Since this was a practice run, I have to compare it to marathon training where one does at least three or four “long runs” (32 kilometres) in the few months prior to the marathon. If those runs are easy then you would never finish the 42.2 kilometres of a marathon. If they are tolerable, then you would not do any better than you did in your last marathon. And if they are hard (or even better, really hard) then you are likely to have a successful marathon or even a PB (personal best).
When it comes to accreditation, we are planning for a PB!
So, as many know, we had a “mock accreditation visit” from February 5-8—from Sunday evening through Wednesday at noon. Dr. Tom Marrie, former dean at both the University of Alberta and Dalhousie who guided both schools off probation, and Dr. Cam Enarson from University of North Carolina, who has done 37 full accreditation visits over his career, did the work! They were incredibly thorough (tough, even) and tremendously helpful.
As a reminder to all, our full accreditation visit is October 29 to November 2, 2017. The process, as dictated by the Committee on Accreditation of Canadian Medical Schools (CACMS), began with a medical student-led Independent Student Analysis (ISA) 18 months before the visit. Our students were extremely engaged and did a great job on the ISA in the spring of 2016.
The next step was populating the first draft of the Data Collection Instrument (DCI), which is a series of questions and data requests regarding each of the 12 standards subdivided into 94 elements.
An Accreditation Steering Committee led six task forces that then divided up the 12 accreditation standards into key areas of focus – administration, admissions, curriculum, educational resources, learning environment, student services – and reviewed the DCI. An iterative process followed by which issues uncovered were fixed, the DCI was updated and a draft submitted to our mock accreditors in mid-December 2016 for review. This process of continuous improvement will continue. For example, Faculty Council passed some policies on admissions just last week which will require an update to the DCI. We have until mid-June to rewrite and polish our DCI before submitting the final version to CACMS.
A mock has never been done before at our college but has become standard practice at all Canadian medical schools over the last three years. Other medical schools have found it invaluable—and all have found it terrifying, as they discovered work yet to be done.
The mock was a dress rehearsal, a fact finding mission, and a reality check. All three are important. An external review by people we employ to find all the gaps that we may be blind to is incredibly valuable. I joked on the final day of the visit that if Tom and Cam were here to find all of our weaknesses, we got incredible value for money!
Let me expand on the reality check. If the real visit were next week, we would have a negative outcome. The accreditors reminded us that this isn’t an exercise in how far we have come; it is an exercise in determining if we meet the standards on the day of the visit.
Overall, I am optimistic. While I now know we still have an incredible amount of work to do—in fact, more than I thought—the good news is we know where to focus our efforts.
On the positive side, Tom and Cam were fully aware of the scope of the transformation underway at the CoM and felt we were going in the right direction. In fact, they noted that we are at a turning point and for the first time in many years the CoM has the potential to be the medical school Saskatchewan deserves! They thought we had the right team in place with: UGME leadership; department heads; the dean’s office; unit, course and clerkship leads; faculty; and staff. They were very complimentary of our faculty, staff and learner engagement in the visit. They were also very positive about the support and commitment from the health regions.
So in summary: right direction, unique opportunity, great team and great engagement.
On the negative side, while our visit logistics worked perfectly for the accreditors, there is work to do on the internal logistics. (On behalf of the team that was working very hard and rapidly behind the scenes, our apologies for some of the confusion in our communication and scheduling.) Also, our DCI had gaps, from broken hyperlinks, to some missing information or weak responses. We took copious notes, and these will all be fixed.
Another challenge is communication. The mock accreditors said not enough people knew and understood all the things going on at the CoM in terms of changes that have been made and processes and progress on accreditation.
So count on plenty more accreditation and CoM progress updates.
While all who met the team were very engaged, more preparation is needed. But it is on the accreditation team and dean’s office to ensure every individual and every team who meet with the accreditors in the fall have the preparation they need. Our team has learned a lot about visit organization, and we will improve. We already are making plans for assisting everyone in their preparation for the real visit early in the fall. We will ensure you are ready. And if you don’t think so, call us on it before the visit.
Some of the remaining issues we must address are big. Not all our students know where to turn in cases of mistreatment and are not entirely confident their concerns will be addressed. We will fix this! Let me assure all students the CoM, UGME team, faculty and staff are committed to a safe learning environment. Let me be clear: this is a very big accreditation issue!
I believe, and the mock accreditors confirmed, our greatest strength—other than great faculty, staff, and learners—is the transformation underway at the CoM. However, accreditation is a data-driven business and so our greatest challenge is having data that demonstrates the transformation is succeeding. This is big, so we will need your help, especially from our students, as we will be doing a follow-up student survey.
There is no doubt that we have had great financial support from the province in the past, but the accreditors made it clear that we are still in the middle of transformation. We are all aware of the current provincial fiscal challenges, but we have conveyed to our government partners the need for a restoration of required funding, and are in constant discussions with them about the college and its critical role in the health care system of the province. However, it was clear to Tom and Cam that if the needed financial support is not available that the transformation and accreditation will be difficult to achieve. This is really big!
And finally, we need to abandon our humble Saskatchewan ways. We were told it is time to assert our excellence and emphasize the things at which we are really good. I will give you a good example. On the elements for diversity and social accountability, I was asked on Sunday how many Indigenous faculty we have, and while I knew personally some of our Indigenous faculty, I could not answer the question. So on Monday I asked Val Arnault-Pelletier if she would match our list of 73 self-identified First-Nation and Metis medical graduates with our list of faculty appointees. I now know we have one PhD and 21 MD Indigenous faculty appointees, and a number of them are in leadership positions! Tom and Cam were blown away by this information and emphasized we have lots to brag about. Now is the time to start.
I thank Tom and Cam profusely. We are really in their debt. I need to thank and compliment Dr. Athena McConnell, assistant dean quality, and Marianne Bell, accreditation specialist, as well as Dr. Pat Blakley, associate dean UGME and Dr. Kent Stobart, vice-dean education and the great team that backed them up. You know who you are.
Most importantly, I thank all who participated in the mock accreditation. Your engagement is inspiring.
However, the work ahead is daunting. Accreditation is our collective first priority after our patients, learners, and research! There will be more requests for information, opinion, surveys, policy development and meetings. We have all been working on multiple high priority initiatives over the past few years and are entering a time period through the fall where we will have to focus our efforts on UGME accreditation. I am committed to removing barriers for our entire CoM team to work on this, as our highest priority. I am also counting on all of you and know that, when asked, you will step up to the plate and be the great team players you have been leading up to, and during, this mock visit.
Remember, while success in marathon running depends very much on the individual, accreditation success depends on a team effort. As I’ve said many times, it’s a team sport! Thank goodness for that, as we will need many contributing to the work ahead, and we have a great and committed team.
I think of teaching, research and patient care as the fun parts of our collective work. A PB in accreditation will free us all up to have more time for the fun stuff!
And, as always, I am here to listen.