Presentation Notes

Poster presented at the Alliance of Independent Academic Medical Centers 2021 National Initiative VII Virtual Meeting 4. March 26-27, 2021; Nashville, TN & Virtual.


Background: Numerous sources from the ACGME[1] to the literature[2] highlight the need to align sponsoring institution’s (SI) and GME’s goals and strategic priorities. For example, the common program requirements1 emphasize that “…the program is expected to define its specific program aims consistent with the overall mission of its Sponsoring Institution, the needs of the community it serves...” Yet there is limited guidance regarding how to identify those alignments and the supporting evidence to demonstrate GME’s contribution/value to the SI’s mission(s).

Objectives: To use a stepwise key stakeholder (SI & GME leaders) driven evaluation approach to identify the value GME programs to the SI and associated evidence of that value.

Methods: SI leaders (via structured interviews) and GME leaders (via GMEC meetings) identified perceived values and associated evidence in response to 3 questions: a) What do you highlight when advocating for the value of our GME Programs? b) What do you wish others knew re: GME’s value? and c) What evidence supports GME’s value? SI leaders included C-Suite (CEO, COO, CFO, DNO), clinical (CMOs), and administrative (legal, QI). GME Leaders included program directors (PDs) attending Winter 2020 GMECs who discussed then recorded their dyad/triad responses to the questions. Interviewer field notes and GME leaders recorded responses were analyzed iteratively to identify value themes and associated supporting evidence. A GME leaders workgroup reviewed the final themes (member check), then prioritized the evidence by theme as high impact and feasibility to track over time.[3]

Results: Respondents: 93% of invited SI leaders (29/31) and GME leaders representing 22 programs. Strong agreement within and between all leader groups on how GME adds value and what wish others knew regarding GME’s value to SI including: 1) Pipeline for physician workforce; 2) Promoting a culture of continuous learning = high reliability organization; 3) Enhancing reputation/prestige of the system; and 4) Community/professional expectations. Evidence includes quantitative metrics, benchmarked to a standard (eg, pipeline: retention relative to external recruitment; culture: teaching site engagement scores; GME related clinics engagement scores community: diversity of GME matriculates/graduates; QI projects = Community Needs Assessment) and qualitative data including 1-minute elevator-like exemplars (eg, culture: GME driven innovations, how learners “teach” their teams). Strategies to feasibly obtain this qualitative data include updates during GMEC meetings and a shared repository by theme.

Significance: Through a systematic key stakeholder driven evaluation process we identified what key stakeholders’ values about GME and the associated measures to provide guideposts for clear messaging in all communications. Evidence of GME’s value to our SI includes traditional metrics (pipeline). Identification of additional themes such as our role in promoting learning within our organization (essential for high reliability organizations) and our value in meeting community/professional expectations consistent with SI missions and the communities we serve provides new areas for GME locally and nationally to demonstrate our value.

[1] ACGME Common Program Requirements. Effective July 1, 2019. Accessed 9.29.2020.

[2] Gupta R, Sehgal N, Arora VM. Aligning delivery system and training missions in academic medical centers to promote high-value care. Academic Medicine. 2019 Sep 1;94(9):1289-92.

[3] Balmer DF, Riddle JM, Simpson D. Program Evaluation: Getting Started and Standards. J Grad Med Educ. 2020;12(3):345-6.

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