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Table 1 PGME accreditation structured according to Sinek’s Golden Circle

From: How changing quality management influenced PGME accreditation: a focus on decentralization and quality improvement

Accreditation Former systems Current system Future system
1966 1999 2004 - present 2018
Why Primary objectives Quality of PGME +− + ++ ++
Quality of health care +− +
Secondary objectives Standardization ++ ++ ++ +−
Coaching +−
Self-evaluation +− ++
Accountability +− + ++
What PGME quality domains Quality of education + + ++ ++
Residency performance + ++
Quality of physician practice +− ++
How Quality management approach Quality assurance +− + ++ +−
Quality improvement ++
Quality control +
Who Actors’ responsibilities Resident +− ++ ++
Clinical educator(s) ++ + + +
Organization +− +− ++
Accreditor ++ + + +−
  1. This is an overview of overall shifts in the intensity of use of themes over a period of time based on qualitative data: ++ intensive, + frequent, + − moderate, − limited, −- never