The Wilson Centre, University Health Network and Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Med Educ. 2023 Dec;57(12):1210-1218. doi: 10.1111/medu.15143. Epub 2023 Jun 1.
The COVID-19 pandemic had significant impacts on many aspects of health care and education, including the accreditation of medical education programmes. As a community of international educators, it is important that we study changes that resulted from the pandemic to help us understand educational processes more broadly. As COVID-19 unfolded in Canada, a revised format of undergraduate medical accreditation was implemented, including a shift to virtual site visits, a two-stage visit schedule, a focused approach to reviewing standards and the addition of a field secretary to the visit team. Our case study research aimed to evaluate the sociomaterial implications of these changes in format on the process of accreditation at two schools.
We interviewed key informants to understand the impacts, strengths and limitations of changes made to the accreditation format. We used an abductive approach to analyse transcripts and applied a sociomaterial lens in looking for interconnections between the material and social changes that were experienced within the accreditation system.
Stakeholders within the accreditation system did not anticipate that changes to the accreditation format would have significant impacts on how accreditation functioned or on its overall outcomes. However, key informants described how the revised format of accreditation reconstructed how power was distributed and how knowledge was produced. The revised format contributed to changes in who held power within each of the programmes, within each of the visiting teams and between site members and visiting team members. As power shifted across stakeholders in response to material changes to the accreditation format, key informants described changes in how knowledge was produced.
Our findings suggest that the most powerful knowledge about any given programme might best be obtained through individualised tools, technologies and voices that are most meaningful to the unique context of each programme. Deliberate attention to how knowledge and power are influenced by the interactions between material and social processes within accreditation may help educators and leaders see the effects of change.
COVID-19 大流行对医疗保健和教育的许多方面都产生了重大影响，包括医学教育计划的认证。作为一个国际教育者社区，研究大流行带来的变化非常重要，这有助于我们更广泛地了解教育过程。随着 COVID-19 在加拿大的发展，本科医学认证的修订格式得以实施，包括向虚拟现场访问的转变、两阶段访问时间表、审查标准的重点方法以及在访问团队中增加一名现场秘书。我们的案例研究旨在评估格式变化对两所学校认证过程的社会物质影响。
我们采访了主要利益相关者，以了解认证格式变更对认证过程的影响、优势和局限性。我们采用了溯因方法来分析转录本，并在寻找认证系统内经历的物质和社会变化之间的相互联系时应用了社会物质视角。
认证系统内的利益相关者没有预料到认证格式的变化会对认证的运作方式或其总体结果产生重大影响。然而，主要利益相关者描述了认证的修订格式如何重构了权力的分配方式以及知识的产生方式。修订格式导致了每个计划内、每个访问团队内以及现场成员和访问团队成员之间权力的变化。随着认证格式的物质变化导致利益相关者之间的权力转移，主要利益相关者描述了知识产生方式的变化。
我们的研究结果表明，关于任何特定计划的最有力的知识可能最好通过与每个计划的独特背景最相关的个性化工具、技术和声音来获得。刻意关注认证过程中物质和社会过程之间的相互作用如何影响知识和权力，可能有助于教育工作者和领导者看到变革的影响。
