The Practice Accreditation Resident Reviewer Program (PARRP): A National Program to Educate Residents About Radiation Oncology Practice Accreditation Through Mentored Chart Review

While instruction in patient safety and quality improvement is a core requirement for radiation oncology graduate medical education, many residents feel their training in this domain is inadequate. To address this discrepancy, we developed a mentorship program that allows residents to serve as junior chart reviewers within the American College of Radiation Oncology (ACRO) practice accreditation program. Practice accreditation is a voluntary process by which a radiation oncology facility's adherence to quality treatment standards is assessed through comprehensive evaluation of their equipment, personal, and treatment records. We hypothesize that hands-on training in practice accreditation will increase resident knowledge of quality care standards. This prospective study will be open to PGY-4 and PGY-5 radiation oncology residents nationally. Residents will initially undergo a self-administered didactic curriculum - consisting of readings and webinars - on the principles of practice accreditation, quality standards, and documentation review. Subsequently, residents will serve as junior reviewers within the ACRO accreditation program. During each chart review cycle, residents will be paired 1:1 with an experienced accreditation faculty mentor. Both resident and faculty will independently review the same set of charts/treatment records and score documentation quality using a pre-specified rubric. After chart evaluation, faculty will meet with residents via videoconference to discuss scoring and provide feedback. To graduate the program, residents must complete 3 chart review cycles and evaluate at least 10 charts. Primary endpoint is improvement in resident understanding of quality care standards, practice accreditation, and documentation review, which will be assessed through pre- and post- program surveys. At the end of each chart review cycle, surveys will be used to assess secondary endpoints including residents' time to complete chart review, confidence in chart review, and perceptions of faculty mentorship. Faculty mentors will also evaluate resident competence in chart review at the end of each chart review cycle. This is the first program to teach radiation oncology residents about practice accreditation. By providing mentorship and hands-on experience, we aim to better equip residents with the knowledge and skills needed to maintain care and documentation standards as an attending physician. In doing so, this program highlights how patient safety and quality improvement can be incorporated into every day practice.