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


METHODS
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.
D. Hunt is co-secretary, Liaison Committee on Medical Education, and senior director for accreditation services, Association of American Medical Colleges, Washington, DC. M. Migdal is senior research analyst, Liaison Committee on Medical Education, Association of American Medical Colleges, Washington, DC. D.M. Waechter is assistant secretary, Liaison Committee on Medical Education, and senior director of surveys and team training, Association of American Medical Colleges, Washington, DC. B. Barzansky is co-secretary, Liaison Committee on Medical Education, and director, Division of Undergraduate Medical Education, American Medical Association, Chicago, Illinois. R.F. Sabalis is assistant secretary, Liaison Committee on Medical Education, Association of American Medical Colleges, Washington, DC.
Dan
D
Hunt
Michael
M
Migdal
Donna M
DM
Waechter
Barbara
B
Barzansky
Robert F
RF
Sabalis
D000068:Accreditation / Q000592:standards*; D026683:Advisory Committees; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000592:standards*; D006801:Humans; D015397:Program Evaluation; D012577:Schools, Medical / Q000592:standards*; D014481:United States