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Specialties accreditation: challenge for the academic community of medical science universities
Acreditación de las especialidades: reto para la comunidad académica de las universidades de ciencias médicas
Jesús Yasoda Endo Milán1* http://orcid.org/0000-0002-0616-4204
Delia Eugenia Sosa Morales1
http://orcid.org/0000-0002-7124-6118
1Villa Clara University of Medical Sciences. Académico Vicerectorate. Santa Clara Villa Clara. Cuba.
*Author for correspondence. Email: deliaeugenia@infomed.sld.cu
Submitted: 24/02/2020
Accepted: 03//03/2020
At present, the medical specialties in Villa Clara are engaged in undergoing the assessment by the National Accreditation Board (NAB); it is now possible to deepen inside this issue due to the importance it has for the National Health System, the province and for the Cuban nation.
Today, the healthcare professional requires high competitiveness and skills to transfer, apply and design new technologies as well as make decisions quickly; possessing these capacities confer additional value to their results that means a quality performance.(1)
At the moment Cuba and its health system face a brutal aggression in the economic field by the United States; its hostile policy has led it to launch defamatory statements against doctors and what they represent in the field of health; these attacks forced some internationalists to be removed from their honorable missions where they had unconditionally gone to solve the problems of the most humble populations on the planet.
The Cuban National Health System makes a great effort to achieve the necessary qualification of its human resources; This has been present since the beginning of the Revolution from the training of professionals not only prepared in the scientific-technical order, but also in the consolidation of ethical and political-ideological values that are part of the results obtained in health.
The main objective of medical specialization is to deepen in the command of theoretical, technical and methodological knowledge in the area of a professional discipline or field of application, expanding training through practice. In the end it obtains the academic degree of specialist with a profession or field of application.
The specialties respond to a current need to provide the development of job skills to solve - totally or partially - the problems that arise in professional practice. In each area of knowledge they have their own characteristics conceived in a program, with its objectives, graduate profile, work activity and evaluation.(2)
The development of postgraduate specialties has as its main role the improvement of professional activity in an area of knowledge, characterized by political, economic and social demands expressed in the objectives of the program and the profile of the graduate.(2)
The organizations interested in using this postgraduate modality aim to satisfy demands made in order to achieve a high degree of professional development in their graduates, based on the activity that requires a certain job, where specific skills are acquired and/or perfected for optimal performance.(2)
Saborido Loidi, the Minister of Higher Education, at the opening conference of the University 2020 event(3) stated: «Cuba has a mature system of evaluation and accreditation of programs and institutions (...) to train comprehensive, competent professionals, committed to the Revolution, achieve the completion of the teaching staff (...) and increase the impact of universities ...».
Resolution No. 307/15(2) establishes the System of Evaluation and Accreditation of Postgraduate Specialties (SEA-PS), which states that: «The main objective of accreditation is to contribute to the improvement of the quality of Higher education in Cuba through the national and international certification of programs and institutions that meet established quality requirements». Therefore, the quality of training in Cuban higher education is based on educational work, with emphasis on the political-ideological, because it encompasses education based on the value system of the Cuban Revolution that tends to the training of professionals who combine high competences with strong revolutionary convictions.
Quality is achieved when all the people and entities linked to the graduate programs endorse the ideals reflected in the pattern. In that sense, the self-assessment processes are of special importance as they constitute the way for the formation of a quality culture and strong support for the continuous improvement of postgraduate education. Quality in contemporary higher education aims for a qualitative change, of constant transformation, using at all times the comparison with a quality pattern.(2)
The degree of social relevance of a program or institution is measured by the social impact it generates, due to the flow of repercussions and transformations that objectively occur in society, presumably as an effect of the accumulation of contributions made by such program. It is evident that the concept of quality of university education has varied, it has been perfected; many factors have affected it and this means an opportunity for universities, and at the same time a challenge, since those that are not able to orient themselves and adapt to the new social demands, will simply disappear or become fossils.(4)
For Tunnermann(5) the concept of quality of higher education is multidimensional and not only encompasses the three classic functions: teaching, research and extension, it´s translated into the quality of its teaching staff, its program and teaching learning methods; It also includes the quality of its students, its infrastructure and its academic environment. Add to this a good direction, a good government and a good administration to determine the operation of the university and the institutional image projected towards society. In this process the teaching staff is involved and perfected in the work around the training of future specialists, and residents strive for their program to be accredited and their qualification allows them to proudly display the specialty they are studying.
Experience has made it possible to ensure that accreditation is not only an exercise that allows quality assessment, but also increases the sense of belonging of all involved. It is a process in which the planned is compared with the result of the execution and the desired degree of accomplishment with the achieved; that is, it compares what was planned and what was achieved through an analysis of its components, functions, processes and results.
The process is complex and has a great dedication in the days preceding the arrival of the JAN evaluators, so that intra-university relations are expanded, collectivism is encouraged, the sense of responsibility is increased and the demand is raised. In it six variables are valued: relevance and social impact, teaching staff, students, and infrastructure, curriculum and work places.(2) Each of them contributes to the system of indicators that allow looking inside the entire process of resident training.
Constant self-assessment is what should allow you to declare itself ready to be visited by the JAN; That is why this introspection systematically allows for improvement; and when the visit in which national experts and board members participate takes place, it is certain that the work will be valued fairly and will serve to grow and set the banner of the quality of the Cuban health system even higher.
The impact is the change in the outcome of a process (product). This can be seen in the way of carrying out the process or in the practices that are used and that depend, to a large extent, on the person or people who execute them, because with this variable we want to assess how training work has an impact on people´s health. Professors' prestige, professional experience and ethical-moral values are valued, supported by research results, experience in teaching, medical care and research work in the area of program knowledge. Hence the degrees are explored and the second degree specialists and the PhDs are taken into account, with their researching ranks, and years of medical care and teaching experience.
Residents are also analyzed from the process: compliance with the admission requirements, the students dropped out and their causes, the relationship between enrollment and theses presented in the planned deadlines, if the thesis topics were forecasted in problem banks of the institution and if they solve them. It also analyzes their scientific productivity and the way in which they have been academically evaluated by reviewing the cards, where other general aspects are also reflected: bearing and personal appearance, work discipline, medical ethics, human relations, unconditionality and integrality. In addition, it is explored whether resources are guaranteed for the teaching-learning process and if students can access electronic information and printed literature for their preparation; if complementary materials have been developed, if they access the different updated bibliographic sources declared as basic in the program and the complementary bibliography for knowledge enrichment on the specialty.
Regarding the professors of the specialty, it is valued if they have developed study guides, books, educational videos, educational software, simulators, certified publications and multimedia with the required quality that complement and facilitate the students' learning, as well as if residents have access to the scientific-technical information available on the network or other media. The theoretical and methodological foundation of the program, the applicability of the knowledge received in the professional activity, the planning, control and evaluation of the courses and the activity in the workplace to meet the general objective of the program, the theoretical and/or practical updating of the program, the curriculum and continuous improvement process, the profile of the graduate and their correspondence with the competences, the problems identified in the workplace and their solutions, and the evaluation of the performance of the future specialist are also analyzed.
The work place where residents are trained in direct interaction with the work object of the profession is of vital importance, so that infrastructure conditions are valued in order to meet the requirements for specialist training.
There are seven accredited specialties at Villa Clara University of Medical Sciences: two in Dentistry and five in Medicine; of excellence: Orthodontics, Cardiology and Pediatrics and certificates: Periodontics, Nephrology, Pathological Anatomy and Ophthalmology. This entity continuously works to achieve accreditation processes that raise the quality of the training of specialists to higher levels and commits to the authorities of the National Health System that their educators will once again raise the quality of its graduates.
BIBLIOGRAPHIC REFERENCES
1. Urbina Laza O. La educación de posgrado en las universidades médicas cubanas. Educ Med Super [Internet]. 2015 [citado 06/03/2018];29(2):[aprox. 8 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412015000200017
2.- Junta Nacional de Acreditación. Resolución No. 307/15. Sistema de Evaluación y Acreditación de Especialidades de Postgrado (SEA-EP). La Habana: MES; 2015.
3.-Saborido Loidi JR. Conferencia inaugural del Congreso Universidad 2020. La Habana: MES; 2020.
4. Águila Cabrera V. El concepto calidad en la educación universitaria: clave para el logro de la competitividad institucional Dirección de Postgrado. Rev Iberoamericana de Educación [Internet]. 2005 [citado 20/02/2020];37(12):[aprox. 7 p.]. Disponible en: https://rieoei.org/RIE/article/view/2886
5. Tünnermann C. Pertinencia social y principios básicos para orientar el diseño de políticas de educación superior. Rev Educación Superior y Sociedad [Internet]. 2000 [citado 20/02/2020];11(1)[aprox. 15 p.]. Disponible en: http://ess.iesalc.unesco.org.ve/ess3/index.php/ess/article/view/364
Declaration of interests
The authors declare no conflict of interest.
Authors' contribution
Both authors wrote the article using the consulted bibliography and their experiences in the accreditation processes.
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