5. Methodology

Review of existing guidelines:

Our team first reviewed the existing guidelines for protected faculty time.  The American Academy of Family Physicians publishes Residency Program Solutions, a highly-regarded collection of consensus-based best practices for family medicine GME programs_­(5).  Furthermore, the group reviewed guidance the ACGME formerly provided to Designated Institutional Officers (DIOs) with specified minimum time allocations for faculty and program director based on specialty-specific review committee recommendations prior to 2019 (4, (Accreditation Council for Graduate Medical Education, 2018).

Literature search strategy:

A literature review was conducted.  A search of Pubmed database with the terms [“protected academic faculty time” OR “Protected administrative faculty time” OR “Protected nonclinical time”] was performed.  Over 1000 results were returned and abstracts read for relevance.  The bibliography of relevant titles was reviewed to ensure additional helpful articles were not missed.

Additional relevant materials were provided for review by the WWAMI Regional Medical Education Program, the authors of an ongoing study surveying program directors to estimate the amount of clinical time faculty spend performing various activities, and the ACGMEs Data Resource Book and its published archives of faculty characteristics as reported in ADS.

These materials were collected and utilized by the panel to form the basis of their consensus guidelines.

Identification of guideline statements and development of consensus:

After reviewing relevant literature, the team separately developed recommendations for statements pertaining to program director, associate program director and faculty nonclinical time as well as other pertinent recommendations.  At a meeting, each guideline statement was vetted by a panel of experts who formed the Protected Faculty Time Task Force.  Statements underwent successive edits until the panel reached a consensus about the statement’s relevance and presence within our specified scope.  The final collection of statements was approved by the task force.  The task force discussed use of levels of evidence and noted that given the low overall quality of evidence, levels of evidence would not be included in the final recommendation statements.  

External Review

After the task force completed its guidelines and supporting statements, these were submitted for internal review by a reactor panel comprised of additional experienced family medicine faculty representing a broad range of roles, geographic locations and practice settings.  After further edits, the task force submitted the guidelines to the Family Medicine Leadership Consortium for endorsement.