AGP
Fellowship Project: Accreditation Evaluation
RATING SCALE:
1=meets requirement 2=needs improvement 3=does
not meet requirement
I. General Requirements
1.1. _____An accredited AGP program must exist in conjunction with
and be an integral part of a core pediatric residency program accredited
by the Accreditation Council for Graduate Medical Education (ACGME).
1.2. _____Interaction of the academic general pediatric fellows and
faculty with the residents in the core pediatrics residency program
is required.
1.3. _____Lines of responsibility for the pediatric residents and the
academic general pediatric fellows must be clearly defined.
Institutional Organization
2.1 Sponsoring Organization
2.1.1. _____The AGP fellowship program must be sponsored by the same
institution that sponsors the related core pediatrics residency program.
2.1.2 _____The institution must provide sufficient support to the Program
Director, support staff and trainees to show an ongoing commitment
to fellowship education.
2.2 Appointment of AGP Fellows
2.2.1 _____Prerequisite training for entry into a pediatric fellowship
program should include the satisfactory completion of an ACGME-accredited
pediatric residency or other training judged suitable by the program
director (e.g. internal medicine – pediatrics or international
pediatrics residency training).
Duration and Scope of Training
3.1 _____AGP fellowship programs must provide at least two years of
training.
3.2 _____The program must provide the AGP fellow with instruction and
opportunities to ensure effective interaction with patients, patients’ families,
professional associates, and others in carrying out their responsibilities
as physicians in the field.
3.3 _____Clinical work should range from 15% time at a minimum to a
50% at a maximum, averaged over the course of the fellowship. Programs
with a heavy clinical load should consider a three-year training cycle.
3.4 _____The fellowship program also must develop in its fellows a
commitment to lifelong learning and must emphasize scholarship, self-evaluation
and self- directed learning, planning for continuous learning, evidenced
based medicine, critical analysis of clinical problems, clinical decision
making, quality improvement, and understanding of the health care system.
3.5 _____Each fellow should formulate a focus of clinical and scholarly
activity that will serve as a base for future career development.
Program Personnel
Program Director
4.1.1 _____There must be a single program director based at the primary
teaching site who is fully committed to the program and devotes sufficient
time to ensure achievement of the educational goals and objectives.
4.1.2 _____The director must possess the requisite educational, investigative,
and administrative abilities and experience and have an appointment
in good standing to an academic institution participating in the program.
4.1.3 _____The program director must have a written curriculum that
outlines the educational goals of the program with respect to knowledge,
skills, and other attributes that the AGP fellows must achieve by the
end of training. The curriculum must also include a list of teaching
activities and evaluation methods that are linked to the goals and
objectives.
4.1.4 _____This curriculum must be distributed to AGP fellows when
they enter the program, as well as to faculty. It should be reviewed
and modified over time, based on periodic program evaluations.
4.1.5 _____The program director oversees selection of AGPs fellows
for appointment to the program in accordance with institutional and
departmental policies and procedures.
4.1.6 _____The program director oversees the selection and supervision
of the teaching staff and other program personnel at each institution
participating in the program.
4.1.7 _____The program director supervises AGP fellows through explicit
written guidelines describing supervisory lines of responsibility for
the care of patients. Such guidelines must be communicated to all members
of the program staff. Academic general pediatric fellows must be provided
with prompt, reliable systems for communication and interaction with
supervisory physicians.
4.1.8 _____The program director oversees implementation of fair procedures,
as established by the sponsoring institution, regarding academic discipline
and AGP fellows’ complaints or grievances.
4.1.9 _____The program director monitors and documents the procedural
skills of the fellows where appropriate.
4.1.10_____The program director monitors stress in AGP fellows, including
mental or emotional conditions inhibiting performance or learning and
drug- or alcohol- related dysfunction. Training situations that consistently
produce unhealthy stress for fellows must be evaluated and modified.
4.2 Mentor
4.2.1 _____Each trainee must have at least one faculty member who will
guide the fellow's career decisions through the training period.
The mentor must supervise the academic advancement of the fellow,
be certain that the Scholarship Oversight Committee is active and
effective, and oversee the professional well being of the trainee.
4.3 Teaching Staff
4.3.1 _____There must be sufficient numbers of teaching staff who devote
adequate time to the educational program to enable it to meet its
educational goals and objectives. In addition to the AGP program
director, there must be at least one other qualified member of the
teaching staff.
4.3.2 _____If the program is conducted at more than one institution,
a member of the teaching staff of each participating institution must
be designed to assume responsibility for the day-to-day activities
of the program at that institution, with overall coordination by the
program director.
4.3.3 _____The teaching staff must provide evidence of a commitment
to and productivity in the disciplines that are central to the program’s
core curriculum, including research and education, and ongoing pursuit
of scholarship. The APA will consider the following as indicative of
the commitment of the teaching staff to scholarly activity:
Projects funded by agencies requiring peer review
Publications in peer-reviewed journals
Presentations at national, regional, or international scientific meetings
Research protocols approved by the local Institutional Review Board
and implemented.
Leadership in research networks or regional/national educational organizations.
_____All members of the teaching staff must demonstrate a strong interest
in the education of AGP fellows, sound clinical and teaching abilities,
support of the goals and objectives of the program, a commitment to
their own continuing education, and participation in scholarly activities.
Other Professional Personnel
_____Consultants should be available, including biostatisticians, methodologists,
programmers, medical education specialists, economists and others
as needed.
Scholarship Oversight Committee
_____Each fellow must have a Scholarship Oversight Committee. The Scholarship
Oversight Committee should consist of three or more individuals,
at least one of whom is based outside the academic general pediatric
discipline. The fellowship program director may serve as a trainee’s
mentor and participate in the activities of the oversight committee,
but should not be a standing member.
_____The Scholarship Oversight Committee performs the following:
Determine whether a specific activity is appropriate to meet the APA
guidelines for scholarly activity
Determine a course of preparation beyond the core fellowship curriculum
to ensure successful completion of the project
Evaluate the fellow’s progress as related to scholarly activity
Meet with the fellow early in the training period and regularly thereafter
Require the fellow to present/defend the project related to his/her
scholarly activity
Advise the program director on the fellow’s progress and assess
whether the fellow has satisfactorily met the guidelines associated
with the requirement for active participation in scholarly activities.
Facilities and Resources
_____Fellows must have access to appropriate patient populations and
clinical facilities needed for the clinical experience.
_____AGP fellows must have access to an on-site library or collection
of appropriate texts or journals in each participating institution
or must have access to electronic databases and other data processing
applications.
_____There must be adequate resources for scholarly activity, research and
critical analysis. These must include adequate laboratory space, equipment,
teaching facilities and access to learning, financial support, and computer
services.
Educational Program
A. Program Design
_____Every program must develop written educational goals and objectives
(Curriculum Requirement A), learner needs assessment and progress
tracking (Curriculum Requirement B), learning activities (Curriculum
Requirement C), and evaluation methods (Curriculum Requirement D),
all of which should be linked to the program’s goals and objectives.
_____ The AGP fellowship program must provide advanced clinical training
to allow fellows to acquire expertise as a provider, consultant, and
care coordinator in the field (general pediatrics, child protection,
environmental health, etc.)..
_____Education must be provided in three academic competency domains:
1) Academic Development and Leadership, 2) Research and 3) Education.
_____Program goals are sufficiently comprehensive within domains (cover
important curricular topics)
_____Program objectives are appropriate in length and detail and prioritization
of objectives is realistic for program implementation.
_____The fellowship program must address the competency of professionalism
and evaluate trainees in this area.
_____The fellowship program must teach and demonstrate a commitment
to continued learning and improvement.
_____The fellows must learn the important skills of time management
and balancing multiple priorities.
B. Clinical Skills (NOTE: The quality of the clinical program is not
the focus of this fellowship review.)
_____The fellows’ clinical and academic experiences should be
integrated and complementary.
_____Fellows should participate in quality improvement activities in
a clinical setting.
C. Educational Activities
_____Teaching and learning activities in the program must be linked
to the written goals and objectives of the curriculum.
_____There must be a formally structured educational program in academic
general pediatrics that uses an effective combination of didactic,
interactive, and experiential activities. A reasonable diversity of
learning activities is used (e.g., suitable for settings, adaptable
to individual learning and teaching styles.)
_____The AGP fellow should actively participate in the planning and
implementation of these educational activities, including conferences,
experiential projects, and teaching sessions with students and residents.
_____At the time of entry into the program, each fellow should develop
an individual learning plan that includes both required and self-directed
educational activities that will prepare the fellow for his/her chosen
career path. All learners must revisit and revise their learning plans
annually.
D. Teaching Experience
_____AGP fellows must be given the opportunity to teach using a variety
of methods and settings, and to assume some departmental administrative
responsibilities.
_____Fellows should participate in clinical teaching.
E. Scholarly Activity
_____Each program is expected to engage fellows in scholarly activities
that relate to the core academic competency domains of Academic Development
and Leadership, Research, and Education.
_____The core experience of the fellowship curriculum should be a research
or scholarly project. All fellows must engage in hypothesis-testing
projects or in projects of substantive scholarly exploration and analysis
that require critical thinking. Areas in which scholarly activity may
be pursued include, but are not limited to: basic, clinical, or translational
biological or behavioral medicine; health services; quality improvement;
bioethics; education; community advocacy; and public policy.
_____Fellows must acquire and analyze data, derive and defend conclusions,
place conclusions in the context of what is known or not known about
a specific area of inquiry, and present their work in oral and written
form to their Scholarly Oversight Committee (see below) and elsewhere.
These activities require active participation by the fellow and must
be mentored.
Evaluation, Guidance, and Oversight
A. Evaluation of Fellows
_____The program must have formal mechanisms by which the knowledge,
skills, and professional growth of the AGP fellows, based on the program’s
written educational goals and objectives, are evaluated at least annually.
_____The fellow must be given a copy of the written educational goals
and objectives at the start of training and are told in advance that
they will be evaluated and that objectives must be met for successful
completion of the program..
_____A written record of these evaluations must be maintained, must
be formally reviewed with the AGP fellow at least annually, and must
be accessible to authorized personnel. More frequent, informal assessment
and feedback sessions between the fellow and mentor and/or Scholarship
Oversight Committee are strongly recommended.
_____The program director, in consultation with the teaching staff
and Scholarship Oversight Committee, must provide a written final evaluation
for each AGP fellow who completes the program. This final evaluation
should be part of the AGP fellow’s permanent record, which must
be maintained by the institution.
____Remediation plans should be developed and monitored if needed for
learners making unsatisfactory progress.
_____Educationally appropriate evaluation methods are assigned to key
objectives
_____A reasonable diversity of evaluation methods and sources used
_____Evaluation tools are well constructed and informative (focused,
specific, reliable)
_____Faculty are given instruction on how to conduct good evaluations
B. Evaluation of Faculty
_____Teaching faculty must be evaluated at least annually. Documentation
of faculty evaluation must include an assessment of their teaching
ability and commitment to teaching, their clinical knowledge, and
their active participation in scholarly activity.
_____Faculty should receive formal feedback from these evaluations.
_____Faculty evaluation tools are sound and informative.
_____Faculty should discuss their teaching and other educational contributions
with the program director.
C. Evaluation of the Program
_____The teaching staff must be organized and have regular documented
meetings to review program goals and objectives as well as program
effectiveness in achieving them. They should annually review AGP
fellows’ time allocations (to clinical care, teaching, and
research) and evaluate the fellows’ academic performance in
relation to their educational goals and objectives.
_____Periodically, the program should evaluate the academic outcomes
of program graduates. The evaluation should also review the quality
of supervision of fellows, and teaching quality of faculty and the
program’s use of available resources, e.g., financial and administrative
support of the program, the volume and variety of patients available
for educational purposes, and the contributions of the participating
institutions. Information gained from these evaluations should be used
to implement improvements in the program.
_____Long term professional outcomes of fellows available suggest that
the program is effective.
_____Annual review and evaluation of the program in relation to the
educational goals, the quality of the curriculum, the needs of the
AGP fellows, and the clinical and research responsibilities of the
faculty must be documented. At least one AGP fellow representative
should participate in these annual reviews. Formal input should be
provided from fellows, faculty and important stakeholders (e.g. department
chair, funders)
_____Program responds to evaluation results in an appropriate and timely
way
_____Past program evaluations have contributed to continuous quality
improvement (Appendix E).
Infrastructure Subtotal ______
Education Subtotal ______
Please attach a narrative assessment of the program’s
strengths, weaknesses, challenges/barriers, and opportunities for
growth and improvement.