Equity in basic medical education accreditation: A scoping review

Area of Science:

• Medical Education
• Accreditation Standards
• Health Equity

Background:

• Accreditation standards are crucial for ensuring quality in basic medical education (BME).
• The role of equity in the development and implementation of BME accreditation standards is not well-defined.
• Existing literature often conflates equity with diversity and inclusion.

Purpose of the Study:

• To explore how the concept of equity is portrayed in the literature concerning basic medical education accreditation.
• To identify implicit and explicit discussions of equity within BME accreditation standards.

Main Methods:

• A scoping review was conducted following the Joanna Briggs Institute protocol and PRISMA-ScR guidelines.
• A systematic search of five databases and grey literature was performed up to May 2024.
• Inductive thematic analysis was used for the selected literature.

Main Results:

• Fifteen records out of 1105 met the inclusion criteria; none explicitly used the term "equity."
• Discussions of equity were implicit, focusing on the "contextual" adaptation of accreditation standards.
• Three implicit domains of equity emerged: interregional (Global North/South disparities), intraregional (resource differences), and surveyor level (evaluator influence).

Conclusions:

• Equity is a fundamental yet vaguely defined concept in basic medical education accreditation.
• A proposed three-level framework can aid regulators, accrediting bodies, and policymakers in developing and implementing accreditation processes with greater equity.