Symposia

Licensure, Accreditation and Certification: Achieving Harmonic Resonance

Moderator:
Susan Wagner, Producer, Dr. Oz Show

Panelists:
Geraldine Bednash, Ph.D., Executive Director, American Association of Colleges of Nursing
Claire Bender, M.D., Director for Education, Mayo Clinic in Minnesota
Richard Hawkins, M.D., Senior Vice President for Professional and Scientific Affairs, American Board of Medical Specialties
Thomas Nasca,M.D., CEO, Accreditation Council for Graduate Medical Education

Moderator Susan Wagner provided introductions and began the discussion by asking the panelists to define licensure, accreditation and certification. Then, discussion revolved around identifying steps to change licensure, accreditation and certification standards/processes without a clear sense of what reforms will shape the care delivery system.

Geraldine Bednash, Ph.D., R.N., discussed efforts in advanced practice nursing to bring together the different standard-setting groups to agree on a common set of standards for certification and accreditation. Dr. Bednash noted that licensing occurs at the state level by government and is influenced more by political considerations instead of evidence of capability of providers.

Expanding sharing opportunities is an area that can be explored immediately, according to Claire Bender, M.D. Dr. Bender described new efforts at Mayo Clinic to bring different providers together in the same class when curriculum is applicable to both. It has been successful in demonstrating that different providers have and need different skills. The model also provides an environment that allows different health care professionals to become familiar with each other and respect the abilities of each type of provider.

Thomas Nasca, M.D., pointed out that it will be difficult to get hundreds of professional societies, accrediting bodies and licensure boards around the table, but that it may be possible to begin agreeing on unifying themes that move across discipline boundaries. It will be important to make sure that licensure, accreditation and certification standards don't prohibit change, and reinforce core competencies that learners can carry forward as health care delivery systems evolve.

Richard Hawkins, M.D., discussed how assessments can be redefined to reinforce the principles of teamwork in a reformed health care environment. He suggested creating a feedback cycle from clinical care into the education and certification process.

Participants spent a portion of the session submitting ideas for changes in licensure, certification and accreditation to aid in transforming the educational system to support patient-centered, coordinated health care reform. The following actions received the highest endorsement.

• Introduce team-based minimum standards for training and care models for both certification and accreditation.
• Introduce team-based exercises as part of individual certification.
• Certification should more closely mirror real-life clinical situations.
• Consider use of a public/private entity, independent of Congress, to bring societies and professions together and adopt more common standards for training, certification and accreditation.