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.