The structure of program evaluation: An approach for evaluating a course, clerkship, or components of a residency or fellowship training program

Background: Directors of courses, clerkships, residencies, and fellowships are responsible not only for determining whether individual trainees have met educational goals but also for ensuring the quality of the training program itself. The purpose of this article is to discuss a framework for program evaluation that has sufficient rigor to satisfy accreditation requirements yet is flexible and responsive to the uniqueness of individual educational programs. Summary: We discuss key aspects of program evaluation to include cardinal definitions, measurements, needed resources, and analyses of qualitative and quantitative data. We propose a three-phase framework for data collection (Before, During, and After) that can be used across undergraduate, graduate, and continuing medical education. Conclusions: This Before, During, and After model is a feasible and practical approach that is sufficiently rigorous to allow for conclusions that can lead to action. It can be readily implemented for new and existing medical education programs.