Osteopathic Postdoctoral Training Institutions
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《美国整骨期刊》
the Department of Education, American Osteopathic Association, Chicago, Ill.
The Osteopathic Postdoctoral Training Institution (OPTI) program has flourished since the American Osteopathic Association (AOA) established it in 1995 as a system to structure and accredit osteopathic graduate medical education (OGME). Each OPTI is a community-based training consortium composed of at least one AOA-accredited college of osteopathic medicine and one AOA-accredited hospital. Additional hospitals and ambulatory care facilities may also form partnerships within an OPTI.
Each of the 17 OPTIs is required to undergo a site survey on a regular basis to determine the institution's quality and compliance with AOA standards. The results of this site survey are used to determine the length of the OPTI's continuing accreditation. For example, if an OPTI is considered to be standard compliant and is functioning close to the expected level of quality, it may be granted a 4-year continuing accreditation. The next site survey of that institution would take place at the end of that 4-year period. Conversely, if an OPTI is deficient in various standard areas and is not operating at the expected level of quality, it may be granted only a 1-year continuing accreditation and will have to be inspected again at the end of that year. Five years is the maximum length of accreditation that can be granted to an OPTI, according to AOA guidelines.
At publication, each of the OPTI sites has been visited by AOA inspectors at least twice since site surveys began in 1997 (Figure 1). The average length of accreditation granted has increased with each new cycle of site surveys, indicating increased compliance with AOA standards. The average length of accreditation granted in the initial site survey cycle was 2.3 years. In the most recent site survey cycle, an average accreditation length of 3 years was granted to OPTIs.
Analysis of Compliance with Standards
In an attempt to further improve upon OPTI performance and elevate the level of service provided to the OPTIs' hospital and ambulatory care facility partners, the AOA Committee on Osteopathic Postdoctoral Training Institutions (COPTI) has analyzed OPTI compliance with AOA standards. At the 2005 Annual OPTI Workshop held in Tucson, Ariz, in May, the findings of this analysis were presented and discussed.
In the AOA COPTI analysis, results from the two most recent OPTI site survey cycles were examined for each OPTI. In the prior survey cycle, 12 OPTIs were granted 2 years' continuing accreditation, while only one OPTI received 4 years' continuing accreditation. In the most recent survey cycle, seven OPTIs received 4 years' continuing accreditation.
Similar progress was found in the AOA COPTI analysis in regard to cited deficiencies of OPTIs in meeting standards of compliance. In the prior survey cycle, nine OPTIs were cited for four or more deficiencies in meeting standards, while only one OPTI had no cited deficiencies. In the most recent survey cycle, four OPTIs had four or more cited deficiencies, and six OPTIs had no cited deficiencies. It is clear that OPTI compliance with AOA standards is steadily improving.
The AOA COPTI analysis determined that OPTIs most frequently failed to meet standards within the organization, administration, and finance section of the standard requirements. Fifty-four percent of the OPTI deficiencies cited during the prior survey cycle were in this section, and 40% of the OPTI deficiencies cited during the most recent survey cycle were in this section (Figure 2). In addition, 24% of the cited OPTI deficiencies in the prior survey cycle pertained to the standards section on faculty and instruction, and 27% of the cited OPTI deficiencies in the most recent survey cycle were in this same section (Figure 2).
the prior to the most recent survey cycle, a shift occurred in the most frequently cited deficient individual standards. The prior survey cycle found a lack of compliance primarily in the submission of institution bylaws and development of educational program policies (Table 1). The most recent survey cycle found increased deficiencies in standards regarding the integration of osteopathic principles and practices in teaching services (Table 2). Standards regarding the presence of OGME committees, the meeting of research requirements, and the development or evaluation of faculty in OPTIs were consistently deficient in both survey cycles.
Plans to Address Deficiencies
Discussions regarding the best practices for addressing these cited deficiencies took place in the OPTI Workshop breakout groups in Tucson. Participants focused on the deficiencies pertaining to faculty development, OGME committee activity, and research. Suggestions were offered for meeting the standards related to these deficiencies. In addition, concerns were expressed regarding possible obstacles to meeting the standards. The OPTI Clearinghouse (available through http://www.do-online.org) was proposed as an appropriate method for sharing more detailed models of those OPTI programs that have effectively complied with AOA standards.
The group comments were shared with all of the workshop participants and will form the basis for further discussion at the 2006 Annual OPTI Workshop, scheduled to be held in Savannah, Ga, on April 4, 2006. Additional workshop topics will include defining the role of the OPTI versus the role of the individual partner institutions, determining how OPTIs can better assist their partner institutions in meeting AOA requirements, and identifying how OPTIs can continue to improve upon their services to the osteopathic medical community.
Proposed Scoring System
In light of the increased OPTI compliance with AOA standards, an important question remains unanswered: Are OPTIs simply complying with minimal standards, or are they functioning in the optimal intended capacity In order to address this question, the AOA COPTI—under direction of the AOA's Bureau of Osteopathic Education—has begun to identify measurable outcomes for the OPTIs that better reflect compliance rates with optimal standards. The evaluation tool being designed by COPTI is a type of scoring system that will help gauge whether each OPTI is providing a quality product to its partners. This proposed scoring system would also help make the OPTI evaluation process more uniform than it presently is. The expected implementation date of the OPTI scoring system remains undetermined.
Conclusion
The AOA's OPTI program is striving to provide a high quality, seamless continuum of osteopathic medical education and training for osteopathic graduate medical students. The data from the site surveys indicates that the OPTI program is steadily evolving and progressing. The AOA intends to further improve upon the existing OPTI framework through continued self-analysis and sharing of best practices.(Jonathan B. Webb, MPH)
The Osteopathic Postdoctoral Training Institution (OPTI) program has flourished since the American Osteopathic Association (AOA) established it in 1995 as a system to structure and accredit osteopathic graduate medical education (OGME). Each OPTI is a community-based training consortium composed of at least one AOA-accredited college of osteopathic medicine and one AOA-accredited hospital. Additional hospitals and ambulatory care facilities may also form partnerships within an OPTI.
Each of the 17 OPTIs is required to undergo a site survey on a regular basis to determine the institution's quality and compliance with AOA standards. The results of this site survey are used to determine the length of the OPTI's continuing accreditation. For example, if an OPTI is considered to be standard compliant and is functioning close to the expected level of quality, it may be granted a 4-year continuing accreditation. The next site survey of that institution would take place at the end of that 4-year period. Conversely, if an OPTI is deficient in various standard areas and is not operating at the expected level of quality, it may be granted only a 1-year continuing accreditation and will have to be inspected again at the end of that year. Five years is the maximum length of accreditation that can be granted to an OPTI, according to AOA guidelines.
At publication, each of the OPTI sites has been visited by AOA inspectors at least twice since site surveys began in 1997 (Figure 1). The average length of accreditation granted has increased with each new cycle of site surveys, indicating increased compliance with AOA standards. The average length of accreditation granted in the initial site survey cycle was 2.3 years. In the most recent site survey cycle, an average accreditation length of 3 years was granted to OPTIs.
Analysis of Compliance with Standards
In an attempt to further improve upon OPTI performance and elevate the level of service provided to the OPTIs' hospital and ambulatory care facility partners, the AOA Committee on Osteopathic Postdoctoral Training Institutions (COPTI) has analyzed OPTI compliance with AOA standards. At the 2005 Annual OPTI Workshop held in Tucson, Ariz, in May, the findings of this analysis were presented and discussed.
In the AOA COPTI analysis, results from the two most recent OPTI site survey cycles were examined for each OPTI. In the prior survey cycle, 12 OPTIs were granted 2 years' continuing accreditation, while only one OPTI received 4 years' continuing accreditation. In the most recent survey cycle, seven OPTIs received 4 years' continuing accreditation.
Similar progress was found in the AOA COPTI analysis in regard to cited deficiencies of OPTIs in meeting standards of compliance. In the prior survey cycle, nine OPTIs were cited for four or more deficiencies in meeting standards, while only one OPTI had no cited deficiencies. In the most recent survey cycle, four OPTIs had four or more cited deficiencies, and six OPTIs had no cited deficiencies. It is clear that OPTI compliance with AOA standards is steadily improving.
The AOA COPTI analysis determined that OPTIs most frequently failed to meet standards within the organization, administration, and finance section of the standard requirements. Fifty-four percent of the OPTI deficiencies cited during the prior survey cycle were in this section, and 40% of the OPTI deficiencies cited during the most recent survey cycle were in this section (Figure 2). In addition, 24% of the cited OPTI deficiencies in the prior survey cycle pertained to the standards section on faculty and instruction, and 27% of the cited OPTI deficiencies in the most recent survey cycle were in this same section (Figure 2).
the prior to the most recent survey cycle, a shift occurred in the most frequently cited deficient individual standards. The prior survey cycle found a lack of compliance primarily in the submission of institution bylaws and development of educational program policies (Table 1). The most recent survey cycle found increased deficiencies in standards regarding the integration of osteopathic principles and practices in teaching services (Table 2). Standards regarding the presence of OGME committees, the meeting of research requirements, and the development or evaluation of faculty in OPTIs were consistently deficient in both survey cycles.
Plans to Address Deficiencies
Discussions regarding the best practices for addressing these cited deficiencies took place in the OPTI Workshop breakout groups in Tucson. Participants focused on the deficiencies pertaining to faculty development, OGME committee activity, and research. Suggestions were offered for meeting the standards related to these deficiencies. In addition, concerns were expressed regarding possible obstacles to meeting the standards. The OPTI Clearinghouse (available through http://www.do-online.org) was proposed as an appropriate method for sharing more detailed models of those OPTI programs that have effectively complied with AOA standards.
The group comments were shared with all of the workshop participants and will form the basis for further discussion at the 2006 Annual OPTI Workshop, scheduled to be held in Savannah, Ga, on April 4, 2006. Additional workshop topics will include defining the role of the OPTI versus the role of the individual partner institutions, determining how OPTIs can better assist their partner institutions in meeting AOA requirements, and identifying how OPTIs can continue to improve upon their services to the osteopathic medical community.
Proposed Scoring System
In light of the increased OPTI compliance with AOA standards, an important question remains unanswered: Are OPTIs simply complying with minimal standards, or are they functioning in the optimal intended capacity In order to address this question, the AOA COPTI—under direction of the AOA's Bureau of Osteopathic Education—has begun to identify measurable outcomes for the OPTIs that better reflect compliance rates with optimal standards. The evaluation tool being designed by COPTI is a type of scoring system that will help gauge whether each OPTI is providing a quality product to its partners. This proposed scoring system would also help make the OPTI evaluation process more uniform than it presently is. The expected implementation date of the OPTI scoring system remains undetermined.
Conclusion
The AOA's OPTI program is striving to provide a high quality, seamless continuum of osteopathic medical education and training for osteopathic graduate medical students. The data from the site surveys indicates that the OPTI program is steadily evolving and progressing. The AOA intends to further improve upon the existing OPTI framework through continued self-analysis and sharing of best practices.(Jonathan B. Webb, MPH)