Governance as it relates to the control and operation of the training program is important to ensure transparency, fairness and accountability in program delivery. It impacts on the ethics, administration, compliance and risk management of the program1 and provides direction to respond to community health and training needs. Good governance promotes effective program delivery, quality improvement and quality assurance.
The governance structure can vary depending on context but does need to be such that there are appropriate levels of responsibility, capability and decision-making authority to enable planning, implementation and evaluation of the program and to set relevant policy and procedures.
A training program model that provides strategic direction for program planning and delivery should be aligned to the goals of the organisation delivering the training. The educational guiding principles of the RACGP educational framework provide a statement of the best practice medical education of GPs and are directed by the RACGP operational plan. These guiding principles provide a framework for training models.
Stakeholders need to be involved to ensure a presence and voice in the governance structure. Involving stakeholder groups improves understanding and engagement of such groups in the program. It improves communication and provides feedback about the effect of decisions on those most impacted. It also provides stakeholder groups with an opportunity to identify issues and express concerns to decision making bodies. Appropriate stakeholders who could be involved in GP training are included under guidance for Outcome 5.2.
Effective communication occurs when ideas and messages between those involved are understood clearly and lead to better cooperation and collaboration. This is especially important where multiple stakeholders are involved. This may include communication within and between teams in a program as well as communication between the RACGP and others who deliver training, including other specialist and international colleges.
The identification and management of risk is an important component of governance. Not only is it important to manage individual risks as they arise, but evaluation of risk profiles affords a means to identify aspects of the program that require improvement. Policies and procedures are part of risk management, for example those that deal with conflicts of interest or critical incidents.
A program of evaluation needs to be embedded across the whole program. This provides the opportunity for quality improvement of the program at all levels. It also facilitates development of best practice in training delivery.2 Systematic collection and analysis of data is fundamental to evaluation. Effective evaluation enables the program to respond to evolving needs and external demands, and to respond to changing best practice recommendations for both clinical and educational activities.