience and to review the resources available. B2.2 There must be clearly defined objectives for each of the CanMEDS/CanMEDS-FM competencies. • B2.2.1 The educational objectives must be functional and reflected in the planning and organization of the program

  9. Patients’ Needs CanMEDS CFPC Red Book “Care of Aboriginal populations:Residents must develop the skills to work with and provide appropriate care for aboriginal populations” B 5.1.4 Medical Expert “Teaching must include issues of age, gender, culture, ethnicity and end of life issues as appropriate to the discipline”

  10. Previously identified problems B 3.5.1 Service demands must not interfere with the ability of the residents to follow the academic program. B 5.6.1 The program must provide opportunities for residents to acquire knowledge and skills for effective teaching. B 1.3.8.5.1 There must be an effective mechanism to provide teaching staff in the program with honest and timely feedback on their performance.

  11. Lobbying Red Book 1999, 2006 All family medicine residents must spend a minimum of 8 weeks in a rural family practice as part of their core family medicine experience. Red Book 2013 A sufficient clinical experience in a rural practice setting must be provided to all residents to ensure that the competencies and experience necessary to serving the needs of rural communities are acquired

  12. Specialty Committees • “This is how I was trained” • View from the urban tertiary care centre

  13. Blocks of subspecialty experience “All residents MUST complete rotations (one block each or equivalent longitudinal rotation) in at least seven (7) of the following fourteen (14) pediatric subspecialties and MUST be involved in the care of patients in all the other subspecialties. Maximum of two (2) blocks per subspecialty will be accepted”

  14. Fourteen (14) months or equivalent training in selectives, which must include training in at least 8 of the following: • Cardiology • Clinical Immunology and Allergy • Clinical Pharmacology and Toxicology • Critical Care Medicine • Dermatology • Endocrinology and Metabolism • Gastroenterology • etc…….

  15. How does this relate to the health of the people of Northern Ontario

  16. Encouraging trends • Distribution of Med Ed • Competency based training • Increasing supply of physicians • Renewed focus on generalism • Ken Harris

  17. You are NOSM We are NOSM

  18. The Royal College Needs The Royal College Needs NOSM

  19. Distribution of Physicians in Canada

  20. The Future of GeneralismRural Specialists Forum Kenneth A. Harris MD, FRCSC Director, Office of Specialty Education

  21. General Surgery Recommendations (1) • Redesign General Surgery training and curricula through the introduction of enhanced areas of expertise that are tailored to differing practice contexts in addition to foundational training • General Surgery residency programs should incorporate an explicit period of training geared towards, and focused upon, an individual making the transition to independent practice

  22. General Surgery Recommendations (2) • Support broader transition to a hybrid model of competency-based medical education in postgraduate medical education. • Post-General Surgery residency training, in the form of recognized subspecialty residency programs, Areas of Focused Competence (diplomas), and clinical fellowships, should be developed as complements to enhanced areas of expertise in General Surgery residency programs and undertaken as they are relevant to particular professional practice environments.

  23. Potential Solutions (incomplete) • Competency based approach • Identify foundational elements of disciplines • Facilitate skill/knowledge acquisition • Pre-certification • Post-certification • Facilitate bilateral transfer of required referrals • Provide support • Communities of practice • Patient focused care

  24. You are the experts • You tell me

  25. CBD Identified Initiatives ePortfolio For Fellows For Residents Assessment In-Training Competency-Based Assessment In-Practice Competency-Based Assessment Change Exam Governance Re-EngineerExam Delivery Develop Exam Content CBME Credentialing Accreditation Redesign Policy: Outcome-Based Focus Re-Engineer Accreditation Process Redesign Policy: Competency-Based Focus Re-Engineer Credentialing Process Create Competency Framework & Milestones (Generic & Speciality-Specific) CanMEDS 2015 Deliver CohortedRoll-Out Affirmation of Continued Competence Faculty Development and Faculty/Education Support Lifelong Learning

  26. CanMEDS 2015: Planned Updates

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