The ACGME outcome project: retrospective and prospective.

BACKGROUND: The Accreditation Council for Graduate Medical Education began an initiative in 1998 to improve resident physicians' ability to provide quality patient care and to work effectively in current and evolving healthcare delivery systems.

AIMS: This initiative, called the Outcome Project, seeks changes in residency programs that focus education on the competency domains, enhance assessment of resident performance and increase utilization of educational outcomes for improving residents' education. Increased emphasis on educational outcome measures in accreditation is another important goal.

RESULTS: A considerable amount of development, dissemination and educational activity has been carried out to support project implementation. Thus far, observed effects include changes to accreditation requirements and information collection and enhancements of the educational environments and curriculum of residency education programs.

CONCLUSION: Prospects for meaningful change are good. Further development of assessment methods is needed to advance in-training evaluation of residents and the ACGME goals for utilizing performance data in accreditation and linking education and patient care quality.