Heard Jeanne K, O'Sullivan Patricia, Smith Christopher E, Harper Richard A, Schexnayder Stephen M
Accreditation Council for Graduate Medical Occasion, 515 North State Street, Suite 2000, Chicago, IL 60610, USA.
Acad Med. 2004 Sep;79(9):858-64. doi: 10.1097/00001888-200409000-00011.
This study sought to investigate whether an institution's Graduate Medical Education Committee (GMEC) could develop a system of continuous quality improvement of its residency programs using an annual survey provided by the institution for all residents.
Beginning in 2000, residents were surveyed annually about their educational and work environments. The GMEC determined standards of performance for the items on the survey based on four areas commonly cited by the Accreditation Council for Graduate Medical Education: supervision, feedback/evaluation, scholarly time, and duty hours. Residency program directors submitted action plans to improve those areas rated below the standard by the residents in the program.
The 2000 survey served as baseline. In 2001, residency programs met the standard for 55.2% of the items, and 18 programs submitted 67 action plans. In 2002, programs met the standard for 80.6% of the items. For the items below standard, programs showed improvement in 14.9% and declined in 4.5% of the items compared with baseline. Six of the 18 programs had accreditation site visits during the study period. Five received no citations in the targeted areas. The sixth program was visited three months after it developed action plans for its six deficient areas. It received citations for two of the six areas.
An institution that sponsors residency programs can develop and sustain an effective system to continuously monitor and evaluate its programs and improve the educational quality as evidenced by successful accreditation decisions.
本研究旨在调查一个机构的研究生医学教育委员会（GMEC）是否能够利用该机构为所有住院医师提供的年度调查，开发一个对其住院医师培训项目进行持续质量改进的系统。
从2000年开始，每年对住院医师进行关于其教育和工作环境的调查。GMEC根据研究生医学教育认证委员会普遍提及的四个领域：监督、反馈/评估、学术时间和值班时长，确定调查项目的绩效标准。住院医师培训项目主任提交行动计划，以改进项目中住院医师评价低于标准的那些领域。
2000年的调查作为基线。2001年，住院医师培训项目在55.2%的项目上达到标准，18个项目提交了67项行动计划。2002年，项目在80.6%的项目上达到标准。对于低于标准的项目，与基线相比，14.9%的项目有所改进，4.5%的项目有所下降。在研究期间，18个项目中有6个接受了认证实地考察。其中5个在目标领域未被指出问题。第六个项目在为其六个缺陷领域制定行动计划三个月后接受考察，其中六个领域中有两个被指出问题。
一个主办住院医师培训项目的机构可以开发并维持一个有效的系统，以持续监测和评估其项目，并提高教育质量，成功的认证决定就是证明。
