The link between quality and accreditation of residency programs: the surveyors' perceptions.
Accreditation of medical residency programs has become globally important. Currently it is moving from the goal of attaining minimal standards to a model of continuous improvement. In some countries, the accreditation system engages peers (physicians) to survey residency programs. The surveyors are sometimes volunteers, usually engaged in multiple clinical and education activities. Few studies have investigated the benefits of residency program evaluation and accreditation from the perspective of the surveyors. As peers they both conduct and receive accreditation surveys, which puts them in a privileged position in that it provides the surveyor with an opportunity to share experiences and knowledge and apply what is learned in their own context. The objective of this study is to obtain the perceptions of these surveyors about the impact of an accreditation system on residency programs. Surveyors participated in semi-structured interviews. A thematic analysis was performed on the interview data, and resulting topics were grouped into five themes: Burden (of documentation and of time needed); Efficiency and efficacy of the accreditation process; Training and experience of surveyors; Being a peer; Professional skills and recognition of surveyors. These categories were organized into two major themes: 'Structure and Process' and 'Human Resources'. The study participants proposed ways to improve efficiency including diminish the burden of documentation to the physicians involved in the process and to increase efforts on training programs and payment for surveyors and program directors. Based on the results we propose a conceptual framework to improve accreditation systems.


BACKGROUND
PD: Program director.
a Department of Education and Health, Faculty of Medicine , University of São Paulo (USP) , São Paulo , Brazil.|b Mental Health Unit , University Hospital of Brasília, University of Brasília (UnB) , Brasília , Brazil.
Renato Antunes
RA
Dos Santos
c McGill's Centre for Medical Education , Montreal , QC , Canada.|d Royal College of Physicians and Surgeons of Canada , Ottawa , ON , Canada.
Linda
L
Snell
e Discipline of General Practice and Propaedeutic, Department of Internal Medicine , University of São Paulo (USP) , São Paulo , Brazil.
Maria do Patrocinio
MD
Tenorio Nunes
D000068:Accreditation / Q000592:standards*; D002983:Clinical Competence; D006801:Humans; D007318:Inservice Training; D007396:Internship and Residency / Q000592:standards*; D007407:Interviews as Topic; D010379:Peer Group; D010465:Perception; D015397:Program Evaluation / Q000379:methods*; D015203:Reproducibility of Results; D013997:Time Factors
Accreditation; medical education; program director; residency; surveyors