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Pieces of the Puzzle Perspectives on the Accreditation Visit

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Slide 2 Pieces of the Puzzle Perspectives on the Accreditation Visit Slide 3 Central Theme Accreditation and Assessment are critically linked in contemporary accreditation models. They were parallel themes in recent past but have collided to form a new accountability in higher education. Ratcliff JL et al, How Accreditation Influences Assessment, Josey Bass 2001 Slide 4 How does accreditation and assessment come together? Two key questions: How should learner outcomes be demonstrated in the accreditation process? How should assessment information be used to show improvement in programs, services, and student/resident learning? Slide 5 Accreditation Purposes Fostering excellence through the development of criteria and guidelines for assessing effectiveness Encouraging improvement through ongoing self-study and planning Ensuring external constituents that a program has clearly defined goals and appropriate objectives, maintains faculty and facilities to attain them, demonstrates it is accomplishing them, and has the prospect for continuing to do so Ratcliff JL et al, How Accreditation Influences Assessment, Josey Bass 2001 Slide 6 Accreditation Purposes Provides advice and counsel to new and established programs in the accrediting process Ensures that programs receive sufficient support and are free from external influence that may impede their effectiveness and the freedom of inquiry Ratcliff JL et al, How Accreditation Influences Assessment, Josey Bass 2001 Slide 7 Program Accreditation Needs to fulfill two dimensions of program quality: There should be some evidence that the programs have clear goals and courses of study to attain them The process should demonstrate that responsibilities associated with the goals are being carried out. Peers interpret quality in the context of the programs own aims and activities Central issue: Program review is conducted as a self study process. Central assumption: Evaluators from outside cannot effectively examine and judge until those inside have reached a judgment about its quality. Ratcliff JL et al, How Accreditation Influences Assessment, Josey Bass 2001 Slide 8 Program Review Audit Style Issues identified by outside party Buy-in from program director? Reactive Fear about the inspection Approach cover the basics, get by this one and on to the next Not stimulated to think about points of excellence only points of deficiency Outcome from Inspection: Fear relieved get on to the next one. Yardstick: STANDARDS Basic/Minimal Slide 9 Program Review Assessment Style Self Study and Peer assessment against target goals: Minimal standards = musts Growth goals Improvement goals Outcome goals Buy-in for Program Director Proactive ownership of goals Outcome of Inspection External validation of internal assessment (agree or not) How much progress has been made against goals? Yardstick: Goals achieved or improvement beyond minimal standards Points of Excellence Slide 10 Federal and Local Rules OPTI Standards Basic Standards For I R Specialty College Standards Practicality? Last Inspection? Time? Salary? Patient Care? Productivity? Family? What about the Residents? How am I Doing as a PD? Malpractice? Slide 11 Federal and Local Rules OPTI Standards Basic Standards For I R Specialty College Standards YES!! ??? What role? What am I supposed To do with this? Slide 12 Federal and Local Rules OPTI Standards Basic Standards For I R Specialty College Standards Do they agree??? ? ? ? ? Which one takes precedence? Slide 13 Experience with the Audit Program Review. Attempts to help program directors and DMEs to prepare for upcoming inspections. Attempts to find common areas of support need across OPTI programs of same discipline Based on BASIC STANDARDS developed Crosswalks to assist in review of individual standards and collective standards. Slide 14 Standards Crosswalk and Worksheet Specialty:______________ Completed by:_____________ Date:_____ Slide 15 Program Pre-Inspection Findings Hospital_______________ Completed by:________________ Slide 16 Standards often do not: Consider practical issues A complete research paper per year of residency (human subject approvals take almost half that time). Ability of community hospital to afford out rotations since the BBA 1997 Ability of trainer to (again) teach subjects which were dropped from practice in time past. Consider federal rules or procedures Institutional Review Board and HIPPA approval for human subject research Documentation standards Slide 17 Standards often do not: Reflect the need to include the following in the curriculum and assess effectiveness: Ethics Communication skills Require the assessment of outcomes of study Clinical skill development or OSCEs In Service Examination and Analysis (individual and program wide). Progress exams or oral exams Require that a program develop an ongoing quality assessment program and benchmarks for process and learning outcomes goals. Slide 18 Experiences with Accreditation Visits an OPTI view..example: Program Review 40 areas of concern standards not met in crosswalk Affiliation agreements for major components not completed (for over 10 years) Manual in disarraynever distributed to residents for past three years PD mostly practices at alternate hospitals (where residents not welcome) for >70% time Etc. Inspector Wonderful program with dedicated PD and hospital No major deficiencies Recommend increase in number of trainees Commendable PD attention to program Recommend full five year accreditation. Net result:: OPTI is too tough. see, We are OK!! Slide 19 Experiences with Accreditation Visits an OPTI view..example: Program Review 36 areas of concern on Standards Crosswalk No resident manual in print/no written curriculum Resident work hours = 2 weeks on call continuously 2 yr program required by PD/1 yr by specialty college.few recent trainees complete the two years. Certificates difficult to obtain. Certification rates =

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