National Task Force Urges Accreditors to Adopt Uniform Standards and Requirements

SAN FRANCISCO - The community of educators and accreditors involved in assuring the quality of higher education programs that prepare new health professionals for practice needs to take a hard look at itself - and change with the times. underserved communities," said lead author Elizabeth Mertz, MPA, project director at the Center. Even more disturbing are the findings that the communities most in need of services are the same communities least likely to have them, according to the study published in the summer quarterly issue of the Journal of Public Health Dentistry.

According to a report released today by a panel of experts in health professions education, the traditional systems for maintaining educational quality and promoting its improvement are sadly out of date -- and out of sync -- with sweeping changes in the global health care and higher education environments.

The result: The accreditation seal of approval that functioned as a public guarantee of quality has lost its meaning and no longer serves students, higher education programs, nor the public well, according to the report by the Task Force on Accreditation of Health Professions Education. Instead, it has become a complex and inefficient process that focuses more on rigid compliance with arcane rules than on improving the quality of educational programs that graduate new health professionals, the Task Force says.

The Task Force was established in 1996 by the University of California San Francisco Center for the Health Professions to provide policy analysis and recommendations for health professions accreditation. The Task Force's work was conducted in parallel with the work of the Pew Health Professions Commission. A list of the Task Force's members is attached.

The report recommends that accreditors be more responsive to the needs of students and the public, adopt a uniform approach to accrediting all programs, explore new technologies that would streamline accreditation, and decrease the amount of time they spend at higher education campuses.

"Accreditation today is at a crossroads - caught between the 'old way' of doing things and demands for a 'new way' of doing business," said James R. Kimmey, M.D., M.P.H., vice president at St. Louis University and chairman of the Task Force. "Students have a right to know that the programs they enter will prepare them to be good physicians, nurses, dentists, or therapists. And members of the public have a right to know that the people to whom they entrust their health have the education they need to do their jobs well."

Part of the problem with accreditation lies in the number of accrediting agencies: There are more than 50 accreditation programs that evaluate higher education programs for physicians, nurses, dentists, pharmacists, acupuncturists, and other health professionals. All of them use different standards and reporting requirements, which creates more work for education programs seeking accreditation and increases the cost of accreditation.

In addition, the process itself is far from ideal, the Task Force notes. Standards for accreditation are developed with little if any public input. Teams of site visitors are notoriously uneven in their evaluations. They also tend to be myopic - not seeing the forest for the trees. "Add to this the considerable human, physical, and financial resources consumed by the accreditation process, and it is not surprising that many in higher education circles are calling for fundamental changes in accreditation," the Task Force writes.

The Task Force identified four major issues in accreditation:

1. the need for a simplified process,
2. the development of, and transition to, a process focused on improvement,
3. the creation of closer linkages between the accreditation community and its stakeholders, and
4. the use of generic benchmarks or standards.

After engaging in extensive discussions and consultations with educators, accreditors, professional associations, and government regulators, the Task Force developed the following core recommendations:

• Educational institutions, programs, and accreditors must recognize their shared responsibility for responding to the changing needs of the public, employers, professional bodies, and students.

• Educators and accreditors must work together to foster an organizational culture centered on educational assessment and improvement.

• Accreditation must reward innovative methods to enhance efficiency, minimize waste and duplication, and streamline assessment processes.

• All accrediting agencies should adopt a consistent approach to accreditation that uses five common criteria and one profession-specific criterion.
  
  
• Accrediting agencies must continually review their own accreditation programs and make improvements to ensure that they respond to the needs of the people they serve

Each recommendation is accompanied by a set of specific implementation strategies for educators and accreditors alike. For example, to improve efficiency, the Task Force suggests that accreditors restructure their site visits as focused reviews and emphasize opportunities for constructive consultation. In collaboration with educators, they should also explore the incorporation of new, resource-conserving information technologies into the accreditation process.

"Accreditation has a crucial role to play in the education of new health professionals," said Sherril B. Gelmon, Dr.P.H., project director for the Task Force and professor at Portland State University. "At its best, accreditation should promote a process of guided self-evaluation and self-improvement. We hope that the recommendations and strategies in this report will help achieve that ideal."

Copies of the Task Force's report, which includes a set of issue papers by Task Force members on issues related to accreditation, are available from the Center for the Health Professions by calling (415) 476-8181 or from the Center's web site at http://futurehealth.ucsf.edu.

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Task Force on Accreditation of Health Professions Education
Membership, 1996-1998

Chair
James R. Kimmey, M.D., M.P.H., Saint Louis University

Project Director
Sherril B. Gelmon, Dr.P.H., F.A.C.H.E., Portland State University and UCSF Center for the Health Professions

Members
Janis P. Bellack, Ph.D., R.N., F.A.A.N., Medical University of South Carolina and UCSF Center for the Health Professions

Carol L. Bobby, Ph.D., L.P.C., N.C.C., Commission on Accreditation of Counselling and Related Educational Programs

Roger J. Bulger, M.D., Association of Academic Health Centers (1997-1998)

Michael Covert, M.H.A., F.A.C.H.E., Sarasota Memorial Hospital (1996-1997)

Steven D. Crow, Ph.D., North Central Association of Colleges and Schools

John P. Evans, Ph.D., University of North Carolina - Chapel Hill

Arthur MacKinney, Ph.D., University Center at Tulsa (Emeritus)

Theodore Marchese, Ph.D., American Association of Higher Education

Edward H. O'Neil, Ph.D., Pew Health Professions Commission and UCSF Center for the Health Professions

Neil Sampson, M.P.H., M.G.A., Bureau of Health Professions, U.S. Department of Health and Human Services (1997-1998)

Paul Schwab, M.P.A., Bureau of Health Professions, U.S. Department of Health and Human Services (1996-1997)

John E. Trufant, Ed.D., Rush University/Rush Presbyterian St. Luke's Medical Center