a Medical Education Department, College of Medicine , Qassim University , Buraidah , Saudi Arabia.
b School of Medicine & Public Health Faculty of Health and Medicine , University of Newcastle , Callaghan , Australia.
Med Teach. 2017 Apr;39(sup1):S1-S7. doi: 10.1080/0142159X.2016.1254746. Epub 2017 Jan 20.
The accreditation of undergraduate medical education is a universal undertaking. Despite the widespread adoption of accreditation processes and an increasing focus on accreditation as a mechanism to ensure minimum standards are met in various fields, there is little evidence to support the effectiveness of accreditation. Traditionally, accreditation has worked toward achieving two ends: assuring and improving quality. Many recent articles emphasize the need for continuous quality improvement mechanisms to work, as well as the quality assurance role of accreditation.
The aim of the study was to examine the purposes and outcomes of accreditation, and stakeholders' experience of accreditation in Saudi Arabia. Triangulation of data was achieved through literature review, analysis of accreditation documents, examined the outcome of accreditation process (pre and post) through stakeholders' experience of accreditation (learner, teacher, and academic leader perspectives). Data were interrogated using thematic analysis approach involving identifying, analyzing, and reporting repeated patterns (themes) of meaning within data.
Three themes emerged from the three phase study: "Passing the exam" versus long-term benefit, generic versus specialized accreditation standards, and internal quality assurance and self-evaluation. The data revealed a number of strategies that stakeholders can employ to achieve a balance between an "accreditation threat" and a quality improvement approach that is likely to have a lasting effect on educational outcomes.
This empirical study revealed strong parallels between assessment and accreditation purpose, engagement, and outcomes. Like an increasing number of commentaries in the literature, this study suggests that accreditation bodies would do well to shift toward a holistic approach to quality management in medical education; implementation of quality improvement by an external "other"-described by some participants as the "policeman approach"-is not ideal for promoting sustainable quality education. Sustainable accreditation for long-term education improvement is not presented as a method, but as a way of thinking about important, and often overlooked, aspects of accreditation practice. Sustainable accreditation means that there is a need to meet both the immediate accreditation standards ("the exam") as well as establishing a basis for continuing quality improvement.
本科医学教育认证是一项普遍的工作。尽管认证程序已被广泛采用，并且越来越关注认证作为确保各个领域达到最低标准的机制，但几乎没有证据支持认证的有效性。传统上，认证有两个目的：保证和提高质量。许多最近的文章强调需要建立持续的质量改进机制，并发挥认证的质量保证作用。
本研究旨在考察认证的目的和结果，以及利益相关者在沙特阿拉伯的认证经验。通过文献回顾、认证文件分析、从利益相关者的认证经验（学习者、教师和学术领导视角）来考察认证过程的结果（前后），实现了数据的三角分析。使用主题分析方法对数据进行了分析，包括识别、分析和报告数据中重复出现的模式（主题）。
从三个阶段的研究中得出了三个主题：“通过考试”与长期利益、通用与专门的认证标准，以及内部质量保证和自我评价。数据揭示了利益相关者可以采用的一些策略，以在“认证威胁”和可能对教育成果产生持久影响的质量改进方法之间取得平衡。
这项实证研究揭示了评估和认证目的、参与和结果之间的紧密联系。与文献中越来越多的评论一样，本研究表明，认证机构最好转向医学教育质量管理的整体方法；外部“他者”实施的质量改进——一些参与者将其描述为“警察方法”——对于促进可持续的质量教育并不是理想的。为了长期教育改进而进行可持续的认证不是一种方法，而是一种思考认证实践中重要但往往被忽视的方面的方式。可持续认证意味着需要同时满足当前的认证标准（“考试”）和建立持续质量改进的基础。
