WFME

WORLD FEDERATIONFOR

MEDICAL EDUCATION

MEDINE Task Force IIIon

Quality Assurance Standards

Developing European Standards in Medical Education based on the WFME Global Standards

by

Hans Karle

MEDINE ANNUAL CONFERENCEPRAGUE, CZECH REPUBLIC, MAY 2006

RESPONSIBLE ORGANISATIONS

World Federation for Medical Education (WFME).

Association of Medical Schools in Europe (AMSE).

WFME May 2006

MEMBERS OFMEDINE TASK FORCE III

Dr. Hans Karle (WFME chair), Denmark

Professor, Dr. Herman J.M. van Rossum (AMSE chair), Netherlands

Professor Leif Christensen, Denmark

Professor Maria Rosa Fenoll-Brunet, Spain

Professor Roger Green, UK

Dr. Hannu Halila (UEMS chair), Finland

Professor Jadwiga Mirecka, Poland

Professor Iskender Sayek, Turkey

Professor Dieter Scheffner, Germany

Dr. Christophe Segouin, France

Stud. med. Christina Jensen-Dahm

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TASK FORCE III SECRETARIAT

World Federation for Medical Education (WFME)University of CopenhagenFaculty of Health SciencesThe Panum InstituteBlegdamsvej 3BDK-2200 Copenhagen NDenmarkwfme@wfme.org

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OBJECTIVE I

Work to enhance overall standards of medical education in Europe through sharing of ideas, dissemination of best practice, and quality assurance, in conjunction with other European agencies such as ENQA and the regional ERA and making use of the work already carried out by the WFME.

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OBJECTIVE II

Analyse how to adapt the WFME standards to the European context of medical education and to the Bologna process in order to establish minimum requirements for accreditation at medical schools in Europe.

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OBJECTIVE III

Produce a set of quality assurance standards for medical education in Europe, building on and adapting existing work such as the WFME Global Standards, as framework for institutional self-evaluation and for accreditation of undergraduate medical education programmes.

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PHASES OF MEDICAL EDUCATION

Basic Medical Education (undergraduate)

Postgraduate Medical Education

Continuing Medical Education (CME) (Continuing Professional Development (CPD) of Medical Doctors)

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TIMELINES

Year 1: Collection of information about existing accreditation methodologies, assessment

systems and standards in European medical education.

Year 2: Analysis of previous data and comparison with international standards in medical education

defined by WFME and IIME.

Year 3: Proposals for quality assurance standards for basic medical education, postgraduate medical

training and continuing medical education (CME) for institutional self-evaluation and accreditation of undergraduate medical education programmes.

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WFME TRILOGY OF GLOBAL STANDARDS

A foundation for accreditation

WFME GLOBAL STANDARDS:TWO LEVELS OF ATTAINMENT

Basic Standards or Minimum Requirements (“musts”)Accreditation foundation to be met from the outset

Standards for Quality Development(“shoulds”)Reform purposes in accordance with international consensus about best practice

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WFME GLOBAL STANDARDS:ORIENTATION AND COVERAGE

Institutional/Educational Programme Level

Institutional structure and organisation Curriculum/content/processLearning environmentOutcomeManagement

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Basic Medical Education

Postgraduate Medical Education

Continuing Professional Development (CPD)

1. Mission and Objectives 1. Mission and Outcomes 1. Mission and Outcomes

2. Educational Programme 2. Training Process 2. Learning Methods

3. Assessment of Students 3. Assessment of Trainees 3. Planning and Documentation

4. Students 4. Trainees 4. The Individual Doctor

5. Academic Staff/Faculty 5. Staffing 5. CPD-Providers

6. Educational Resources 6. Training Settings and Educational Resources

6. Educational Context and Resources

7. Programme Evaluation 7. Evaluation of Training Process

7. Evaluation of Methods and Competencies

8. Governance and Administration

8. Governance and Administration

8. Organisation

9. Continuous Renewal 9. Continuous Renewal 9. Continuous Renewal

WFME Trilogy of Standards: Areas

Basic Medical Education Postgraduate Medical Education and CPD

Medical knowledge – biomedical, clinical,

behavioural and social sciences and

ethics

Patient care –

health problems and health promotion

Attitudes and clinical skills – history taking,

physical examinations, procedures,

emergency practices

Medical knowledge – biomedical, clinical,

behavioural sciences and ethics

Communication skills, ICT Interpersonal and communication skills, ICT

Treatment, prevention and

health promotion

Appraisal of new scientific knowledge

Clinical reasoning and problem solving Supervisor, trainer and teacher

Ability to undertake life-long learning Scholar

Professional development Knowledge of public health and health policy

Understanding of health care

Professionalism

WFME Trilogy of Standards: Competencies

Basic Medical Education(Student + graduates)

Postgraduate Medical Education (Trainees)

CPD(Medical doctors)

Definition and statement of

methods

Definition and statement of

methods

Documentation of needs

Criteria for passing exams Criteria for passing exams Monitoring of relevant

CPD-activities

Documentation of reliability

and validity

Documentation of reliability

and validity

Use of self-assessment

Balance between formative

and summative assessments

Emphasis on formative,

in-training methods

Use of portfolio and site visits

by peers

Number of and balance between

written and oral exams

Use of portfolio and

log-book-system

Criteria for maintenance of

licensure (documentation

for practice exper. and CPD)

Use of integrated assessments Special exams: OSCE etc.

Special exams: OSCE etc Use of external examiners

Use of external examiners

Development of new methods

WFME Trilogy of Standards: Assessments

USE OF STANDARDS

Framework for institutional (voluntary) self-evaluation

External evaluation and counselling from peer review committees, including site visits

Combination of these proceduresRecognition and accreditation of

institutions/programmes

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CONCLUSIONS FROM FIRST TASK FORCE MEETING, AMSTERDAM, JANUARY 2006

Europe to be defined as the geographical area covered by the European Council

Working conditions for the Task Force acceptedSurvey about quality assurance instruments for

medical education institutions and programmes and each of the European countries

Proposal for European standards

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SURVEY OF QUALITY ASSURANCE AND ACCREDITATION OF MEDICAL EDUCATION IN THE EUROPEAN REGION

Questionnaire divided in:

  

A. Information on Quality Assurance and Accreditation of Basic (Undergraduate) Medical Education.

 

B. Information on Quality Assurance and Accreditation of Postgraduate Medical Education.

 

C1. Information on Quality Assurance and Accreditation of Continuing Medical Education (CME).

 

C2. Information on Quality Assurance and Accreditation of Continuing Professional Development of Medical Doctors (CPD).

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DEVELOPING EUROPEAN STANDARDS - WFME STANDARDS AS A TEMPLATE

Conclusions from first Task Force meeting

WFME global standards considered relevant and adequate

European standards could be more detailedEuropean standards should not be very

prescriptiveProbably no need for sub-regional variationRelationship to results from Task Force I on

competencies

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DEVELOPING EUROPEAN STANDARDS - WFME STANDARDS AS A TEMPLATE

Conclusions from first Task Force meeting

Methods to be used in development: Change of division line between basic standards and

standards for quality development Modification of annotations In some cases additions/deletions Special remarks regarding the European region

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WFME Global Standards inBasic Medical Education

1 MISSION AND OBJECTIVES 1.1 STATEMENTS OF MISSION AND OBJECTIVES

Basic standard: The medical school must define its mission and objectives and make them known to its constituency. The mission statements and objectives must describe the educational process resulting in a medical doctor competent at a basic level, with an appropriate foundation for further training in any branch of medicine and in keeping with the roles of doctors in the health care system. Quality development:The mission and objectives should encompass social responsibility, research attainment, community involvement, and address readiness for postgraduate medical training.

WFME May 2006

WFME Global Standards inBasic Medical Education

1 MISSION AND OBJECTIVES 1.1 STATEMENTS OF MISSION AND OBJECTIVES

Annotations:• Statements of mission and objectives would include general and

specific issues relevant to institutional, national and regional policy.

• Any branch of medicine refers to all types of medical practice and medical research.

• Postgraduate medical training would include preregistration training, vocational training, specialist training and continuing medical education/professional development.

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THE EUROPEAN VERSION OFWFME GLOBAL STANDARDS FOR BME

No present change of the global standards Issuing an addendum: the European version to be followed by the global standards plus the addendumContent of the addendum:

An introduction with a list of the quality development standards to be regarded as basic standards in the European Region Supplement to the annotations: “Specifications for the European Region”

WFME May 2006

WFME

WORLD FEDERATIONFOR

MEDICAL EDUCATION

Web-site: http://www.wfme.org