For today’s post we depart slightly from our usual style as the LCME released an updated version of the Data Collection Instrument (DCI) in April 2023 for schools with visits during 2024-25. Several elements had notable changes to their associated DCI narrative prompts and tables. Some of the most significant will be included below.

Getting a bit more picky……

Explicit examples of CQI throughout the DCI:

Several changes to the narrative prompts throughout the DCI require description of the processes in place to identify areas of concern and evidence of follow through/reporting.

Examples of specific expectations for policies/guidelines and procedures:

• Ensure (not merely ‘support’) the participation of faculty based at regional campuses in medical school governance (2.6 Functional Integration of the Faculty)
• Explicitly listing the categories included in Element 3.4 in your institution’s anti-discrimination policy:
  • A medical school has a policy in place to ensure that it does not discriminate on the basis of age, disability, gender identity, national origin, race, religion, sex, sexual orientation or any basis protected by federal law.
• Narrative prompt includes guidelines for what would be considered use of alternate methods for a students to satisfy required clinical experiences – narrative includes notation of ‘more than 20% of cases’ (8.6 Monitoring of Completion of Required Clinical Experiences)
• Specifically asking whether there is a centrally developed and approved policy for when students should receive narrative assessments in the curriculum (9.5 Narrative Assessment)
• Formal attestation and monitoring of attestations to ensure medical school applicants AND enrolled medical students are familiar with and capable of meeting the technical standards (10.5 Technical Standards)
• Notation about whether procedures for how students can request an alternative assignment is codified in formal guidelines/policy (10.9 Student Assignment)

Ummm – in case you are wondering – this means – Get it in a formal policy – now!

• Inclusion of typical time frame in which a student can gain access to their educational records (11.6 Student Access to Educational Records)
• Need for policy language related to the effects of infectious and/pr environmental disease or disability on medical student learning activities (12.8 Student Exposure Policies/Procedures)

Best Practices

Be sure to review the changes to the DCI each year when they are revised and released by the LCME. Take note of the changes in language, even if slight changes, as it can impact the intent of the element. Codify into formal policy ANY mention in the DCI of “do you have a policy for this?” or “do you have guidelines for that?” Err on the side of caution and codify any & all policies that you can—and then be sure you are following through on the procedures you have in place to monitor compliance with said policy!

Continuous Quality Improvement

Keep a log of ALL your CQI activities. As demonstrated in the DCI recent changes, there are numerous elements that are asking for you to provide evidence of your CQI action plans—so be sure to track everything and when applicable, tag the action plan to the applicable element(s). Future you will thank past you for this evidence inventory!