Legitimizing Continuous Quality Improvement (CQI): Navigating Rationality in Undergraduate Medical Education

In July of 2015, the Liaison Committee on Medical Education (LCME)—the primary accrediting body for North American allopathic medical schools—formally advanced a model of “formative accreditation” by requiring that medical schools engage in “ongoing planning and continuous quality improvement processes that establish short and long-term programmatic goals, result in the achievement of measurable outcomes that are used to improve programmatic quality, and ensure effective monitoring of the medical education program’s compliance with accreditation standards.” As these and parallel forces redefine undergraduate medical education (UME) in increasingly rationalistic (i.e., operational, measureable, controllable) terms, efforts to implement meaningful continuous quality improvement (CQI) processes may be challenged to overcome perceptions of questionable purpose, worth, and impact often associated with administration mandates. This commentary discusses potential factors underlying the growing rationalism in UME and offers practical strategies to shield CQI from being passively dismissed, excessively routinized, or redirected toward other institutional ends—remaining, instead, purposefully focused on the task at hand: Enhancing teaching and learning in undergraduate medical curricula.