Preparing Your Team for a Smooth LCME Survey Visit
Lois Margaret Nora, MD, JD, MBA
As the culmination of a challenging and important process, the LCME survey visit often generates a blend of excitement and nervousness on medical school campuses. To help alleviate worries and ensure everyone is prepared, leaders should have a plan for sharing information about what to expect during the visit.
Here are six tips to get your team ready to showcase your school at its best.
Tip One: Ensure Stakeholders Across the School Are Informed Throughout the Process
Keeping the school aware and engaged at every stage of the process is a key ingredient in any positive accreditation journey. Orientation meetings are a great way to inform the school about the importance of accreditation; kick off the self-study process; outline the milestones to come, including important dates to save; and educate stakeholders across the institution about how they may participate.
Planning both regular updates for the school as a whole and more focused updates for specific stakeholder groups keeps accreditation top of mind and ensures details aren’t forgotten by the time the LCME arrives. Schedule meetings with leaders in areas such as medical education and student affairs to explore self-study findings, reinforce key policies, and share relevant continuous quality improvement (CQI) activities.
These informational updates will become more important—and likely more engaging—as planning for the LCME visit begins in earnest.
Tip Two: Bring the Right People into Each Conversation with the LCME
One of the more important tasks for survey visit planners is determining who should attend each meeting with the survey team. The LCME-provided agenda can serve as a helpful starting place for these decisions. Include people whose roles involve compliance with the elements scheduled for discussion, as well as those who may have important context and experience to offer. For chair, clerkship director, and resident meetings, the required clerkship specialties should be represented. Make sure to provide all participants with calendar information promptly, so the necessary time can be reserved.
In general, people should be prepared to answer questions specific to their work. Assume that multiple people will be expected to speak during each session, rather than a single senior leader who ostensibly speaks for everyone. That said, a senior person should be prepared to step in and clarify information as necessary.
The LCME team meets with both pre-clerkship (usually M1 and M2) and clerkship (usually M3 and M4) students. Aim for five to six learners from each training year, ensuring all groups accurately reflect the composition of the student body and the structure of the school. For example, regional campuses and special programs (e.g., medical scientist training programs, parallel tracks) should be represented. If it is early in the academic year, ask your team secretary whether you should invite a few M3 students who can speak to the M2 year during the pre-clerkship meetings. Leaders of student organizations and those who took part in the Independent Student Analysis (ISA) are also good candidates for these meetings, as well as for the student-led campus tour.
When selecting tour guides, plan on one student for every two survey visitors and consider involving students who already lead tours at the school.
Tip Three: Familiarize the Team with Relevant Background Information
Meeting participants often have questions about what is likely to come up during their sessions. Discussions are sure to reference information in the Data Collection Instrument (DCI), meaning participants should familiarize themselves with any relevant portions and supporting documents.
Areas of concern, such as negative AAMC Graduation Questionnaire or ISA findings, are likely to be a particular focus, so participants should be prepared to discuss them. Negative findings are not uncommon, but the LCME will be looking for evidence that the school is utilizing CQI principles to address them. Participants should be ready to speak to how issues were investigated, the root causes that may have been identified, and the actions and follow-up monitoring implemented as a result. The LCME team survey report can be a helpful indicator of what the team will be concentrating on.
It’s common for the LCME to triangulate information across meetings to reinforce or refute findings, so make participants aware that they may be asked about relevant areas beyond the specific standards or elements planned for a given meeting’s discussion. For example, while the focus of the Education meeting is standards 6, 7, and 8, a question about how the curriculum management structure considers adequacy of patient volumes (element 5.5) or the learning environment (element 3.5) could emerge as part of the conversation.
Tip Four: Create Opportunities for Teams to Practice
Many faculty accreditation leads arrange opportunities for survey visit participants to practice beforehand to alleviate stress and allow participants to ask questions about what to expect.
Practice sessions can easily be facilitated by internal teams, with a few experienced leaders taking on the role of the LCME survey visitors. LCME materials and any challenging portions of the DCI can provide fodder for practice questions, creating opportunities to correct misperceptions; confirm participants’ understanding of findings, school policies, and other items; and help alleviate nervousness. This practice also helps participants get comfortable with candid discussions about the issues identified during the self-study and the ways the school is addressing them. Mock survey visits offer another, more structured, type of dry run that can closely mirror the full survey visit experience. In addition to preparing the team, these activities can serve as a source of professional development for up-and-coming leaders who may have a role in future accreditation work.
Performing a dry run of the campus tour may also be helpful, as students will lead the tour without staff. Accompanying guides on a walk-through ahead of time ensures students have an opportunity to get comfortable and ask questions. Walking the route also gives your team a chance to highlight areas of interest and confirm that staff across the school are aware that their spaces will be included on the tour.
Tip Five: Encourage Professional Appearance and Behavior
Although school leadership will have been engaged in the self-study for many months—if not years—before the LCME’s arrival, the survey visit is a milestone and a chance to showcase your team and your school. You’ll want to make a positive impression.
Suits aren’t required, but professional attire is expected and will reinforce to the LCME team that the school takes the proceedings seriously. Scrubs should be avoided if possible.
Participants should remain engaged throughout their session(s) with the visiting team, regardless of whether the questions relate directly to their areas of expertise. That means leaning in, listening to questions and colleagues’ answers, and avoiding the use of mobile devices during meetings. If a participant simply must keep their phone handy because of clinical or family issues, the sound should be turned off, and they should step outside to text or take emergency calls.
Tip Six: Create Space to Prepare and Debrief
Schools will benefit from setting up both a green room for participants to gather before entering meetings and a debriefing room where they can connect briefly after finishing. Ask participants to arrive in the green room 15 minutes before their meeting begins. This is where they will pick up their name cards and any prepared meals. Additionally, many schools ask participants to drop off their phones in the green room before entering the meeting room.
Use the debriefing room to collect name cards and return phones after each meeting. Participants should also take a few moments to share their impressions of where the school is shining, identify potential areas of misunderstanding, and make a plan to obtain any materials requested by the LCME. Be sure to provide any follow-up items to the survey team by the end of the day.
Embracing the Survey Visit as an Opportunity to Celebrate Your School
Every aspect of the LCME survey visit—from the interviews to the campus tour to the art on the walls—creates an opportunity to demonstrate and celebrate what makes your school special. Encourage your team to bring genuine enthusiasm for the great work they’ve done and the institution they love, as their commitment and passion are essential ingredients for both a successful survey visit and a positive accreditation journey overall.
