Systems of quality assurance in medical education
Health professionals’ education occurs in a range of contexts, carried out by a variety of institutions and professional bodies. The locus of control in these areas depends on whether the health professional is a student, trainee or independent practitioner. Although each healthcare profession has its own unique set of educational structures and processes, there are similarities across the disciplines.
The undergraduate context
Students preparing for professional registration are generally enrolled in university programmes which, though relying on practicing clinicians for much of the teaching, remain under the control of universities and through them to the agencies that have a mandate for audit. These agencies are primarily concerned with assuring governments that taxpayers are getting ‘value for money’ and that graduates are fit for purpose`.
In the UK, undergraduate medical education is funded by the Higher Education Funding Councils and the Department of Health (to support clinical placements). Quality assurance is carried out by the Quality Assurance Agency (QAA) and by the Department of Health through monitoring of funding streams that support clinical education. The QAA is an independent body working across all higher education provision under contract from the Higher Education Funding Councils.
Professional and statutory bodies also have a role in the approval and accreditation of undergraduate programmes offered by universities to assure fitness for purpose of graduates. The General Medical Council) manages this through the Quality Assurance of Basic Medical Education (QABME) process (General Medical Council, 2009). These mechanisms assure professional bodies that programmes meet defined ‘threshold’ standards in terms of curriculum outcomes and delivery methods and that the provider institution has resources, systems and governance arrangements to ensure appropriate delivery of the approved programme. Initial approval and accreditation is followed up with a cycle of reviews and audits.
The postgraduate context
In the UK, the Department of Health is responsible for specifying the curriculum for foundation trainees and medical Royal Colleges are responsible for determining the curricula, carrying out assessments for trainees in various specialities, revalidation and professional development. The responsibility for ensuring that the educational experience of trainees meets quality standards falls to the (which took on this responsibility when the Postgraduate Medical Education and Training Board merged with the General Medical Council in April 2010. Regional deaneries carry out quality monitoring and evaluation of educational organizations in their area.
Continuing professional development (CPD) and revalidation
In terms of continuing professional development and revalidation, quality assurance processes are influenced by a number of policy shifts. These include further formalizing revalidation, recertification and licensing (quality assured by the General Medical Council and Royal Colleges); a shift towards specification of competencies at all levels; a greater emphasis on educational and clinical supervision and formalizing staff and educational development. In response to these shifts, new professional standards frameworks for teachers and supervisors are being introduced, adding another layer to the quality assurance processes (Postgraduate Medical Education and Training Board, 2008; Academy of Medical Educators, 2009).
Thinking point:
Whether you work in undergraduate, postgraduate or continuing medical education (or a mixture of each), quality assurance is key to both maintaining and improving standards.
Do you feel you are fully familiar with the external quality assurance processes that impact on your teaching and learning?
If not, take some time to explore the quality assurance context within which your teaching occurs and, if time allows, offer to become involved in these quality assurance processes.
Save a PDF of this module, so you can print it and read it in your own time.
Let us know what you think about this module or give us your feedback.
More information about this module, further reading and a complete list of glossary terms.
Read about the recommended learning activities for this module.