Site Visitor Training Standards NATA Annual Meeting St. Louis June 22-23, 2015.

Site Visitor Training

Standards

NATA Annual MeetingSt. Louis

June 22-23, 2015

TRANSFORMING THE PROFESSION THROUGH QUALITY EDUCATION

• Review Standards Quiz• Post-Professional Degree

Program Standards• Post-Professional Residency

Standards• Professional Program

Standards• Lessons Learned / FAQ• Evaluation

Agenda

Overview of Standards

• Standards for the Accreditation of Professional Athletic Training Programs (2012)

• Standards for the Accreditation of Post-Professional Athletic Training Degree Programs (2014)

• Standards for the Accreditation of Post-Professional Athletic Training Residency Programs (2014 )

Standards ComparisonProfessional Degree Post-Professional Degree Post-Professional Residency

Core Competencies Core Competencies

Sponsorship (1-3) Sponsorship (1-7) Sponsorship (1-13)

Outcomes (4-13) Outcomes (8-19) Outcomes (14-25)

Personnel (14-41) Personnel (20-40) Personnel (26-51)

Program Delivery (42-63) Program Delivery (41-59) Program Delivery (52-69)

Health & Safety (64-80)

Financial Resources (81-82) Financial Resources (60) Financial Resources (70-71)

Facilities & Instructional Resources (83-87)

Operational Policies & Fair Practices (88-90)

Program Description & Requirements (91-97)

Student Records (98-105) Student Records (79-83) Resident Records (98-102)

Distance Learning Sites (If Applicable) (106-109)

Standards Terminology

• Must/Shall:– A verb used to denote that a standard is a Compliance Standard

that is required to ensure minimal educational quality.– “Must” example Professional Degree Standard 3– “Shall” used in Post-Professional Degree and Residency Standards

• Should: (only used in the Post-Professional Degree and Residency Standards)

– A verb used to denote that a standard is an Aspirational Standard that is recommended to achieve a desired state that is beyond minimal educational quality

– “Should” example Post-Professional Degree Standard 7 and Residency Standard 5

Agenda

2014 Post-Professional Degree Standards

Post-Professional Core Competencies• Evidence-Based Practice • Interprofessional Education and Collaborative Practice • Quality Improvement • Healthcare Informatics • Professionalism • Patient-Centered Care

Sponsorship (1-7)• Institutional Accreditation• AT Designation on

Transcripts (major, specialization, concentration, emphasis, or track)

• Affiliation Agreements

• Post-baccalaureate (post-professional) masters or doctoral degree

• Degree should be in Athletic Training

Outcomes (8-19)• Develop a Plan• Assessment Measures• Collect Data• Data Analysis• Action Plan

• The program’s outcomes and objectives must – Reflect its faculty expertise and

resources– Increase students’ depth and

breadth of understanding of athletic training subject matter areas, skills, and Post-Professional Core Competencies, beyond the knowledge, skills, and abilities required of the professional preparation program

Personnel (20-40)• Program Director• Faculty• Medical Director

• The Program Director must – Terminal degree (e.g., PhD, EdD)

from a regionally accredited institution

– Graduate faculty, where applicable, as defined by institutional policy.

– Ongoing involvement in the athletic training profession as evidenced by scholarly publications / presentations and involvement in the profession.

• No clinical coordinator required• No Preceptors required

Program Delivery (41-59)• Post-Professional Core

Competencies are integrated within the program.

• Formal Instruction• Clearly written syllabi• Non-discriminatory clinical

placements• Assessment of clinical sites

• The program’s students must be: – Credentialed and be in good

standing with the Board of Certification (BOC).

– Possess a current state athletic training credential and be in good standing with the state regulatory agency (where applicable)

• The number of work hours performed during clinical experiences and graduate assistantship experiences must be in compliance with institutional and Federal policy.

Program Delivery (41-59)• Scholarly experience

– Designed to improve student critical thinking and decision making

– Sufficient time and opportunity must be provided within the program for students to engage in scholarly experiences.

– Should lead to dissemination of new knowledge in athletic training.

– Should emphasize clinical research designed to inform athletic training practice

• Clinical Practice– Designed to improve the students’

ability to provide patient care– Sufficient time and opportunity must

be provided within the program for students to engage in advanced clinical practice experiences.

– Integrate the Post-Professional Core Competencies

– Individualized advanced clinical education plan (individual goals and/or objectives) for each student to improve the students’ ability to provide patient care

Financial Resources(60)• Must receive adequate,

equitable & annually available resources

Facilities and Instructional Resources (61-65)• Classroom/Laboratory

space• Number and quality of

instructional aides• Equipment & supplies• Library and other

Information Sources• Offices for faculty and staff

available

Operational Policies and Fair Practices (66-71)• Admissions standards and

criteria• Accurate terminology• Publically accessible

academic tuition, fees, and other required program specific

• Full financial responsibilities and benefits (e.g., tuition and fees, tuition waivers, financial aid, graduate assistantships) must be provided to the student, in writing, prior to the student committing to attend the institution

Program Description and Requirements (72-78)• Clearly written and consistent description of curriculum

available. Description must include:– Program mission, goals & objectives– Curriculum and course sequence– Program requirements for completion of the degree

• Published procedure for processing grievances• Published policies and processes for student withdrawal and

refund of tuition and fees• Accessible policies and procedures governing award of

available funding for scholarships administered by the program

Student records (79-83)• Maintain appropriate student records that demonstration

progression through curriculum. At minimum include :– Program admission application and supporting documents– Remediation and disciplinary actions (when applicable)– Advanced clinical practice experiences

• Student records must be stored in secure location(s)

How does the Review Process Differ for Post-Professional Degree Programs?

• Less standards = shorter self-study!

• Looking for different things in curriculum, scholarship, & clinical experiences

• Other aspects of review and site visit are essentially the same

Agenda

Disclaimer

• The purpose of this talk is to provide general information about CAATE accredited post-professional residency programs.

• Not making standards interpretations or policy declarations for the Commission on Accreditation of Athletic Training Education.

• We can’t discuss any specifics of programs who have applied for accreditation or are in the accreditation process

Presentation Objectives

• Discuss “focused area of clinical practice within the scope of athletic training”

• Discuss incorporation of the Core-Competencies

• Standards to keep your eye on

Focused Area of Clinical Practice within the Scope of Athletic Training

• Focused on patient-based specialization that provides preparation of the resident as an advanced practice healthcare provider

• Training usually occurs within a specifically defined patient population (pediatrics, performers etc.) or system (prevention programming, rehabilitation, etc.)

• Residency training is rigorous and requires a significant investment of time and resources

Current Athletic Training Accredited Residency Programs

• New Hampshire Musculoskeletal Institute– Focused Area of Clinical Practice = Primary Care

• Ben Hogan Sports Medicine– Focused Area of Clinical Practice = Orthopaedic Rehabilitation

Focused area of clinical practice within the scope of athletic training

• Examine the residency models of specialization in peer health professions – Medicine– Pharmacy– Physical therapy

• Programs bear the burden of establishing why their chosen focused area of clinical practice is appropriate to advance the residents depth of knowledge and skills in a specialized area of athletic training practice

177 Residency Programs in Physical Therapy

Types of Residencies in Physical Therapy

• Cardiovascular & Pulmonary (3)• Clinical Electrophysiology (1)• Geriatrics (14)• Neurology (25)• Orthopedics (82)• Pediatrics (14)• Sports (must possess ATC, EMT, or certification as an EMR) (29)• Women’s Health (8)• Wound Care Management (1)

Focused Area of Clinical Practice within the Scope of Athletic Training

• What do the programs need to provide?– Plan which revolves around the focused area of clinical practice

(assessment, data, action items)– Core-competencies linked to focused area of clinical practice– Preceptors who have expertise in the focused area– Defined and planned didactic education experiences in the focused

area of clinical practice– Defined and planned scholarly experience within the focused area

(identify, assimilate, review, measure, disseminate)

Why a focused area of clinical practice? Clinical Specialists are needed

• Entry = general knowledge and BOC• Post-professional = specialized knowledge• Specialized knowledge = specialty certifications

How do Residency Programs contribute to athletic training?

• Residency programs aim to develop clinicians who can: – Solve complex patient problems,– Practice with the current best evidence integrated with their

clinical expertise and patient values,– Contribute to the literature through research and scholarship,– Measure and disseminate information about the clinical

outcomes of the services they provide, and– Ultimately enhance their patients’ health-related quality of

– American Society of Hospital Pharmacists (ASHP) Standards for Specialized Pharmacy Residency Training

What Residency Programs are and are not

• These are MENTOR driven advanced clinical education and training programs

• What they ARE NOT:– More GA Positions– Employer-based on-the-job training– Restricted only to graduate programs– Restricted to clinicians with a masters– Administration or teaching focused– Required to maintain BOC certification

Residency Accreditation Standards 102 (New Sections)

• Sponsorship• Outcomes • Personnel• Residency Program Delivery• Financial Resources• Facilities and Instructional Resources• Operational Policies and Fair Practices• Program Description and Requirements• Resident Records

Post-Professional Core Competencies

• “Integrated within the program”– Plan– Assessment measures– Data collected– Data analyzed– Action plan

• “beyond the professional level”– Need to assess at entry into the Residency

Patient-Centered Care

Evidence-Based Practice

Quality Improvement

Healthcare Informatics

Interprofessional Education and Collaborative

Practice

*Enhanced Quality of Patient Care

*Optimized Patient Outcomes

*Improved Health-Related Quality of Life

Professionalism

Merger of IOM & ACGME Competencies

Incorporating the Core Competencies

• Define each competency for the residency• Incorporate each competency• Measure each competency• Adjust the residency as needed

• Example of Quality Improvement definitions

Incorporating the Core Competencies

• Define each competency for the residency• Incorporate each competency• Measure each competency• Adjust the residency as needed

• Example of Quality Improvement definitions

Quality Improvement

• Competency in quality improvement relates to the athletic trainer’s recognition of the need for constant self-evaluation and life-long learning, and it includes the ability to:– Identify a quality improvement objective– Specify changes that are expected to produce an improvement– Quantitatively confirm that an improvement resulted from

implementation of the change (e.g., improved patient outcomes from administration of a specific intervention or utilization of a specific protocol).

Additional Residency Standards to watch

21. Assessment Measures: The residency program’s aggregate organizational data (as defined by the CAATE) for the most recent three years must be provided.

41. The RPD must mentor the preceptors as they interact with the resident.

64. The resident must actively engage in measuring patient oriented outcomes as part of systematic data collection and ongoing assessments within the focused area of clinical practice and disseminate the information that has been compiled.

Agenda

• Sponsorship (1-3)– Institutional

Accreditation– AT Designation on

Transcripts– Affiliation Agreements

• Outcomes (4-13)– Comprehensive

Assessment Plan– Assessment Measures– Collect Data– Data Analysis– Action Plan

2012 Professional Standards

• Personnel (14-41)– Program Director– Clinical Education

Coordinator– Faculty– Preceptors– Medical Director

• Program Delivery (42-63)– Encompass didactic,

laboratory and clinical education courses

– Formal Instruction– Clearly written syllabi– Non-discriminatory clinical

placements– Assessment of clinical sites– Specifics related to

Evaluations, KSAs

• Health & Safety (64-80)– Technical Standards– Immunizations– Communicable Disease Policy &

Exposure Plan– BBP Training & access to equipment– Venue Specific EAPs– Liability Insurance– Safety Policies– Calibration & Inspection of

Equipment– HIPAA and/or FERPA training

• Financial Resources (81-82)– Must receive adequate,

equitable & annually available resources

– Commensurate with other programs

– Specific line items identified

• Facilities & Instructional Resources (83-87)– Classroom/Laboratory space– Number and quality of

instructional aides– Equipment and supplies– Library and other information

sources– Offices for faculty and staff

available

• Operational Policies & Fair Practice (88-90)– Admissions standards

and criteria– Accurate terminology– Publically accessible

academic tuition, fees, and other required program specific

• Program Description & Requirements (91-97)– Clearly written and consistent description of curriculum

available. Description must include:• Program mission, goals & objectives• Curriculum and course sequence• Program requirements for completion of the degree

– Published procedure for processing grievances– Published policies and processes for student withdrawal and

refund of tuition and fees– Accessible policies and procedures governing award of

available funding for scholarships administered by the program

• Student Records (98-105)– Maintain appropriate student records that demonstration

progression through curriculum. At minimum include :• Program admission application and supporting documents• Remediation and disciplinary actions (when applicable)• Clinical experience/advanced clinical practice experiences

– Student records must be stored in secure location(s)– Other records at minimum must include:

• BBP training• Signed technical standards and accommodation plan (if necessary)• Academic progression

• Distance Learning Sites (106-109)– Not applicable for all professional programs – All sites and resources must provide comparable and

equally accessible learning opportunities and access to classroom and laboratory instruction and equipment

Comments from the Review Committee on Specific Standards

Summary of 2014-15– 77% of schools 0-10 NC’s (mean 7.08 with Range 0-24)– 7.07 Recommendations/School (Range 2-12)– RC and SVT agreed 84%

Category Rankings

CITATION RANKING 2014-15 Program Delivery 20.86%

Outcomes 18.18% Health & Safety 15.51%

Personnel 12.83%

CITATION RANKING 2013-14 Outcomes 28.32%

Program Delivery 18.58% Health & Safety 18.14%

Personnel 12.83%

Top Standards Cited (order of frequency):

– Standard 72 (Calibrations/Safety checks)

– Standard 10 (Data Analysis related to mission/goals/objectives)

– Standard 57 (Minimum/Maximum hours)

– Standard 9 (Outcome Data Collection)

– Standard 12 (Action Plans)

– Standard 51 (Clinical Evaluation)– Standard 3 (Clinical

Agreements)– Standard 6 (Assessment Tools)– Standard 17 (PD Release Time)– Standard 45 (Clearly Written

Course Syllabi)– Standard 78 (Venue Specific

Disparity Between Site-Visitors and Review Committee

• Largest Disparity in Accuracy: Outcomes Category (74%)

• Standards of Highest Disparity Between SVer’s and RC– Standard 85 (Equipment to instruct KSA’s)– Standard 91 (Clearly written program description related

to mission/goals/objectives)

Professional Program Standard 3

All sites where students are involved in patient care or observation-only experience (excluding the Program’s sponsoring institution) must have an affiliation agreement or memorandum(s) of understanding that is endorsed by the appropriate administrative authority (i.e. those bearing signature authority) at both the sponsoring institution and site. In the case where the administrative oversight of the preceptor differs from the affiliate site, formal agreements must be obtained from all parties.

Develop a Plan: There must be a comprehensive assessment plan to evaluate all aspects of the educational program. Assessments used for this purpose must include those defined in Standards 6 and 7. Additional assessments may include, but are not limited to, clinical site evaluations, clinical instructor evaluations, completed clinical proficiency evaluations, academic course performance, retention and graduation rates, graduating student exit evaluations, and alumni placement rates one year post graduation.

Assessment Measures: The program’s assessment measures must include those stated in Standards 6 and 7 in addition to any unique metrics that reflect the specific program, department, or college. The specific volume and nature of this information is influenced by the individual character of the institution and should be in keeping with other similar academic programs within the institution. The assessment tools must relate the program’s stated educational mission, goals and objectives to the quality of instruction, student learning, and overall program effectiveness

Collect the Data: Programs must obtain data to determine program outcomes as indicated in Standards 6 and 8 (above).

– Mission, goals and objectives– Quality of instruction– Student learning– Overall program effectiveness– Number of students graduating from

the program who took the examination

– Number and percentage of students who passed the examination on the first attempt

– Overall number and percentage of students who passed the examination regardless of the number of attempts

Data Analysis: Programs must analyze the outcomes data to determine the extent to which the program is meeting its stated mission, goals, and objectives.

Professional Program Standard 12a-12d

Action Plan: The results of the data analysis are used to develop a plan for continual program improvement. This plan must:a. Develop targeted goals and action plans if the program and

student learning outcomes are not met; and b. State the specific timelines for reaching those outcomes; and c. Identify the person(s) responsible for those action steps; andd. Provide evidence of periodic updating of action steps as they

are met or circumstances change.

Program Director must administrative have release time. The Program Direct release time must be equivalent to similar health care programs in the institution. If no such similar program exists at the institution, then benchmark with peer institutions.

Clearly written current course syllabi are required for all courses that deliver content contained in the athletic training knowledge, skills, and abilities. Syllabi must be written using clearly stated objectives.

The program must provide proof that therapeutic equipment at all sites is inspected, calibrated, and maintained according to the manufacturer’s recommendation, or by federal, state, or local ordinance.

All sites must have a venue-specific written Emergency Action Plan (EAP) that is based on well-established national standards or institutional offices charged with institution-wide safety (e.g. position statements, occupational/environmental safety office, police, fire and rescue).

The equipment and supplies needed to instruct students in the current athletic training knowledge, skills, and clinical abilities must be available for formal instruction, practice, and clinical education.

• Oropharyngeal Airway• Nasopharyngeal Airway• Core Temperature• Pulse Oximetry• Blood Pressure• Protective:

– Splints– Braces– Devices– Tape– Wrap

• Ambulatory Aids• Splinting Materials• Epi-Pen Trainer• Spine Board/Equipment• Cervical Stabilization • Wound Closure• Supplemental Oxygen

– Nasal Cannula– Non-Rebreather

Equipment and Supplies

• Pocket Mask• Bag Valve Mask• AED (trainer)• Protective Equipment• Environmental

Assessment– Sling Psychrometer

• Glucometer• Peak Flow Meter• Otoscope

• Urinalysis Supplies/Device

• Opthalmoscope• Stethoscope• Nebulizer• Neurological Assessment

Devices• Body Composition

Assessment

• Therapeutic Equipment

Agenda

Site Visitor Do’s and Don’ts

Site Visitor Do’sThe CAATE expects the SVer to:

– Act professional (behavior, appearance, language, action) at all times – Keep an objective eye and an open mind– Practice political correctness– Be familiar with the program and its self-study report– Be fair and consistent– Display an unbiased understanding of the Standards

Site Visitor Do’s and Don’ts

Site Visitor Don’ts– Do not be afraid to ask questions or call the CAATE if you are unsure of

something– Do not compare your program with the one being visited

Resources Available

• Go-To-Meetings – Contact Ashley (ashley@caate.net) for assistance

• Doodle Poll – meeting scheduling tool (free online)

• Contact:– CAATE Office– Names on CAATE Contact List

Questions?

Please complete program evaluation form

Site Visitor Training Standards NATA Annual Meeting St. Louis June 22-23, 2015.

Documents

Transcript of Site Visitor Training Standards NATA Annual Meeting St. Louis June 22-23, 2015.

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