Putting your best foot forward

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Putting your best foot forward

• Writing a good PSQ
• Dr Roy Wyman
• September 8th, 2006

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220 days
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Objectives

• Describe the purpose of the accreditation PSQ
• Avoid common pitfalls in completing a PSQ
• Make most efficient use of the 8 weeks remaining
  to get it done
  
• To alleviate some fear in writing the PSQ

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What is the PSQ?

• A Pretty Stupid Questions?
• B Partially Sliced Quince?
• C Panic Starting Queries?
• D Pre-survey Questionnaire?

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What is the PSQ?

• Summary of program conduct
• Components
• Demographic information
• Response to previous weaknesses
• Curriculum
• Runs through an accountability of the four
  principles
  
• Ensures that 5 standards of accreditation are
  met
  
• Principles and Objectives
• Learning Environment
• Evaluation
• Faculty Development
• Scholarly Activity
• Program summary of strengths and weaknesses

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Target Audience

• The College of Family Physicians of Canada
• The Survey team

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The surveyor

• Receives the PSQ in advance of the survey along
  with the standards and checklists for review of
  the PSQ
  
• The PSQ is the first introduction to the program
• Often read on the plane on the way to the review
• Surveyors expect a sloppy PSQ to reflect a sloppy
  program
  
• An experienced surveyor will confirm all key
  components during site visit
  

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Top ten ways to annoy your surveyor
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Sloppy formatting
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• Messy formatting can be very frustrating
• Inconsistent fonts
• Random cutting and pasting
• Dont Change the form
• Solutions
• Have someone spend a half day proofing cleaning
  it up
  
• Distinguish questions from answers by bold or
  italics
  
• Check pagination

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Bad Writing
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• No one expects great prose
• Poorly written document wont tell the story you
  want to tell
  
• Solutions
• Avoid writing in point form
• Use a spell-checker and get it proofed
• Get a colleague to read look over
• Avoid Acronyms

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Attachment-itis
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• Referring readers to separate attachments is
  distracting
  
• Appears lazy and inconsiderate
• Referring to other questions for answers
• Solutions
• Only give them what they ask for
• Summarize topics like curriculum outlines and
  include in relevant sections
  
• Have key documents at hand for site visit

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Appearing defensive
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• Dismissing previously identified weaknesses does
  not go over well
  
• Taking issue with requirements of training also
  not good
  
• Dont blame other rotations or teachers
• The surveyor doesnt make the law, he/she just
  interprets it
  
• Solution
• Accept criticism gracefully
• Show evidence that you are trying to address the
  issues identified
  

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Ignoring requirements of training
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• Accreditation standards have a few MUSTS and some
  SHOULDS
  
• The specialty committee and the surveyor will
  carefully check that those are in pace
  
• Solution
• Read over the Red Book and ensure that the MUSTs
  are addressed
  
• Make clear in the relevant section of the PSQ
  that they are met

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Not answering the questions
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• Most PSQs are long
• Surveyors do not want to fish for the answer to
  questions
  
• If they question is not answered directly,
  surveyors will assume that there is a problem
  
• Solution
• Be direct, answer the question asked
• If it does not show your program favorably, live
  with it, it will come out anyway

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Vague generalities
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• Vague answers are irritating, leaving surveyors
  to look elsewhere for more details
  
• Be specific about frequency of meetings,
  composition of committees, components of
  curriculum and evaluation
  
• Avoid temptation to utilize
• happens in clinical setting
• occurs with role modeling

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Creative license with the truth
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• What should be happening and what is happening
  are often different
  
• Dont overstate or embellish
• Meetings with residents, frequency of rounds,
  Whether exams are happening, etc
  
• Insufficient time between now and the survey to
  make major changes to the program but minor
  changes can occur
  
• Avoid the temptation to promise initiatives that
  you cannot deliver
  
• It is fine to predict a few changes you are sure
  will be up and running in April

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Not addressing previous weaknesses
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Levees in New Orleans (2005)-still not fixed
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Having no idea what is going on!
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• Ensure that any programs that you refer to are in
  fact still going on as you suspect they are
  
• Ensure you are comfortable with everything that
  you have written in the PSQ

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What is being done to help
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Centrally prepared material

• Templated answers prepared by PGME for and
  central office at DFCM on
  
• Resident stress
• Harassment and Intimidation
• Need to check with Dave and Margaret
• Programs encouraged to modify or expand upon the
  provided answers

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Preparing for PSQ
Program Specific PSQ from 2001, PSQ from IR, IR
report PGME common language for cross program r
esources (e.g. evaluation guidelines, Board of
Examiners etc) Before submitting it, get input fr
om RPC and residents PSQ review all will be rea
d and if needed revised
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Making the most of your remaining time
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DONT PANIC!!!

• It can be done!
• There may be areas that feel uncomfortable to
  answer-do your best
  
• Still have some time to work at the program

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Plagiarize (but not too much)

• Previous PSQs, annual reports, and other
  documents can be useful resources
  
• Best not to duplicate old documents, use them for
  ideas
  
• Dont just cut and paste

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Delegate

• This should not be a one man/woman show
• If there is someone in your division that has a
  better sense of a certain area have them help
  out.
  
• Get an administrative person to collect data

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Carefully look over key sections

• Response to prior weaknesses
• Scholarly aspect of the program
• Evaluation
• Reflective statement (strengths and weaknesses)

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Editing and proof-reading

• Make sure to give yourself sufficient time to
  look over the final draft
  
• Make sure that an administrative person has time
  to carefully proof and format
  
• Someone with grant experience can be very helpful

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Share

• If there is a question you are unsure how to
  answer then ask your colleagues or the downtown
  department.
  
• Make sure that those that need to know, know what
  you are writing.

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Peer review

• Once you have a mature draft get input from as
  many of the following as possible
  
• The residency program committee (A must)
• The residents (strongly recommended)
• A colleague outside the program (another program
  director)

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Conclusions

• The PSQ is the introduction to your program and
  will frame the site visit
  
• A useful opportunity for self-reflection
• Need to minimize drudge work and focus on
  conveying structure, curriculum and evaluation
  system
  
• There is help