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PHILIPPINE ACADEMY OF FAMILY PHYSICIANS

RESIDENCY TRAINING PROGRAM

TOOL FOR ACCREDITATION OF RESIDENCY TRAINING PROGRAMS

EVALUATION FRAMEWORK: CIPP MODEL by Stufflebeam
[Modifications done March 2017]

“The most important purpose of program evaluation is not to prove but to improve”
Daniel Stufflebeam

INSTITUTION ADDRESS

ACCREDITORS DATE WHEN PROGRAM PREVIOUS DATE OF VISIT

ACCREDITED AS NEW ACCREDITATION
PROGRAM STATUS

PART I: ABSOLUTE REQUIREMENTS:

Please check [√] if requirements are complied with. Put an [X] if it is not complied with.

□ At least 30 bed capacity for hospital whose only residency training program is in Family Medicine.
(At least 50 if there are other residency training programs).

□ Residency Training Manual describing the three Year Residency Program for traditional and not
less than four (4) years for Practice-based Residency Program and the written curriculum that
covers all the required competencies of the 15 foundation courses of Family and Community
Medicine specialty training.

□ Residency Training Manual must have all the PAFP prescribed content.
□ Head/Chair of Department is an active Fellow of the PAFP.
□ Residency Training Coordinator must at least be an active Diplomate of the PAFP .
□ Has at least 1 resident trainee in Family Medicine at the time of the accreditation visit.
□ A Family Medicine Clinic = pertains to clinic space where patients from pediatric to geriatric age
maybe attended to. FM residents are major health providers in the area…

□ Accreditation fees paid

□ Submitted annual report/s using prescribed format on or before the annual convention of the
following year. [ For previously accredited programs]

□ Both the Chair and the RTO are active members of Foundation for Family Medicine Educators
Inc

□ Administrative order on the creation of the Department of Family and Community Medicine and/or
recognition of the department in the base hospital organizational chart

□ Self evaluation by FCMRTP using the prescribed accreditation tool handed to accreditors on day of
visit

NB : Only programs who have complied with all these ABSOLUTE requirements maybe visited for
accreditation as NEW program.

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CONTEXT - (38 points)

Context evaluation looks into needs assessment and curricular goals

INSTRUCTIONAL DESIGN

1. TEACHING LEARNING STRATEGIES Check if available . Give remarks if

Appropriate activities to expected inadequate or no provision .
Competencies [ 22 pts.]

1.1 Conferences – Resident presentations (4 pts)

1.1.1 clinical case
1.1.2 family case
1.1.3 community/population project
1.1.4 original research
1.2 Didactics on foundation courses: (15 pts) Mentioned in ANNUAL REPORT
1.2.1 Clinical – acute care
1.2.2 Clinical – primary
1.2.3 Laboratory exams specifically ECG and
imaging modalities
1.2.4 Preventive care/ wellness
1.2.5 Communication and counseling skills
1.2.6 Family medicine principles
1.2.7 Community oriented primary care
1.2.8 Evidence Based Medicine
1.2.9 Quality assurance
1.2.10 Research
1.2.11 Medical ethics and professionalism
1.2.12 Occupational medicine
1.2.13 Legal medicine, health issues and
advocacies
1.2.14 Hospice and palliative care
1.2.15 Practice management
BONUS: Integrative medicine
BONUS: Toxicology/ environmental medicine
1.3 Variety of learning activities ( SGDs,
preceptorships, community immersion )
1.4 Use of information technology or computer
based information systems like tele-
conferencing, webinar etc
1.5 Elective/s opportunities ( not prescribed by
trainers but chosen by trainees)

2. TRAINERS/ RESOURCES [2 pts] REMARKS

2.1 FM consultant to trainee ratio is better than 1:2
2.2 At least 1 trainer per major foundation course
[ family, population care, research/EBM ]
Checked in Training Manual
3. EVALUATION TOOLS/CRITERIA [10 pts]
3.1 Trainee / Resident Evaluation
3.1.1 Criteria for admission to program explicitly
stated
3.1.2. Evaluation Tools for all major academic
Conferences
3.1.3 Evaluation tool for performance in different
rotations
3.1.4 Evaluation tool for Professionalism
3.1.5 Provision for written exams - minimum
quarterly long exams [ > 50 items ]
3.1.6 Provision for OSCE exams – at least
once a year
3.1.7 Criteria for promotion to next year level is well
defined including grade percentages
3.1.8 Criteria for graduation well defined and
includes PAFP prescribed requirements

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3.2 Evaluation tool of trainer for use by Trainee

available
3.3. Program evaluation tool/s for use by staff
and trainee available

4. POLICIES AND IMPLEMENTING GUIDELINES [4 pts.]

4.1 Duties and responsibilities of the trainees
4.2 Duties and responsibilities of the trainers
4.3 Disciplinary measures defined
4.4 Salaries and privileges stated

SUB-TOTAL ________/ 38

INPUTS / RESOURCES (53 points)

Input evaluation identifies the facilities and resources needed to meet the training outcomes

1. Facilities - [ 5 pts. ] REMARKS

1.1 Out patient facility
1.2 Family clinic adheres to quality standards set by
PAFP [ see Manual on Quality Standards and
Competencies 2008] ie adequate space with
provisions for family consultations and equipped
with instruments for examination of children to the
elderly
1.3 Emergency Room
1.4 In-patient facilities
1.5 Community / Population group
BONUS: service beds in private hospitals
BONUS: FM beds in government hospitals
YES REMARKS
2. Services provided - [ 7 pts. ]
2.1 OPD – Primary Care
2.2 In-Patient
2.3 Acute care- ER
2.4 Wellness and Preventive Care
2.5 Chronic disease and/or continuity of care
2.6 Family health care
2.7 Home Care / Hospice and palliative care

3. Adequacy of medical cases based on the IF Small Base

BASE HOSPITAL/ INSTITUTION Hospital Hospital
≤50 bed
REMARKS
MONTHLY patient Census of areas > 50 bed
where residents rotate [ 9 pts] capacity capacity
3.1 In-patient in Base Hospital or Practice Indicate practice based
area for Practice based programs facility if applicable
3.1.1 Children ≥ 30 ≥ 50
3.1.2 Adult and elderly ≥ 50 ≥ 60
3.1.3 Maternal/reproductive ≥ 20 ≥ 30
3.2 Out-patient in Base hospital or Practice Indicate practice based
area for Practice Based Programs facility if applicable
3.2.1 Children ≥ 50 ≥ 100
3.2.2 Adult and elderly ≥ 50 ≥ 100
3.2.3 Women’s maternity health ≥ 20 ≥ 50
3.2.4 Minor Surgical cases ≥10 ≥ 15
3.2.5 Mental health cases ≥5 ≥ 10
3.3 Emergency Room ≥ 150 ≥ 300

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REMARKS
4. Learning Equipment and Materials- [ 7 pts. ]
Equipment must be in good working condition,
Books /journals updated [not more than 10 years old] to be rated
as available
4.1 Books, journals, teaching materials on Family Medicine
( e.g., Textbook in Family Medicine etc)
4.2 Updated clinical practice guidelines of most common clinical
conditions in primary care easily accessible
4.3 Reference materials on EBM and research
4.4 Reference materials on community medicine,
Public health, management, counseling
4.5 Filipino Family Physician ( at least the last 3 years)
4.6 Computer with internet connectivity/ wi fi
4.7 Conference room with AV equipment
BONUS : Software on Family health record

3 2 1 REMARKS
5. Qualification of Trainers [ 9 pts.]
5.1 Family Medicine faculty/trainers 100% > 50% < 50%
diplomates
5.2 FM Trainers are members of 100% of all > 50% ≤50%
FAMED FM trainers
5.3 FM Trainers attend medical 100% of FM > 50% ≤ 50%
Education training trainers

With REMARKS
6. Administrative Support - [ 17 pts. ]
6.1 Family Medicine Office (3 pts.)
6.1.1 Office space
6.1.2 Support staff
6.1.3 Basic office equipment/supplies

6.2 Program Sustainability Plan [ 6 pts.] 3 2 1 REMARKS

6.2.1 Committed items for resident trainees >6 6 <6
6.2.2 Committed item/compensation for trainers >3 3 <3

6.3 Admitting privileges for the faculty trainers in base

hospital

6.4 Benefits and support given by administration of the With REMARKS

FCMRTP [ 7 pts ]
6.4.1 Provisions for Faculty and staff development
6.4.2 Provisions for travel and accommodation for
RTO to attend the annual RTO meeting
6.4.3 Funds for operating expenses
6.4.4 Fund for acquisition of learning resources
and/ or assistance for CME/CPD activities
6.4.5 Funds for residents’ research or community
activities
6.4.6 Residents’ quarters provided
6.4.7 Meals for those on duty or equivalent
subsistence allowance

SUB-TOTAL ____________/54

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PROCESS IMPLEMENTATION (80 points)

Process evaluation investigates the quality of the program’s implementation

1. Evaluation of Trainees [ 22 pts. ] FULL PARTIAL

*full means all residents went through process or REMARKS
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evaluation activity accomplished as planned
1.1 Admission processes done
1.2 Performance Evaluation done after each activity
verified by graded evaluation tools signed by
trainer [6pts]

1.2.1 Rotations/ Preceptorials etc

1.2.2 Conferences
1.2.3 Written reports

1.3 Professionalism evaluated at least annually

1.4 Processing of rotations/ learning activities
especially those conducted outside the
department or outside the base hospital for
practice based programs
1.5 Feedback – properly documented given to
residents by the RTO/ Faculty mentor at least
twice a year
1.6 Written exams at least quarterly including the in
service exam
1.7 OSCE conducted at least annually
1.8 Yearly promotion criteria strictly followed
1.9 Disciplinary measures imposed when warranted
BONUS: Patient satisfaction survey conducted
to assess trainee performance. [Must
have documentation]

2. Evaluation of Trainers [ 2 pts ] REMARKS

[all evaluation forms/letters to FM trainers must be
Documented with proof of acknowledgement]
2.1 Faculty evaluation conducted by chair or supervisor and/or
by peer at least annually
2.2 FM Faculty evaluated by FM residents at least annually

3. Program Evaluation [ 12 pts] 3 2 1

Points given ONLY IF there is documentation of the REMARKS
activity
3.1 Formal evaluation done by trainers ie, SWOT yearly every 3 ≥ 3
analysis years years
3.2 Comprehensive evaluation done with trainees yearly Every 3 ≥ 3
Ie, strategic planning years years
3.3 Plans resulting from internal evaluation acted 99% 66% 33%
upon [ from 3.1 or 3.2]
3.4 Recommendations from previous 99% 66% 33%
accreditation visit were acted upon

4.Training Activity/ [ 24 pts] 3 2 1 REMARKS

Minimum requirements are stated for each
required academic activities
4.1 Clinical Case discussions (chart > 8 hours a 8 hours a < 8 hours
review, case presentations, M and month month a month
M)
4.2 FM principles and communication > 4 hours a 4 hours a < 4 hours
Lectures / workshops/ discussions month month a month
4.3 Community principles, advocacies or Weekly Monthly Quarterly
health issue discussions
4.4 ACTIVE mentoring – FM faculty Once a Every other Once a
mentor to trainee interface. month month quarter
4.5 Trainers conduct teaching activities Once a Twice a Once a
e.g.,bedside rounds, preceptorials, etc week month month
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4.6 EBM sessions conducted by faculty Weekly Monthly Quarterly

with trainee
4.7 Research lectures and/or QA Purposively Fairly Intermitten
guidance/advising / adequately regularly tly
4.8 Ethics and/or legal concerns Almost in all In many Seldom
incorporated in case discussions discussions but done

5. Medical Chart Review - randomly Complete Incomplete REMARKS

selected by accreditor [ 12 pts ]* 2 1
5.1 Clinical history and physical exam
5.2. Family genogram – only relevant
5.3 Medical problems identified
5.4 Diagnostic & therapeutic management
Appropriate (incl. non pharmacologic)
5.5 Recommendations for preventive care
Included in plan
5.6 Appropriate referral and/or follow up
* Each resident must prepare 3 charts for review by the accreditor. Random selection of the chart to be
evaluated will be done during the accreditation visit.

6. Family Health Record: Chart Review Adequate Inadequate Remarks

randomly selected [ 8 pts]* 2 1
[All family health records must be kept in the
base hospital accessible to evaluation by
trainers/accreditors]
6.1. Family genogram – 3 generation
6.2 At least one tool: Family APGAR, Family
map , Family Ecomap, SCREEM
6.3 Health care plans for family system
wellness
6.4 Proof of evaluation by trainer
 Each resident must be able to show one family health record. The accreditor shall make a random
selection of which family health record to evaluate

SUBTOTAL ________________/80

PRODUCT (138 points)

Product evaluation, assesses whether program achieved its objectives

1. PERFORMANCE OF TRAINEES DURING Very Satisfactory Satisfactory

ACCREDITATION VISIT [21 PTS.] Satisfactory [complete] [acceptable]
[Very Satisfactory- ALL resident can give correct and 3 2 1
complete answer ; Satisfactory – at least one resident able
to answer question fully ; Acceptable = answer correct but
incomplete]
1.1 Answered clinical questions
1.2 Applied family medicine concepts and principles
1.3 Discussed community/population health concepts
1.4 Applied EBM processes to clinical cases managed
1.5 Knowledgeable about communication issues with
patients/families/ population groups
1.6 Knowledgeable about ethical principles or medico
legal concerns or health policies
1.7 Knew the mechanics of the training program
NB: Accreditor will ask minimum of 3 questions each per numbered item

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2. Competencies in out-patient, in-patient, community setting accomplished per completed

rotation per resident - [ 76 pts ]
Random selection of resident’s logbook/ tally sheets per year level BUT the most important tally
sheet is that of the most senior resident.

RESIDENTS’ TALLY SHEETS CHILDREN & ADULTS ELDERLY

OF CASES MANAGED ADOLESCENTS
76 CASES 116 CASES 82 CASES
Third Year Resident and above >80% 61 93 65
Second Year Resident >65% 49 75 53
First Year Resident >50% 38 58 41

2.1 CLINICAL CASES (8 pts.) Third to Second First year MOST

Check if resident meets the requirement based Fifth year year Resident SENIOR
on year level of training. Give resident resident RESIDENT
2 = % criteria met TRAINEE
1 = less than required
For Diagnostic purposes For grading
2.1.1 Children and adolescents
2.1.2 Adult general cases
2.1.3 Elderly cases
2.1.4 Families (minimum 5 per
resident per year)

RESIDENTS’ TALLY SHEETS CHILDREN ADULTS Reproductive Minor Communication

OF PROCEDURES DONE & & health Surgery
based on graduation ADOLESCENTS Elderly
requirements.
9 4 8
Take note what is measured are 17 6
just type of procedures not yet
quantity per procedure.
Third Year Resident and above ≥ 80 % 7 14 3 5 6
Second Year Resident ≥ 65% 6 11 2 4 5
First Year Resident ≥ 50 % 5 9 1 3 4

2.2 CLINICAL PROCEDURES (10 pts.) Third to Second First year MOST
Check if resident meets the requirement based Fifth year year Resident SENIOR
on year level of training. Give points resident resident RESIDENT
2 = required % criteria met TRAINEE
1 = less than required
For Diagnostic purposes For grading
2.2.1 Children and adolescents
2.2.2 Adults and elderly
2.2.3 Reproductive health
2.2.4 Minor surgeries
2.2.5 Communication interventions

2.3 COMMUNICATION SKILLS All More than Less than REMARKS

residents 50% of or equal to
[ 15pts ] 50% of
residents
Documentation , Demonstration or description 3 2 residents
1
of activity maybe required.
2.3.1 Patient education
2.3.2 Psychoeducational intervention such
as CEA , Motivation to change
behavior
2.3.3 Public health lectures/
mothers’ classes etc
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FOR SENIOR RESIDENTS 2nd year up

All > 50% of ≤ 50 %
seniors seniors seniors
2.3.4 Family meeting
2.3.5 Primary care counseling e.g.
disclosure of bad news,
bereavement, conflict resolution etc

FOR SENIOR RESIDENTS

2.4 POPULATION HEALTH (10 pts.)
Community defined as a population group placed under the care of the resident. There must be
evidence of engagement of the community / population group by the resident. Two residents or
more may have the same population group but write-up and concerns must differ.
Done with Done but with REMARKS
adequate inadequate
documentation documentation
2 1

2.4.1 Identified a community/population

and defined its characteristics (e.g.,
survey of population or FGD with
major stakeholders to diagnose the
health situation)
2.4.2 Analysis of the problems and
planning of interventions to address a
concern of the chosen/identified
community with major stakeholders
2.4.3 Formulated Specific and measurable
objectives for the planned intervention
2.4.4 Implemented the needed project in
partnership with the community
/population group (COPC)
2.4.5 Monitored and evaluated the impact of
intervention on stated objectives

2.5 RESIDENT’S LEARNING PORTFOLIO [33pts] 3 2 1

All Residents
100 % > 50% ≤ 50 %
2.5.1 Personal learning plan discussed with trainer
( signed by faculty )
2.5.2 Documentation of cases managed [ tally sheets]
2.5.3 Documentation of skills and procedures done based on PAFP
competencies [tally sheets]
2.5.4 Family case report
2.5.5 Clinical case report/s
2.5.6 EBM case report /s
2.5.7 Insights about the training – periodically written and checked by mentor
For senior residents
nd rd
2.5.8 Research protocol for senior residents (2 trad; 3 practice based)
2.5.9 COPC project protocol per senior resident
2.5.10 Advocacy report per senior resident
rd th th
2.5.11 Career plans (3 trad ; 4 or 5 year practice based)

3. PERFORMANCE IN PAFP ACTIVITIES [ 18 PTS. ]

3.1 Annual in-service Exams ( 12 pts) 3 2 1 Remarks

3.1.1 All graduating seniors took the exam. Since 100 % More than Less than
required - non-takers must have a valid 50% 50%
excuse

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3.1.2 Junior Residents took the exam 75 % ≥ 50 % < 50 %

3.1.3 Average Performance of all graduating 75 % 61-74 % 50 – 60 %
seniors who took the exam
3.1.4 Average performance of ALL residents who 75 % 61 – 74% 50 – 60%
took the exam
BONUS : FCMRTP in Top Ten of the in-service exam
BONUS: Senior Resident who took exam in the top ten of the in service exam

3.2 Diplomate Examination (6 pts) 3 2 1 Remarks

3.2.1 Test-takers; non-takers must have All graduates > 50% ≤ 50%
justifiable reasons since last
accreditation
3.2.2 Passed the exam All who took > 50% ≤ 50%
exam
BONUS : Top notcher in latest Diplomate exam
a graduate of the FCMRTP
BONUS: Graduate of the program in the TOP
TEN OF Diplomate exam

4. PAFP Events/ Activities ( 23 pts) YES Partial 1 Remarks

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4.1 All consultants are members of PAFP 100 % < 100 %
4.2 All residents from second year and up are 100 % < 100 %
members of PAFP
4.3 Attend the Annual PAFP Convention Consultants and Either /or
residents
4.4 Participated in local chapter activities Consultants and Either/ or
residents
4.5 Voted during the annual PAFP elections Consultants and Either/ or
residents
4.6 Participated in major on-line PAFRO activities >50 % of ≤ 50% of
residents residents
4.7 FM Faculty involved in PAFP committee activities More than 50 % ≤ 50% of
of faculty faculty
4.8 Publication by faculty/ resident in an indexed peer Consultant and Either/or
reviewed journal or any scholarly publication ie, resident
monographs, textbook chapter

YES REMARKS
4.7 Joined National PAFP Clinical Case Contest
4.8 Joined National PAFP Family Case Contest
4.9 Joined National PAFP research contest
4.10 Chair / RTO attended the General assembly during annual
convention
4.11 Chair/RTO attended the leadership meeting during annual
convention
4.12 RTO attended the Annual RTO meeting
4.13 Consultants and residents can sing the PAFP hymn
BONUS : CCPC/FCPC Regional Winner is a resident of the program
BONUS : CCPC/FCPC entry is in the top 3 of the regional contest
BONUS: CCPC/ FCPC National Winner is a resident of the program
BONUS: Oral Research Contest National winner
BONUS: Poster Research contest National winner
BONUS: Oral Research contest entry other than the national winner is in the top 3 finalists
BONUS: Poster Research contest entry other than the national winner is in the top 5 finalists
BONUS : Publication by resident / consultant in an ISI indexed journal

SUBTOTAL ________________/138

Each BONUS is equivalent to 0.5 points. Total cumulative bonus points = _____________
Maximum Bonus points = 9 pts

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THIS IS TO CERTIFY THAT THE FCMRTP [ traineors and trainees ] WERE GIVEN THE
IMPORTANT AND MAJOR NON-CONFORMANCE ISSUES OBSERVED BY THE ACCREDITORS.

With concordance :

________________________________ _________________________________
Chief Resident Chair/ RTO of the FCMRTP

Accreditor Accreditor Associate

Summary of 1 2 Accreditor EVALUATION AND MPLS
Scores
Context [ 38 ] For Supervisory and Monitoring Visit:
Input [ 54 ] In 1 year = 65 – 74 %
Process [ 80 ] In 2 years = 75 - 84 %
Product [ 138 ] In 3 years = >/= 85 %
TOTAL POINTS: New Program = 35%
310
Grade Recommendation :
Equivalent
AVERAGE Accredited for _______ years
SCORE

NB: THIS ACCREDITATION TOOL MUST BE SUBMITTED TO PAFP WITH THE OFFICIAL
CONSOLIDATED ACCREDITATION REPORT

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