ASPIRE for excellence in student engagement: Examples of how institutions operationalize a complex construct.

Student engagement is a key contributor to educational programme quality. It is a complex construct often defined with the focus on student behaviors. However, a broader, more organizational approach takes into account the institutional context and how this can be structured to encourage and support students' willingness and ability to become engaged. This paper includes suggestions for a student engagement system using key elements recognized in the literature and concrete examples from medical schools that achieved recognition in the ASPIRE-to-Excellence student engagement initiative. The examples from the ASPIRE participants demonstrate that the presence of certain key features creates a mutually beneficial collaborative approach between students and their institutions. This includes opportunities for students to formally engage in four domains touching on the breadth of student life, including institutional governance and policy-making, educational programme development and evaluation, participation in activities in the academic community, and participation in local community and international outreach. Based on an in-depth review of the information from three medical schools that recently received an ASPIRE-to-Excellence award in student engagement, it was possible to identify certain specific practices that individually and taken together allow an institution to demonstrate excellence in this complex construct. As an overarching concept, it was clear that student participation in each of these domain areas benefitted from a supportive institutional culture characterized by specific formal attributes and activities. Examples included codifying student involvement in governance through institutional policies; maximizing communication routes among students and between students and school administrators and faculty; and formalizing a participatory environment through missions statements or strategic plans. For programme planning, a helpful conceptualization is that a successful student engagement programme occurs when change is championed by all stakeholders within an institution and the organization supports a collaborative culture that includes students as active participants and partners.

MD-Granting Medical Schools in the US, 2022-2023.

This Appendix presents data derived from the 2022-2023 Liaison Committee on Medical Education Annual Medical School Questionnaire-Part II.

What Is the Role of Accreditation in Achieving Medical School Diversity?

Diversity standards in medical education accreditation do not guarantee diversity but do stimulate schools' activities to recruit and retain diverse students and faculty. The Liaison Committee on Medical Education's (LCME's) accreditation standard addressing medical school diversity neither mandates which categories of diversity medical schools must use nor defines quantitative outcomes they should achieve. Rather, each medical school is required to (1) identify diversity categories that motivate its mission and reflect its environment and (2) use those categories to implement programs to promote diverse representation of students and faculty. When the LCME assesses each medical school's compliance with these requirements, it considers single point-in-time diversity numbers, trends in student and faculty diversity, and outcomes of programs implemented by the school to promote diversity in the categories it identifies as key to its mission.

Which LCME Accreditation Expectations Support Quality and Safety in Global Health Immersion Experiences for Medical Students?

Almost all allopathic medical schools in the United States allow students to participate in global health immersion experiences. The Liaison Committee on Medical Education accreditation requirements specify that students' home institutions are responsible for overseeing learning experiences, assessing and mitigating risk, ensuring appropriate supervision, and offering instruction about what to expect, ethically and culturally, in a learning setting. Students should also have opportunities to debrief about their experiences.

The Role of Accreditation in Supporting Educational Quality During Difficult Circumstances.

This article was migrated. The article was marked as recommended. Accreditation aims to ensure that generally-accepted standards of educational program quality are being met. The Liaison Committee on Medical Education (LCME), the accrediting body for medical education programs leading to the MD degree, has a process to address circumstances at medical schools arising from acute emergency situations. This involves consultation with faculty and administration at the affected school and collection of data related to compliance with accreditation standards through written reports and on-site visits. The actions of both the medical schools in New Orleans and the LCME following Hurricane Katrina in 2005 illustrate this process. While the need to respond to requests for information from an accrediting body places additional burdens on a medical school's faculty and administration during an emergency, such oversight also ensures that the medical education program continues to meet standards. This provides assurance of educational quality to school personnel and students, as well as to the school's publics. Accreditation agencies should consider how their standards and processes support a timely and flexible response to disaster situations that occur at accredited schools.

The Variables That Lead to Severe Action Decisions by the Liaison Committee on Medical Education.

PURPOSE: To identify the variables associated with severe action decisions (SADs) (unspecified accreditation term, warning status, probation status) by the Liaison Committee on Medical Education (LCME) regarding the accreditation status of established MD-granting medical education programs in the United States and Canada. METHOD: The authors reviewed all LCME decisions made on full survey reports between October 2004 and June 2012 to test whether SADs were associated with an insufficient response in the data collection instrument/self-study, chronic noncompliance with one or more accreditation standards, noncompliance with specific standards, and noncompliance with a large number of standards. RESULTS: The LCME issued 103 nonsevere action decisions and 40 SADs. SADs were significantly associated with an insufficient response in the data collection instrument/self-study (odds ratio [OR] = 7.30; 95% confidence interval [CI] = 2.38-22.46); chronic noncompliance with one or more standards (OR = 12.18; 95% CI = 1.91-77.55); noncompliance with standards related to the educational program for the MD degree (ED): ED-8 (OR = 6.73; 95% CI = 2.32-19.47) and ED-33 (OR = 5.40; 95% CI = 1.98-14.76); and noncompliance with a large number of standards (rpb = 0.62; P < .001). CONCLUSIONS: These findings provide insight into the LCME's pattern of decision making. Noncompliance with two standards was strongly associated with SADs: lack of evidence of comparability across instructional sites (ED-8) and the absence of strong central management of the curriculum (ED-33). These results can help medical school staff as they prepare for an LCME full survey visit.

Continuous quality improvement in an accreditation system for undergraduate medical education: Benefits and challenges.

BACKGROUND: Accreditation reviews of medical schools typically occur at fixed intervals and result in a summative judgment about compliance with predefined process and outcome standards. However, reviews that only occur periodically may not be optimal for ensuring prompt identification of and remediation of problem areas. AIMS: To identify the factors that affect the ability to implement a continuous quality improvement (CQI) process for the interval review of accreditation standards. METHODS: Case examples from the United States, Canada, the Republic of Korea and Taiwan, were collected and analyzed to determine the strengths and challenges of the CQI processes implemented by a national association of medical schools and several medical school accrediting bodies. The CQI process at a single medical school also was reviewed. RESULTS: A functional CQI process should be focused directly on accreditation standards so as to result in the improvement of educational quality and outcomes, be feasible to implement, avoid duplication of effort and have both commitment and resource support from the sponsoring entity and the individual medical schools. CONCLUSIONS: CQI can enhance educational program quality and outcomes, if the process is designed to collect relevant information and the results are used for program improvement.

Transforming educational accountability in medical ethics and humanities education toward professionalism.

Effectively developing professionalism requires a programmatic view on how medical ethics and humanities should be incorporated into an educational continuum that begins in premedical studies, stretches across medical school and residency, and is sustained throughout one's practice. The Project to Rebalance and Integrate Medical Education National Conference on Medical Ethics and Humanities in Medical Education (May 2012) invited representatives from the three major medical education and accreditation organizations to engage with an expert panel of nationally known medical educators in ethics, history, literature, and the visual arts. This article, based on the views of these representatives and their respondents, offers a future-tense account of how professionalism can be incorporated into medical education.The themes that are emphasized herein include the need to respond to four issues. The first theme highlights how ethics and humanities can provide a response to the dissonance that occurs in current health care delivery. The second theme focuses on how to facilitate preprofessional readiness for applicants through reform of the medical school admission process. The third theme emphasizes the importance of integrating ethics and humanities into the medical school administrative structure. The fourth theme underscores how outcomes-based assessment should reflect developmental milestones for professional attributes and conduct. The participants emphasized that ethics and humanities-based knowledge, skills, and conduct that promote professionalism should be taught with accountability, flexibility, and the premise that all these traits are essential to the formation of a modern professional physician.