Early responses of three medical colleges following the implementation of new diversity LCME accreditation standards.

摘要

To enhance diversity in medical education, the Liaison Committee on Medical Education (LCME) introduced new diversity accreditation standards for United States medical schools that grant the Doctor of Medicine (MD) degree. Added in 2009, the two standards related to diversity, identified as MS-8 and IS-16, went into effect with the 2009-2010 accreditation cycle. Their intent is to boost access and graduation rates for underrepresented individuals in medical schools and to enhance diversity in the medical school faculty as well. The long-range goal is to prepare physicians to provide culturally competent care for an increasingly pluralistic society and to address issues related to healthcare disparities.;Thus far, numerous medical schools have fallen short of these standards, putting their accreditation status at risk with resulting citations that may contribute to probationary status. Inherent in the process is the perception from the field that these new standards are highly interpretative and not sensitive to the operational and regional challenges of medical schools in their unique environment. This study focused on how local actors interpret and implement the diversity accreditation policy demands that are made on them.;This qualitative case study of three American medical schools examined the attitudes, challenges, and lessons learned regarding the implementation of these new diversity accreditation standards. The schools selected for the study were stratified by various stages of LCME accreditation (full, provisional, and probationary) and represent varied geographic regions of the United States. The participants were medical school leaders, faculty, medical students, and LCME accreditation surveyors.;This study sought to determine stakeholders' attitudes and perceptions of the standards and their importance, along with perceived barriers and facilitators to their implementation. This study concluded that the LCME diversity accreditation standards are powerful policy levers to stimulate diversity program development. Study findings suggest that medical schools and field surveyors need enhanced education on the application of these standards. Additionally, a number of faculty, staff and students lack a full appreciation of the need for these standards, which necessitates leadership involvement and education. Medical curricula related to diversity, inclusion, and healthcare disparities may need enhancement and implementation in order for schools to achieve their goals related to diversity. Preliminary evidence demonstrates that diversity programs focusing on meeting the standards for the sake of compliance are not as robust and sustainable as diversity programs that align their missions to achieve diversity.;The policy implementation procedures and outcomes associated with compliance or non-compliance with these new diversity standards are important learning opportunities for organizations seeking accreditation and for the accrediting bodies themselves.