Compassionate Care Curriculum

The Absence of Compassion in Accreditation Standards

My project team and I continue our AMS Phoenix Thematic Grant work examining accreditation standards in order to find any language related to compassion and caring (see Leveraging Accreditation Standards to Promote Compassion in Education and Practice project). As we do so, and continue to be surprised about how little is there, we’ve been asked: “Okay, I understand that you are looking for notions of compassion and caring in accreditation standards and not finding anything much, but does that really matter? Couldn’t it just be that compassion and caring are present, but that they are hard to capture and quantify, thus making them inappropriate to require in accreditation standards?

“Do you really think it is a critical gap that none of the accreditation documents you’ve looked at say much about caring and compassion?”

These are important questions.  First, as to whether caring and compassion are sufficiently present in our healthcare and education environments, we think that the existence of the AMS Phoenix Call to Caring Project and the experiences of members of our Phoenix community provide speak to the need to do more in this regard. The next question, as to whether accreditation standards are an appropriate way to focus attention on caring and compassion, is harder to answer. It is very clear that formal accreditation standards powerfully influence what is valued and taught in health professions education, shaping key structures and practices. The same is true with the accreditation healthcare organizations. Experientially, anyone who has been part of an accreditation process (whether of an education programme or a healthcare organization) knows well the significant energy and resources that go into ensuring accreditation success.  Personally, I’ve never seen an accreditation process that was taken lightly.  No matter how many times I participate in an accreditation, at some point along the way I invariably find myself wondering if all the fuss and bother is really the best use of busy people’s time and scarce organizational monies.  Perhaps it is, if the institutional spring cleaning, updating of documents, and refreshing of faculty, staff and students’ minds on procedures and policies are necessary to avoid sloppiness and carelessness. And if it is, it is clearly essential to ensure that accreditation standards do not leave out fundamental ideals, such as caring and compassion.  We need to make sure that during all the fuss and focus on accreditation preparedness, people are attending to the things that make health professionals caring and compassionate and health institutions places that heal and relieve suffering.

It is very clear that formal accreditation standards powerfully influence what is valued and taught in health professions education, shaping key structures and practices. The same is true with the accreditation healthcare organizations.

What if the current structures and processes of accreditation are flawed? A cynic might argue that accreditation preparedness involves applying a superficial sheen so as to gloss over the gritty realities of education and care. If pre-accreditation anxiety leads to such a degree of staging that students, faculty and staff see the institutional portrayal as a fiction, does it then matter if caring and compassion are incorporated in the standards?  We believe that even if this jaded view of accreditation were to be accepted as true, it is still important to make sure that essential values are captured in the standards. For even if the presentation of the institution is widely considered a highly-idealized version of reality, this idealized presentation presumably reflects the institution’s aspirations.  In our analysis to date, the standards that we have examined all foreground efficiency and quality, and have almost nothing about caring or compassion.  If this represents the ideal of educational programs or healthcare organizations, we have reason for concern.

About the author

Cynthia Whitehead

Dr. Whitehead, is an Associate Professor in the Department of Family and Community Medicine at the University of Toronto, and the Vice-President Education, Women’s College Hospital

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