Bridging intentions and outcomes: a program theory approach to residency accreditation standards

These findings identify specific areas requiring attention in residency accreditation standards while providing a structured approach for standards evaluation. Key recommendations include establishing clear objectives before standards development, making explicit choices between threshold and aspirational requirements, examining underlying assumptions, considering unwritten expectations, and structuring standards to optimize expectations alignment among stakeholders. This evaluation framework can support other accreditation bodies in reviewing and updating their standards while maintaining context-appropriate content.