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Introduction to the CanAMS & the Internal Review Process

Introduction to the CanAMS & the Internal Review Process. May 13 th , 2019. Agenda for the Morning. Learning Outcomes. At the end of this workshop, you will be able to: Describe the requirements and procedure for the CanERA internal review

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Introduction to the CanAMS & the Internal Review Process

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  1. Introduction to the CanAMS & the Internal Review Process May 13th, 2019

  2. Agenda for the Morning

  3. Learning Outcomes At the end of this workshop, you will be able to: Describe the requirements and procedure for the CanERA internal review Apply best practices to prepare for your program’s internal review Use the CanAMS to demonstrate your program’s achievement of CanERA standards

  4. Review of the New CanERA System

  5. Acknowledgements Royal College Drs. Karen Finlay and Joanne Todesco

  6. CanWHAT? • CanERA - Canadian Excellence in Residency Accreditation: The name given to the new system of accreditation • CanRAC - Canadian Residency Accreditation Consortium: The conjoint group including the Royal College, CFPC, and CMQ tasked with the development and ongoing support of CanERA • CanAMS- The digital Accreditation Management System: a fundamental component of CanERA)

  7. Highlights of CanERA New Accreditation Standards Digitized Accreditation Management System (CanAMS) Accreditation Site Visits • Changes to institution accreditation decisions • 8-year review cycle Focus on Continuous Quality Improvement

  8. When will this affect me? www.CanERA.ca

  9. Previous Survey Cycle - OLD RCPSC Site Survey 1 6 • Continuous program self-review (CQA) • Faculty evaluations • Rotation evaluations • Curriculum evaluations • Trouble-shooting • Overall program review e.g. retreat 5 2 3 4 PG Office Internal Review

  10. New Survey Cycle • 8 years between regular on-site accreditation visits • New electronic tools for surveyors / less paper & repetition / more flexibility • 2 year follow-ups (some onsite, some not) • Introduction of common software/database (AMS) • Data collected by institutions throughout the cycle, including new sources of information • Selected data provided to RCPSC throughout the cycle

  11. The Survey Process(stays the same) University PSQs ➡ Program Profiles PSQs ➡ Program Profiles Specialty Committee Royal College Comments PSQs& Comments ➡ Program Profiles & Comments Comments Program Director Surveyor

  12. Review of the Standards New standards, not so new Review the new standards with your Residency Program Committee • What needs to be in place? • Fully compliant; partially compliant? New standards will be used for the Internal Reviews Talk with other PDs/ PAs in your discipline and outside for tips on the ‘newer standards’

  13. Program Standards 5 DOMAINS • Program Organization • Education Program • Resources • Learners, Teachers, & Administrative Personnel • Continuous Improvement • ++ Blueprinted from B1-6 • Updated, clarified, & reorganized • Increased focus on outcomes, the learning environment, & CQI • CanMEDS framework remains

  14. Standards Organization Framework Domains were defined by the Future of Medical Education in Canada-Postgraduate (FMEC-PG) Accreditation Implementation Committee to introduce common organizational terminology, to increase alignment of accreditation standards across the medical education continuum. The overarching outcome to be achieved through the fulfillment of the associated requirements. A category of the requirements associated with the overarching standard. A measurable component of a standard. A specific expectation used to evaluate compliance with a requirement (i.e. to demonstrate that the requirement is in place). Mandatory indicators must be met to achieve full compliance with a requirement. Exemplary indicators provide objectives beyond the mandatory expectations and may be used to introduce indicators that will become mandatory over time.

  15. Requirement Rating Scale – NEW! • Meets: all mandatory indicators met • Partially meets: at least one, but not all mandatory indicators met • Does Not Meet: none of the mandatory indicators met

  16. Example - Domain: Program Organization

  17. New Terminology • Area for Improvement (API) • Replaces previous weaknesses • Requirement level (PM or DNM) • Leading Practice and Innovation (LPI) • Replaces strengths

  18. New Accreditation Categories Your Institution will now receive an accreditation category too New programs will now have an External Review Mandated Internal Reviews & Progress Reports are replaced by the APOR APOR = Action Plan Outcomes Report

  19. POSSIBLE CATEGORIES OF ACCREDITATION - NEW • A – RS • A – APOR • A – ER • NOTICE OF INTENT • WITHDRAWAL

  20. APOR = Action Plan Outcomes Report • Replaces A-IR and PR • Living register tracking how weaknesses (AFIs) are being addressed • Discussion with PGME and Program as how best to address AFIs

  21. Accredited program with follow-up at next regular onsite survey (i.e. in 8 yrs) • Acceptable compliance with standards (could have AFIs) • Expectation of good, ongoing CQI throughout the cycle

  22. Accredited program with follow-up by APOR One (or more) significant area(s) for improvement impacting the overall quality of the program requiring follow-up prior to the next regular onsite review, and which can be evaluated via submission of evidence from the program. Predictable 2-year follow up

  23. Accredited program with follow-up by External Review One (or more) significant area(s) for improvement impacting the overall quality of the program requiring follow-up prior to the next regular onsite review, and which can be best evaluated by external peer reviewers. Factors: Persistent area(s) requiring improvement; nature of the area(s) of improvement may require reviewer from outside university and/or from same discipline; concerns with program’s or institution’s oversight or CQI of the program Predictable 2-year follow up

  24. Accredited program on Notice of Intent to Withdraw There are major and/or continuing concerns which call into question the educational environment and/or integrity of the residency program and its ability to deliver high quality residency education. OR Despite notifications and reminders, the program has failed to complete and submit the required accreditation follow-up by the deadline. Current residents & CaRMS applicants must be made aware. Predictable 2-year follow up - Onus is on the program to show why accreditation should not be withdrawn

  25. INTERNAL REVIEWS • Important evidence of Institutional CQI • Accreditation standard for Institutions McMaster Process • Similar process to the Royal College/CFPC on-site surveys • Same documentation • Similar accreditation decisions ( exception: notice of intent) • Accreditation Committee to review all reports

  26. Internal Review • Does not need to be perfect • Quality Assurance and Quality Improvement process • Standardised Process for follow-up important • Attention to program CQI • Attention to Learning environment What we can learn collectively: • New standards- what are frequent compliance issues • Guide education and resources • Best practices • Areas of learning environments that need improvement

  27. Survey Team • Chair- usually a PD or past PD • Faculty member • Resident • Some programs will have an external faculty member from the same discipline ( resource issues; large feeder programs; program identification of need)

  28. Information Provided to Surveyors in Advance • Access to Program Profile (incl response to previous weaknesses) • Specialty specific documents • Survey Report & Transmittal Letter from last RCPSC survey

  29. Information Provided to Surveyors on Site • Resident assessments • Faculty/ rotation evaluation • Face-to-face interviews • RPC & Competence Committee Minutes (past 6 years) • University’s Internal Review process

  30. Program Profile(previously known as the PSQ) IT’S A BIG DEAL!

  31. First impressions count! • Describes how your program is meeting each standard – “evidence” • Guides the surveyor’s questions • Reviewed by many: • PG Dean • Your Surveyor(s), • Accreditation Committee members

  32. Be clear & thorough – • If you are doing something a bit different or are dealing with a challenge, tell us all about it & defend your choices • Attend to spelling, grammar, & formatting • Get help from others. Give yourself lots of time. Hunt down all the numbers, institutional policies, & governance information. You should be the most informed person about your program!

  33. Use abbreviations where necessary, but always include a legend • Final draft should be reviewed by your RPC including resident reps & department head 7. Tell what is happening now rather than what you wish to happen

  34. And finally … AVOID: • We will be … • We hope to … • Only using “role modeling” &“observation” for the intrinsic CanMEDS Roles (OK in 2000, not OK in 2019)

  35. Additional Resources CanERA has developed online training modules. The modules will allow you to: Familiarize yourself with the standards Understand and navigate the CanAMS Access the training modules here: http://www.royalcollege.ca/mssites/canera-uprh/index.html#/

  36. McMaster Postgraduate Medical Education Office postgd@mcmaster.ca

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