Development Strategies in Medical Education

Creditation of medical universities is a proper method for improving the quality of medical education [1]. Since accreditation programs help improve the quality of education for future healthcare providers, it is of particular importance. The goal of these accreditation programs is to ensure the achievement of minimum standards in various dimensions of education and research in medical sciences. In this process, decisions are made based on data extracted from comparison with standards [2]. Medical universities have always benefited from accreditation programs in the field of discovering and removing threats, improving weaknesses, and making optimal use of opportunities. Accreditation improves the position of the university in internal and external rankings and serves as a gateway to enter the international accreditation process, which brings about sustainable development and evolution in medical education [3]. 
Creating attraction in the university to receive financial and spiritual support and motivating top professors and students to participate in the affairs are other benefits of accreditation programs. Accreditation causes a more detailed and deeper look at the student’s academic outcomes and the way to achieve success. Accreditation affects each person by creating a sense of self-criticism and self-regulation and causes the improvement of the self and academic environment.
Although accreditation has many advantages, it creates many hidden and obvious disadvantages. The shortage of human resources in medical universities in Iran makes the university managers face many challenges in implementing accreditation. Holding frequent meetings, collecting documents, and the lack of trained experts in the field of accreditation can turn the accreditation process into trouble and threats instead of opportunities [4], and finally cause fatigue and job burnout, such that accreditation has been introduced as a source of stress for staff. They feel that, while they are heavily involved in accreditation program, they do not actually have a role in decisions and even their performance may be considered worthless [2]. 
 This can cause them not to participate in meetings and be resistance to making changes in the faculty. Spending a lot of time, allocating a large amount of resources, not knowing the importance of accreditation, and not wanting to do the work are serious barriers to accreditation [2]. In addition to staff and professors, university managers are also exposed to harms caused by accreditation. Paying too much attention to the compilation and collection of documents makes them focus only on the metrics and prevents them from management of educational and research challenges in the faculties. Some studies have questioned the effectiveness of accreditation programs [5].
To overcome the disadvantages of accreditation, the intelligent performance of managers in the accreditation process seems necessary. At the levels of macro-decisions, ensuring the compliance of accreditation criteria with the macro-goals of the health system, designing and validating tools for measuring metrics, holding periodical workshops, determining the minimum acceptable level for different faculties, and announcing the accreditation results in a clear manner along with operational feedback to all faculties are essential. 
At the level of universities and faculties, identifying educational needs in the field of accreditation, using accreditation as a basis for revising programs, familiarizing and training human resources about metrics and continuously integrating metrics into the current affairs of the faculty, creating a sense of ownership towards accreditation in staff and professors, explaining the impact of accreditation on the success of a faculty, benefiting from experienced professors, applying the best research results to improve the quality of documenting accreditation criteria based on available scientific evidence, appointing a permanent expert to register accreditation documents along with involving all the staff and professors of a faculty, continuous evaluation and collection of metrics and not devoting a short time to this matter, benchmarking and use of experiences of other faculties and new technologies, creation of organizational learning culture, and active mechanisms for receiving feedback from students and professors are recommended [5]. Also, the financial and spiritual support of staff for their heavy work facilitates this complex process [2].

References

1. Jung H, Jeon WT, An S. Is accreditation in medical education in Korea an opportunity or a burden? J Educ Eval Health Prof. 2020; 17:31. [DOI:10.3352/jeehp.2020.17.31] [PMID]
2. Wilson-Hail CK, Hurst B, Chang CW, Cooper W. Accreditation in education: One institution’s examination of faculty perceptions. Crit Quest  Educ. 2019; 10(1):17-28. [Link]
3. Bedoll D, van Zanten M, McKinley D. Global trends in medical education accreditation. Hum Resour Health. 2021; 19(1):70. [DOI:10.1186/s12960-021-00588-x] [PMID]
4. Blouin D, Tekian A, Kamin C, Harris IB. The impact of accreditation on medical schools’ processes. Med Educ. 2018; 52(2):182-91. [DOI:10.1111/medu.13461] [PMID]
5. Yarmohammadian MH, Khorsani E, Norouzinia R, Mirzaei S, Ehsanpour S, Yamani N, et al. Institutional accreditation in medical education: The experience of the survey visit teams. J Educ Health Promot. 2020; 9:39.[PMID]