How will CAA use the Guidance on Developing Quality Interprofessional Education for the Health Professions related to programs’ activities for IPE?

The Health Professions Accreditors Collaborative (HPAC) and the National Center for Interprofessional Practice and Education released Guidance on Developing Quality Interprofessional Education for the Health Professions  [PDF] in February 2019. The guidance was developed through a multiyear, multiphase consensus process aimed at supporting the development and implementation of quality interprofessional education (IPE). The CAA is pleased to have been a part of the development of this resource for institutional leaders, programs and faculty, and accreditation agencies and volunteers.

The guidance document is intended to foster increased communication and collaboration between educators in various professions and to provide guidance on achieving quality IPE. The document

• offers consensus terminology and definitions for IPE and related concepts;
• encourages institutional leaders to develop a systematic approach to foster IPE in their own institutions and, where appropriate, collaborate with academic institutions, health systems, and community partners;
• suggests a framework for leaders and faculty to develop a plan for quality IPE; and
• provides opportunities for HPAC member accreditation boards/commissions to use the guidance to assess their IPE standards and to train site teams regarding the essential elements of high-quality IPE. [1]

The CAA views this document as a resource to support programs in their preparation of graduate students in audiology and in speech-language pathology as professionals, regardless of clinical externship or practice settings. It is not intended to replace or subsume CAA’s accreditation standards related to IPE, nor will site visitors be directed to consider programs’ IPE plans solely on the basis of recommendations from this document.

The CAA expects programs to be engaged in IPE ultimately to realize the success of their graduates in interprofessional collaborative practice (IPP). For a program, the advantage of using a multidisciplinary, collaborative guidance document as a basis for its own implementation and practice of IPE is that it can facilitate an organized and systematic approach that is consistent with the goals, objectives, and procedures used by other health professions in the training of their students. Such consistency of terminology, focus, process, and assessment across the health professions will help facilitate students’ use of IPP beyond their training and is, itself, a working example of IPP.

 

Related Resources

• Ask the CAA: Should our program include IPE/IPP in our academic and clinical curriculum?
• CAA Standards for Accreditation [PDF]—Standards 3.1 A, 3.4A, 3.1B

[1] Source: https://healthprofessionsaccreditors.org/wp-content/uploads/2019/02/HPACGuidance02-01-19.pdf

What are recommended strategies to collect employment data from graduates?

The CAA requires accredited programs to annually report student achievement data in three areas—program completion, Praxis examination performance, and employment of graduates in the professions. The CAA uses these data to support assessment of a program’s effectiveness.

For reporting employment data, programs should include graduates who are employed in the profession or who are pursuing further education in the profession within 1 year of graduation. The CAA expects programs to report employment data on ALL graduates from the prior year, as stated in Standard 1.9, as well as to meet the CAA-established threshold for this student outcome measure in Standard 5.7.

Programs should make every effort to use all possible mechanisms to collect this data, including but NOT limited to the following:

• Alumni surveys
• Exit interviews
• Use of program director sign-off on certification applications, state licensure forms, or other national credentials to include the opportunity to query for employment status or future education
• Research of graduates’ records in the ASHA certification/membership database
• Research through state licensure boards to identify employment of graduates
• Other creative means or incentives by which to collect this data on program graduates

If your program uses an innovative technique or successful mechanism to collect employment data on graduates, and if you are willing to share it, please contact accreditation@asha.org.

See the CAA Resources page for more information.

The CAA has identified program completion rates as an outcome measure that addresses the quality of the program’s success with respect to student achievement. Further, the CAA believes that program completion rates reflect multiple facets of program effectiveness. When students complete a program within the program’s specified time frame, it suggests that the program’s admissions process was effective, that required course work was offered on a sufficiently regular basis, and that the program provided sufficient clinical education opportunities.

Please note: As of March 1, 2018, the CAA is applying an updated formula for calculating program completion rates for its decisions on accreditation reports. The changes also are reflected in the worksheet for programs when reporting these student outcome data to the CAA. 

Completion Time Frames – Program Tracks

The CAA allows for programs to establish separate time frames for students to complete the program for those enrolled in different tracks, including full-time, part-time, or when the program is offered via different modalities.

A student should be counted as completing “on time” if the student graduates within the published time frame for the appropriate component of the program.

Terms of Student Enrollment

The CAA interprets the published time frame as the number of terms an individual student was actually enrolled in the program. The terms do not have to be consecutive, but the total number of terms must meet the program’s expected time frame for completion. University-approved leaves of absences (e.g., for reasons of health, maternity/paternity, mission work, military assignment) do not count toward the number of terms a student was enrolled in the program.

Program Completion Data

The CAA requires programs to report on the completion status of all students in the accredited or candidate program. The numbers of students who complete the program on time, students who complete the program later than expected, and students who do not complete the program for academic and clinical progress or reasons having to do with program quality factor into the formula the CAA has developed to determine a program’s on-time completion rate.

Students taking longer or who have left the program for reasons related to academic or clinical progress (e.g., insufficient course offerings, remediation, academic integrity, dismissal) cannot be considered as meeting on-time completion expectations.

Students taking longer or who have left the program for reasons unrelated to program quality (e.g., personal, financial, relocation) or for reasons unrelated to the program, faculty and staff, or academic or clinical curriculum will not count toward the 3-year average program completion rate.

The CAA has developed a worksheet to guide programs in providing and calculating discrete data about student completion for the 3-year reporting period.

The CAA revised its interpretation of the elements for calculating program completion rates in July 2017 as a result of recommendations from the CAA’s Working Group on Audiology Program Completion Rates. The Working Group, which was composed of CAA members and CAA-accredited academic program representatives, recommended—and the CAA subsequently approved—that the CAA-established threshold for program completion rates only applies to measures of program quality (e.g., students not completing on time or dropping out for reasons that reflect on the quality of the program) versus personal factors (e.g., financial, relocation, change in life situation) external to the program that do not reflect on the quality of the program. The updated formula, which applies to both audiology and speech-language pathology programs, was implemented March 1, 2018, for CAA’s decisions on accreditation reports. Programs may be asked for additional information related to program completion rates if needed.

Calculating Three-Year Rates

The CAA calculates three-year rates using raw data for the three-year interval reported by a program in its current accreditation report in order to assess compliance with the CAA-established thresholds for program completion, Praxis examination pass rates, and graduate employment rates. This protocol is in accordance with best practices in mathematics and statistical analysis. It is expected that programs use the same practice to calculate the three-year averages for these student achievement measures. Averaging the three annual percentages is not an appropriate method to determine the three-year averages in order to demonstrate the program’s ability to meet the CAA-established benchmarks for the student achievement measures.

The CAA does not require programs to post three-year averages as part of the data that must be presented on the program’s website for student achievement. However, when posted the data must be accurate.

Additional Resources

• Student Achievement Measures
• Presenting Student Achievement Data
• Program Completion Rate Calculator Worksheet

Given the trends in service delivery toward a more nonhierarchical interdisciplinary team approach, both in health care and in other settings, the CAA identified several important aspects of interprofessional education/interprofessional collaborative practice (IPE/IPP) when it recently reviewed the accreditation standards. Because of the support for these concepts, the Council added knowledge and skills outcomes in the 2017 Standard 3.1 that programs must address through the academic and clinical curriculum. As these elements are featured primarily in the Professional Practice Competencies, excerpted below, the CAA expects programs to infuse the competencies throughout the curriculum and be able to describe how the competencies are demonstrated by students as well as how the competencies are assessed and measured.

3.1.1 Professional Practice Competencies (3.1.1A Audiology and 3.1.1B Speech-Language Pathology)

The program must provide content and opportunities for students to learn so that each student can demonstrate the following attributes and abilities and can demonstrate those attributes and abilities in the manners identified.

• Accountability: Understand how to work on interprofessional teams to maintain a climate of mutual respect and shared values.

• Effective Communication Skills: Communicate—with patients, families, communities, interprofessional team colleagues, and other professionals caring for individuals—in a responsive and responsible manner that supports a team approach to maximize care outcomes.
• Professional Duty: Understand the roles and importance of interdisciplinary/interprofessional assessment and intervention and be able to interact and coordinate care effectively with other disciplines and community resources.
• Collaborative Practice: Understand how to apply values and principles of interprofessional team dynamics.
• Collaborative Practice: Understand how to perform effectively in different interprofessional team roles to plan and deliver care—centered on the individual served—that is safe, timely, efficient, effective, and equitable.

For audiology, the CAA included additional elements in the curriculum standard:

3.1.4A Assessment of the structure and function of the auditory and vestibular systems

The program provides academic content and clinical education experiences so that each student can learn and demonstrate knowledge and skills in order to

• engage in interprofessional collaborative practice (IPP) to facilitate optimal assessment of the individual being served.

3.1.6A Intervention to minimize the effects of changes in the auditory and vestibular systems on an individual’s ability to participate in his or her environment

The program’s curriculum provides academic content and clinical education experiences so that each student can learn and demonstrate knowledge and skills in order to

• conduct audiologic (re)habilitation and engage in interprofessional practice (IPP) to maximize outcomes for individuals served.

Definitions

When considering how to incorporate IPE and IPP in the academic and clinical curriculum, programs should keep in mind the definitions employed by the CAA for interprofessional education (IPE) and interprofessional collaborative practice (IPP), which were adapted by ASHA from the World Health Organization’s Framework for Action on Interprofessional Education and Collaborative Practice (2010) [PDF]:

• Interprofessional education—Interprofessional education occurs when individuals of two or more professions learn about, from, and with each other to enable effective collaboration and improve outcomes for individuals and families whom are served.
• Interprofessional collaborative practice—When multiple service providers from different professional backgrounds provide comprehensive health care or educational services by working with individuals, their families, caregivers, and communities to deliver the highest quality of service across settings.

Resources

A number of organizations and academic institutions have developed resources and training on IPE/IPP, and we are highlighting a few of those entities here:

American Speech-Language-Hearing Association (ASHA) – ASHA is focusing on advancing IPE/IPP as part of its 2015–2017 Strategic Plan. ASHA has compiled resources to support individuals and academic programs in their efforts to learn, practice, and model collaboratively with other professions in educational and health care settings. Brief videos, presentations and webinars, survey summaries, links to upcoming conferences, and more are available online.

Interprofessional Education Collaborative (IPEC) – IPEC collaborates with academic institutions to promote, encourage, and support efforts to prepare future health professionals to enter the workforce ready for collaboration with other professionals. Resources include the Core Competencies for Interprofessional Collaborative Practice, last updated in 2016. ASHA became an organizational member in 2017.

National Center for Interprofessional Practice and Education – The National Center, based at the University of Minnesota, provides leadership, evidence, and resources for IPE/IPP as a way to enhance the experience of health care, improve population health, and reduce the overall cost of care.

Health Professions Accreditors Collaborative (HPAC) – The CAA joined HPAC in 2017. HPAC was formed to enhance accreditors’ ability to ensure graduates of health profession education programs are prepared for IPE/IPP and offer a platform for accreditors to work together on common areas of interest.

What is the CAA’s Responsibility When a Program is Not in Full Compliance with Standards?

The CAA monitors all programs’ compliance with the Standards for Accreditation through review of applications, annual reports, and other special reports as warranted. If the CAA identifies any concerns as a result of a report review, the CAA documents its findings in an Accreditation Action Report to the program and differentiates its findings as areas of non-compliance or areas of partial compliance with the standards. The Council also may indicate areas of follow-up for the program to address; these are elements of standards for which the program remains in full of compliance at the time of the report, but for which the CAA needs additional information.

In its reports, the CAA includes opportunities for the program to explain current circumstances, describe plans to address issues that the program has self-identified, provide required responses to previous citations for non-compliance or partial compliance, and respond to elements noted as requiring follow-up. The Council considers this part of the ongoing dialogue between itself and the program about educational quality improvement through compliance with accreditation standards.

Probation and Withdrawal Decisions

At times, the CAA may place a program on probation, or withdraw accreditation from a program when there is clear evidence of circumstances that jeopardize the capability of the program to provide acceptable educational experiences for the students. A program also may be placed on probation because the program has not corrected deficiencies noted earlier by the CAA.

As an accrediting agency recognized by the U.S. Secretary of Education, the CAA must comply with Criterion §602.20 [34 CFR 602.20(a)(2)(iii)]. This criterion requires that if an accrediting agency’s review of a program indicates that the program is not in compliance with any standard, the CAA must establish timelines for programs that are not in full compliance “to take appropriate action to bring itself into compliance with the agency’s standards.” As the programs that the CAA accredits are at least two years in length, the maximum time allowed under this criterion for a program to remain out of compliance is two years. If, after review of a required report, the program remains out of full compliance with any standard and sufficient progress toward compliance has not been demonstrated, the CAA may act to place the program on probation or withdraw its accreditation status in accordance with the policy and procedures outlined in the Accreditation Handbook. However, a program will be placed on probation or have accreditation withdrawn after the review of a third consecutive report reveals that issues continue for the same standard(s) and the program remains not in full compliance with all standards. The CAA applied this clarified interpretation of the recognition criterion with its review of the February 2016 applications and annual report submissions. In order for a probation status to be removed, the program must document compliance with the Standards for Accreditation.

The CAA considers the review processes—for applications and annual reports—as part of a dialogue with the program about its compliance with the Standards for Accreditation. The opportunity to participate in this way provides a more complete representation by the program as part of the overall approach to peer review and self-study that is the core of the CAA’s accreditation program. 

Application Reviews and Site Visit Reports

During an application review, the CAA provides its initial observations to the program, identifying any areas for which information may be unclear, incomplete, or missing. This allows programs the opportunity to provide critical information to the CAA and the assigned site visit team about those issues as well as updates about what has been happening in the program since the application was submitted.

After the site visit, it is critical for the program to respond to all concerns raised in the site visit report for which the team could not verify evidence of compliance. The program’s response could include clarification of any issues, plans for program improvement in areas of concern, descriptions of new policies or processes, timelines for implementation of program improvements, and updates since the time of the site visit that were not stated as a concern (e.g., new faculty hire).

The CAA considers the information from the application, the site visit report, and the program’s responses and updates when assessing compliance with each standard in the overall accreditation decision for the program. The CAA uses the Accreditation Action Report (AAR) to communicate the decision and the level of compliance with the Standards.

Annual Report Reviews

It is important for programs to review the citations noted in the AAR that it receives after each accreditation report review has been completed by the CAA. Any issues identified under areas of noncompliance, partial compliance, or follow-up must be addressed by the program in the next annual report.

When the CAA reviews an annual report, it looks carefully at whether the program has:

• Addressed the prior concerns, including all elements of the citation
• Developed and implemented a plan and timetable for resolving the issues, if warranted
• Made a good-faith effort to address or make progress on issues noted

The CAA considers many variables when making a decision, but failing to address a concern during the past year does not provide the CAA with any new information. If a program has not (a) addressed the concerns, (b) considered how to rectify the issues by implementing a plan, or (c) made progress toward compliance, the CAA must abide by its own policies. Therefore, having no new information, the CAA may place the program on probation or take an adverse action, which it has done in the past. To avoid such a decision, it is critical that the program respond, regardless of the Standards cited.