The Accreditation Council for Graduate Medical Education (ACGME) self-study is a new process for ACGME accredited radiology programs. This article serves to provide the reader with the evolution of ACGME accreditation leading to the conception of the self-study process, detail the self-study method, and offer practical advice to programs embarking upon their inaugural self-study.
Background
Graduate medical education (GME) is in a state of constant evolution; it has evolved from a pure apprenticeship model, through the creation of formal medical schools and loosely organized residencies, and ultimately to the contemporary idea of competency-based graduate medical education . In 1998, the Accreditation Council for Graduate Medical Education (ACGME) formally introduced the Outcome Project, an initiative aimed at both developing competency and assessing performance in each of the six domains that we are all now familiar with as the core competencies . Historically, accreditation was based on evaluation of the process of training residents. The Outcome Project ushered in the era of accreditation based on a residency program’s educational outcomes with respect to the competencies. The Next Accreditation System (NAS) emerged from the Outcome Project ; this new system is grounded by the Milestones and self-study.
To foster assessment based on clinical outcomes, ACGME began to envision developmental milestones as a metric on which to evaluate residents . By 2009, all ACGME specialties were developing specialty-specific milestones as a collaborative venture between ACGME, the American Board of Medical Specialties, specialty colleges, program directors, and residents . In 2013, the Diagnostic Radiology Milestones were formally introduced . The Milestones expand the six core competencies into meaningful outcome measures and form the framework for continuous outcome-based assessment of trainees in the NAS.
One of the pillars of the NAS is the self-study process. The self-study process is not unique to the realm of GME. Other educational accreditation organizations, such as the Council for Higher Education Accreditation, the body that accredits greater than 3000 colleges and universities in the United States, employ a self-study process whereby the institution prepares a written summary of its performance with respect to its relevant accrediting standards . The ACGME self-study process mirrors the processes that have been successfully implemented elsewhere. The aim of this article is to describe the ACGME self-study process and provide practical suggestions to large and small residency programs. For the purposes of this article, future references to “the program” encompass both diagnostic radiology residency and fellowship programs.
ACGME Self-Study and 10-Year Site Visit
With the introduction of new guidelines, requirements, and processes, a sense of anxiety and urgency may befall a program director. However, the ACGME self-study can be enlightening and a more robust version of the now familiar annual program evaluation (APE) . Simply stated, the ACGME self-study is a comprehensive longitudinal evaluation of the residency or fellowship program.
The self-study can be described as a fluid and iterative process defining program aims and measurable outcomes; collecting data to document outcomes; identifying threats, opportunities, strengths, and areas for improvement; and seeking input from various stakeholders in the residency ( Fig 1 ). The self-study culminates in the submission of a summative document to ACGME that reports on the reflective and analytical process of the self-study itself. A plan of action for program advancement, informed by the outcome data, is the ideal output of the self-study process. This, in turn, will prepare the program for the ACGME 10-year site visit, which will occur 12 to 18 months after the submission of the self-study summary. The 10-year site visit is an opportunity for the program to update ACGME with the improvements made in the program as a result of the self-study .
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Components of the Self-Study
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Self-Study Committee
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Program Aims and Outcomes
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Identify and Examine Opportunities and Threats Facing the Program
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Longitudinal Data Review
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Reflection and Creation of the Self-Study Summary
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Conclusion
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Supplementary Data
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Appendix S1
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Appendix S2
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Appendix S3
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