DOES DISTRIBUTED MEDICAL EDUCATION MEAN INEQUITABLE OPPORTUNITIES FOR LEARNING Thoughts from the Acc

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DOES DISTRIBUTED MEDICAL EDUCATIONMEAN
INEQUITABLE OPPORTUNITIES FOR LEARNING?Thoughts
from the Accreditation PerspectiveBarbara
Barzansky, PhDInterim LCME Co-Secretary

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GOAL FOR PRESENTATION

• Discuss the following questions (from a south
  of the border perspective)
• Is distributed learning inevitable?
• Is distributed learning inherently inequitable?
  Do all differences constitute inequity?
• What can accreditation do to mitigate inequity?

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DISTRIBUTED LEARNING IN THE US

• Distributed learning can include anything
  from multiple clinical sites in the same region
  to geographically-separate campuses located at a
  distance from the main campus
• In 2005-2006, the 125 LCME-accredited medical
  schools used a total of 947 hospitals as
  inpatient clerkship sites(the range per school
  was 2-27)
• 24 schools have formal branch campuses(and the
  number is increasing)

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INEQUITYLACK OF JUSTICE, FAIRNESSWebsters
New World Dictionary

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THE ELEMENTS OF EQUITY(For Learners)

• Access
• To expertise- faculty- learning materials
• To support services
• To colleagues
• To a variety of patients
• To equitable evaluation

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THE ELEMENTS OF EQUITY(For Faculty)

• Access
• To institutional rewards(such as compensation,
  promotion)
• To opportunities for scholarship/collaboration
• To a fair and appropriate workload

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ACCESS IN A DISTRIBUTED SYSTEM

• Assumptions
• The potential for inequity always exists in
  distributed learning
• Some differences among sites do not represent
  inequity
• Inequity can be managed to assure that learners
  and faculty can achieve their objectives

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THE ROLE OF ACCREDITATION(Undergraduate Medical
Education)

• LCME/CACMS accreditation standards directly
  address issues related to equity in a distributed
  learning system (at least for students).
• EDUCATIONAL PROGRAM
• Requirement for common educational objectives and
  definition of numbers/types of patients (ED-1,
  ED-2)
• Comparable educational experiences and equivalent
  methods of evaluation (ED-8)

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ACCREDITATION (cont)

• CURRICULUM MANAGEMENT
• Central control and management of the curriculum
  (ED-33)
• Single chief academic officer with responsibility
  for the educational program (ED-36, ED-39)
• Functional integration of faculty across
  sites(ED-41)

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ACCREDITATION (cont)

• STUDENT SUPPORT
• Single standard of promotion/graduationfor
  students (ED-41)
• Comparable rights and support services for
  students (ED-44)

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DISTRIBUTED LEARNING IN GRADUATE MEDICAL EDUCATION

• Accreditation standards of the Royal College
  of Physicians and Surgeons of Canada and the
  College of Family Physicians of Canada imply, but
  do not explicitly address, issues related to
  equity across clinical sites.

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ENSURING EQUITY FOR LEARNERS IN THE MEDICAL
EDUCATION SYSTEM

• EQUITY IN AN ENVIRONMENT OF RESOURCE
  CONSTRAINTSIssues for discussion
• How to assure equity in access to expertise
• How to assure equity in access to support
  services for learners
• How to assure equity in access to fair evaluation
• How to assure equity in access to clinical
  resources