Accreditation as a quality improvement tool: is it still relevant?

Nesibe Akdemir, David A Ellwood, Theanne Walters and Fedde Scheele
Med J Aust 2018; 209 (6): . || doi: 10.5694/mja17.00934
Published online: 17 September 2018

Despite lack of quantitative evidence, accreditation still works, although there is room for improvement

Accreditation is, as a method of reviewing the quality of medical education, more than 100 years old1 and is traditionally based on the episodic “biopsy” model, which involves periodic assessment, usually against defined standards.2 Despite acknowledgement of the importance of accreditation,3,4 there is limited hard evidence to support its effectiveness or impact, reflecting in particular the social constructs of the accreditation model and of the education setting in which it is applied. Accreditation in this context assesses to a significant degree the quality of human interactions, obligating a less measurable research approach, more qualitative than quantitative.5 Applicable social constructivist research methodologies are common in the education setting, as detailed in the recent MJA article by Durning and Schuwirth.6 Although there is some quantitative evidence for the effectiveness of accreditation, such as better clinical learning climate survey scores in accredited programs,7 critical outcomes of impacts on health care have not been quantitated, and a causative link between accreditation and educational quality has not yet been clearly established.4 Further, ongoing changes and innovations in health care and medical education call for a flexible approach to accreditation design,4,8 so even if hard evidence was available, its applicability may be limited to specific and perhaps outdated settings.

  • Nesibe Akdemir1,2
  • David A Ellwood3,4
  • Theanne Walters5
  • Fedde Scheele1

  • 1 OLVG Hospital, Amsterdam, The Netherlands
  • 2 VU University Medical Center, Amsterdam, The Netherlands
  • 3 Griffith University, Gold Coast, QLD
  • 4 Gold Coast University Hospital, Gold Coast, QLD
  • 5 Australian Medical Council, Canberra, ACT


Competing interests:

No relevant disclosures.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.