Steps to Apply: Appendix A
Core Curriculum Requirements
Educational Principles of the Accreditation Process
Accredited fellowship programs are responsible for developing a well planned curriculum that addresses the five essential elements outlined below.Since individual programs differ in their educational emphasis, we encourage each program to seek creative and efficient ways to develop a curriculum that advances its individual mission. The purpose of the accreditation process is not to make all programs alike, nor to waste a program's limited time and resources on activities with no educational purpose. A well planned curriculum succeeds only to the extent that it enhances learning, and produces graduates who are well prepared for their future careers.
A more complete discussion of curriculum elements is available as a faculty development tutorial at www.academicpeds.org/egwebnew (on Menu of Options, click on Tutorials, then select Module 1), from which the following figure is taken.
Core Curriculum Requirements
All accredited fellowship programs must meet Curriculum Requirements A-F. Please refer to Program Requirements, Section VI, Educational Program, for additional information.
Curriculum Requirement A: Goals and Objectives
All programs must have a curriculum that addresses at least the three domains of academic competence listed below, i.e., Research, Education, and Career Development and Leadership. Within these competency domains, a total of 13 educational goals are required. These required goals (with optional objectives, discussed below) are listed in Appendix B: Academic Goals and Suggested Objectives for General Pediatrics Fellows: A Resource for Fellowship Programs.
REQUIRED COMPETENCY DOMAINS AND GOALS
Competency Domain 1: Research
Competency Domain 2: Education
Competency Domain 3: Career Development and Leadership
Programs are expected to vary in their degree of emphasis on the three domains and on the required goals, but some activities related to each required goal should be included in the curriculum. Most fellowship programs will also have clinical goals, which may vary widely from program to program, depending on its educational emphasis. (For more information, see below: Clinical Curriculum Requirement.) Programs that include non-physician fellows will probably want to adapt the goals and objectives required of these learners, although many of the broad goals are likely to be similar for fellows with MD and PhD degrees.
Learning Objective Requirement. Appendix B provides a list of 6-12 suggested academic objectives for each of the 13 required goals. The objectives lists are quite comprehensive, and are intended to provide a menu, not a blueprint. Programs may select objectives from the list that are relevant to their program, or substitute their own objectives, potentially consulting other sources. Learning objectives should be crafted to describe specifically what the program requires fellows to learn and what will be evaluated.
We recommend keeping the list of objectives fairly short, focusing on the knowledge, skills, and attitudes that the program considers essential to teach and to evaluate in all fellows. This list need not include all program activities, only those critical to the program's mission and purpose. As a rule of thumb, the curriculum should encompass goals that are sufficiently comprehensive and objectives that are adequately detailed to provide fellows with good preparation for careers in the discipline(s) targeted by the fellowship program. However, efficiency requires that evaluation be focused on only the highest priority objectives of a program.
It is required that an accredited program have at least 2 or more learning objectives for each goal in its curriculum: goals with major emphasis might have 6-8 objectives, while goals with minor emphasis might include only 2-3 objectives. Curricula that include more than 75 objectives will probably prove too unwieldy to be functional; previously accredited programs have found about 50 essential objectives to be realistic in scope. We recommend including fellows in the selection of essential objectives, and revising the list over time to an achieve balance between comprehensiveness with respect to content and efficiency with respect to program operation.
Clinical Curriculum Requirement. This accreditation program focuses on academic, rather than clinical training. However, fellows with clinical degrees should, over the course of fellowship training, improve their clinical skills by demonstrating growing competence in the care of patients and families. If a program includes physicians, clinical goals are required for accreditation, but are not specified in the accreditation requirements. Each program should develop its own clinical goals in accordance with its individual mission. Learning and evaluation should be accomplished through appropriate mentoring and at least an annual written review and discussion of the fellow's clinical performance, as part of the routine training process of the program. Goals and objectives for the clinical activities of fellows must be defined by the fellowship program to guide its clinical teaching and evaluation, and these objectives must be shared with fellows.
Curriculum Documentation Requirement. A sample Curriculum Table is provided at the end of this file. A program should use this template to document the core content of its curriculum. To make this table useful, limit it to the program's goals and essential objectives that are taught to all fellows and evaluated in all fellows. These are to be listed in Column 1. (Minor or optional objectives should be omitted.) Column 2 should describe how each essential objective is taught, and Column 3, how it is evaluated.
If a program has a complete written curriculum that includes all the information requested in the Curriculum Table template, it can be submitted as a substitute.
Curriculum Requirement C: Learning Activities
Programs must assess fellows' learning needs and educational progress at the beginning and end of enrollment in the fellowship, and at least yearly during the fellowship. This process should include an individual meeting between the fellow and his/her mentor, Scholarship Oversight Committee, and/or program director. The assessment should address the program's educational goals and objectives, and provide fellows with critical information on what is expected of them and how well they are meeting those expectations. A product of these meetings will be an individual learning plan for each fellow, which will be updated annually. These meetings should also be used for individualized educational planning with the fellow, and should provide useful information for continuous program monitoring (see Requirement E).
These yearly evaluation meetings are the minimum standard; more frequent informal feedback sessions are strongly recommended. A record of the times and outcomes of these assessment and planning sessions should be maintained for each fellow for review by the Accreditation Review Committee.
In the case of fellows who are not meeting program expectations, written steps to remedy shortfalls and a timeline for reassessment must be developed in collaboration with the fellow. The remediation plan and timeline should be available for review by the site visit team. Programs should mask personal identifiers on these documents.
Each program should develop learning activities that collectively address all of the written goals and objectives of the curriculum, and demonstrate a reasonable diversity in learning settings, styles, and formats. Some activities will likely be required for completion of the fellowship, but fellows should be given some degree of choice among activities that will meet the program's requirements. For core learning activities, we recommend that a plan be developed that describes its core content, processes, timeline, and learning resources, as well as who will teach and who will evaluate the learners. Learning activities addressing the programs goals and essential objectives must be listed in the Curriculum Table (see p. 5).
Curriculum Requirement D: Fellow Evaluation Methods
Evaluation of fellows at the end of the program should be the culmination of multiple assessment and feedback sessions over time (see Requirement B). Evaluations should focus on the core goals of the program and a reasonably brief list of measurable or observable objectives that define these goals. A sound evaluation process is multi-faceted, with several evaluators who interact with the fellow in different settings. Faculty should be oriented to the evaluation process and tools, to enhance the consistency of learner evaluations. The fellow should participate as a self-evaluator.
A selection of sound and informative evaluation methods must be used, some of them from the external peer review system in which the fellow will participate as a career professional. Sound evaluation methods are valid and reliable; informative methods are objective-based, focused and specific. These methods might include: written exams on cognitive topics; multi-source evaluations that include faculty, other fellows, residents, staff members, and patients; self-evaluations; critical incident analyses; detailed critiques of presentations or papers; and peer review outcomes of grant proposals or publications.
The evaluation methods for essential objectives must be listed in the Curriculum Table (see p. 5). The evaluation tools must be made available for review by the Accreditation Review Committee, including a few completed forms.
In addition, programs must have a process in place to track the career outcomes of their past fellows in an organized fashion. A list of publications, grants, and major career achievements of previous fellows must be provided, going back 5 years, if possible, or to the time of the last accreditation review.
Curriculum Requirement E: Program Evaluation and Improvement
Faculty evaluation. Faculty must be evaluated at least annually by fellows and receive formal feedback on the results in a face-to-face discussion with the program director. Faculty evaluation forms should be sound and informative (as defined in Requirement D). The evaluation forms must be made available for review by the Accreditation Review Committee, including a few completed forms.
Program evaluation. The program must conduct periodic self-assessments to identify potential problems and seek solutions if needed in a timely way. Major stakeholders in the program (fellows, faculty, department chair) should be asked to contribute information. Yearly program assessments should include a review of the evaluations for each fellow, potentially supplemented by focus groups or interviews with fellows and faculty to gather information in areas where problems are identified. Areas of deficiency that generalize to multiple fellows should be thoroughly investigated. The fellows must be included in these periodic reviews. A brief report on yearly self-assessments should be made available for review by the Accreditation Review Committee. Program evaluations should contribute demonstrably to ongoing program improvement.
Accreditation Review Committee will conduct external program evaluations every few years to keep a program's accreditation current.
Curriculum Table Template
List only essential objectives that are taught to and evaluated in all fellows
|Required Goals and Objectives||Teaching Activities
[list for all objectives]
[list for essential objectives only]
|Objective 1b, etc.|
|Goal 3, etc.|
Note: The following coding lists should be modified to match your program's actual teaching and evaluation methods. Items listed are only suggestions.
|Suggested Codes for Teaching/Learning Activities||Suggested Codes for Evaluation Methods|
1. Clinical encounters
5. Morning report
6. M&M conference
7. Individual community project
8. Individual research project
9. Web search and report
11. QI activity
12. Supervisory/teaching activity
13. Presentation by fellow
14. Written abstract
15. Written journal article
16. Written grant proposal
17. Written educational plan/product
|a. Competency-based global rating
b. Direct observation with checklist
c. Expert opinion/comparison
d. 360 deg. ratings
e. Written examination
f. Patient surveys
g. Case/procedure logs
h. EBM activity
i. QI activity
j. Faculty review of writings
k. Peer review of articles, grants
l. Systems error activity
m. Self assessment
n. Teaching assessment
o. Individual learning plans
p. Critical incident reports
q. Other __________
r. Other __________