McGaw’s Overview of the Next Accreditation System (NAS)

Goals of NAS

• Focused on continuous accreditation and improvement

• Increased emphasis on annually submitted data• Enhanced oversight to ensure high quality education

and a safe/effective learning environment• RRCs to assess program performance each year:

– To free good programs to innovate– To assist poor programs to improve– To reduce the burden of accreditation– To provide accountability for Outcomes to the Public

Basic Structure of NAS

• CLER visits• Continuous RRC Oversight/Accreditation• Close Sponsor (McGaw) Oversight• Site Visits (Program or Institution) as needed• Frequent Institutional Review• Self Study

Milestones/Competencies

Milestones

• Developmental steps: (1) Novice; (2) Advanced Beginner; (3) Competent; (4) Proficient; (5) Expert; and (6) Master

• Describe the path from Novice to Practitioner

• “Intuitively” known by experienced medical educators in each specialty

• Provide framework/language to describe progress

• Communicate shared understanding of expectations

• Set aspirational goals of excellence

Program Performance Indicators Under NAS(data reviewed by RRC)

• Annual ADS Update• Program Changes – PDs/Core Faculty/Residents• Program Characteristics – Structure and Resources• Scholarly Activity (both trainees/faculty)

• Board Pass Rate – 3-5 year rolling averages• Resident/Fellow Survey – Common and specialty elements• Resident Clinical Experience – Case logs or other• Faculty Survey – Core Faculty• Semi-Annual Resident Evaluation and Feedback

• Milestone reporting

Example 2 year timeline

Revision of Program Requirements

Program standards revised every ten (10) years and each standard will be categorized:

Core—Statements that define structure, resource, or process elements essential to every graduate medical educational program.

All programs must adhere

Revision of ProgramRequirements (Cont.’d)

Outcome--Statements that specify expected measurable or observable attributes (knowledge, abilities, skills, or attitudes) of residents/fellows at key stages of the graduate medical education.

All programs must adhere

Revision of ProgramRequirements (Cont.’d)

Detail—Statements that describe a specific structure, resource, or process, for achieving compliance with a Core Requirement. Programs in substantial compliance with the Outcome Requirements may utilize alternative/innovative approaches to meet core requirements.

Good programs may innovate

Program Rollouts

Phase I Group – July 2013 Pediatrics Internal Medicine Diagnostic Medicine Orthopaedic Surgery Neurological Surgery Urology

Phase II Group – July 2014 The remaining specialties/RRCs begin using the Next Accreditation

System

Core Teaching Faculty

• Select group of faculty educators• Need to complete ACGME faculty survey

(minimum completion requirements)• Members need to have documented scholarly

activities• Core faculty data will be uploaded to ADS by

programs

Current PD “To Do” List

• Finalize Core Teaching Faculty List and do faculty education

• Finalize and convene Clinical Competency Committee (CCC)

• Complete McGaw Annual Program Update • Review drafts of milestones if available

http://www.acgme-nas.org/milestones.html

• Review RRC Program and Common Guidelineshttp://www.acgme-nas.org/review-comment.htmlhttp://www.acgme-nas.org/ccpr.html

PD Ongoing Tracking Tasks

• Follow ACGME and ACGME-NAS websites closely

• Engage and follow specialty specific training organizations (association of training directors, etc.)