Transcript ACPE Communications - Accreditation Council for Pharmacy

Accreditation Council for
Pharmacy Education (ACPE)
Update for AACP
Council of Deans
ACPE Board of Directors and Executive Staff
AACP Interim Meeting ▪ Savannah, Georgia
February 28, 2011
ACPE Board and Staff Speakers
• Heidi M. Anderson, PhD
ACPE President (University of Kentucky)
• Robert S. Beardsley, RPh, PhD
ACPE Vice President (University of Maryland)
• Michael A. Moné, RPh, JD, FAPhA
ACPE Secretary/Treasurer (Cardinal Health)
• Stephanie F. Gardner, PharmD, EdD
ACPE Board of Directors (University of Arkansas)
• Peter H. Vlasses, PharmD, DSc (Hon.), BCPS, FCCP
ACPE Executive Director
• Jeffrey W. Wadelin, PhD
ACPE Associate Executive Director, and
Director, Professional Degree Program Accreditation
Purpose of Discussion
• Part of ACPE’s ongoing effort to engage in
a collaborative dialogue with stakeholders
• Convey and clarify information on
activities, policies and procedures
• Respond to topics submitted by deans
• Discuss opportunities to improve ACPE’s
interactions with schools/colleges
ACPE Communications Assessment
October – December 2010
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Key Issues Identified
Process vs. Outcomes Assessments
Quality vs. Quantity
Transparency
Consistency in Accreditation Review
Collaborative Approach
Process vs. Outcomes Assessment:
Feedback Received
• Concerns about the evidence-base of
some standards and guidelines
• Accreditation requirements are resource
intensive for colleges and schools
• ACPE’s processes limit flexibility and
innovation
Process vs. Outcomes
Assessment
• Accreditation is outcomes focused; process and
structure are linked to outcomes
• ACPE is committed to assuring quality in all
accredited pharmacy education programs
• “What does ‘good’ look like” – collaborative effort
of practice organizations, AACP, and ACPE
“Accreditation is a trust-based, standards-based,
evidenced-based, judgment-based, peer-based
process.” —CHEA, 2009
ACPE Stakeholder Conference
September 12–14, 2012
Atlanta, GA
• Advancing Quality in Pharmacy Education:
Charting Accreditation’s Future
• Invitational consensus-seeking conference
• In collaboration with a broad array of
leaders in pharmacy, health care, and
education leaders
ACPE Stakeholder Conference
Objectives
• Examine competencies that are currently
required of pharmacists and competencies
that will be required in the future
• Expand evidence-based practices in
assessing the quality of educational
programs
• Inform standards, guidelines, and process
quality improvement initiatives
Dean-Submitted Question
S2007 Guidelines 2.0
Please discuss the “effective
date” and when schools will be
held accountable for new
guidelines during reviews.
S2007 Guidelines 2.0
• Guidelines 2.0 are in effect
–
–
–
–
Site teams will evaluate starting Fall 2011 cycle
Provides clarification and/or quality improvement additions
Reflects ACPE Board of Directors policy decisions
15 new “must” statements (many have previously been
communicated)
• AAMS will be updated by April 30, 2011
• Rubric v4.0 will be released by April 30 and will provide an
overview of key changes
– Effective on July 1
• Self-studies in progress that are using other versions of the
rubric must address the changes in the text of their selfstudy submissions
Dean-Submitted Questions
Accreditation Timeframes
• Will ACPE consider modifying the
accreditation cycle by lengthening terms
(e.g., to 7–8 years)?
• Will ACPE consider reducing the number
of reports by increasing time between
interim reporting?
ACPE Subcommittee to Analyze
Accreditation Cycle and Process
• Subcommittee will analyze accreditation
cycle and process for colleges and
schools of pharmacy
• Comprised of 4 ACPE Board members, 2
deans (AACP-appointed), ACPE staff
member
• Preliminary report to ACPE Board – June
2011
Issues at the Intersection of
Quality and Quantity:
Feedback Received
• Is ACPE adequately addressing quality in
new schools and/or expanded programs?
• Is quality within experiential education
impacted? Adequate sites and preceptors?
• Is quality of faculty and academic
leadership diminished?
Accredited PharmD Programs*
Programs with Accreditation Status (n = 124)
• Full Accreditation Status: 99
– Programs that have graduated students
• Candidate Accreditation Status: 16
– Programs with students enrolled but have not yet produced graduates or
have graduates and have not addressed all the accreditation standards
• Pre-Candidate Accreditation Status: 9
– Programs that have not yet enrolled students or are in their first year of
classes
* Inclusive of January 2011 Board Actions
Distance Campus Expansions
• 26 programs have distance campuses*
– 19 are public and 7 are private
• 3 programs are in the process of being
evaluated to open a distance campus
• 5 programs have branch/distance campuses
out of state
(* Distance campus = delivery of didactic curriculum to/from site)
Pharmacy School Graduation Trends
11,487
Number of Graduates
12000
10000
8000
6,956
6000
4000
2000
0
Source: AACP Fall 2010 Data and ACPE February 2011 Estimates
Pharmacy school graduates 2011–2014
projected based on current enrollment
and ACPE-estimated attrition
13,822
14000
Are new colleges and schools of
pharmacy primarily responsible for
this increase in pharmacy
graduates since 2003?
Increase in Pharmacy Graduates Since 2003
Source: AACP Fall 2010 Data and ACPE February 2011 Estimates
Increase attributable to pre-1995 schools
n = 118
Increase in No. of Graduates
(from 2003 baseline)
7000
n = 114
Increase attributable to post-1995 schools
n = 110
6000
n = 102
5000
4000
n = 98
n = total number of US colleges and
schools with graduates
n = 90
n = 93
n = 89
3000
n = 88
2000
n = 85
n = 83
1000
0
2004
2005
2006
2007
2008
(Actual numbers)
2009
2010
2011
2012
2013
(Projected numbers)
2014
Increase in Pharmacy Graduates Since 2003
Source: AACP Fall 2010 Data and ACPE February 2011 Estimates
Increase attributable to pre-1995 schools
n = 118
Increase in No. of Graduates
(from 2003 baseline)
7000
n = 114
Increase attributable to post-1995 schools
n = 110
6000
n = 102
5000
4000
n = 98
n = total number of US colleges and
schools with graduates
n = 90
n = 93
n = 89
3000
n = 88
2000
n = 85
n = 83
1000
0
2004
2005
2006
2007
2008
(Actual numbers)
2009
2010
2011
2012
2013
(Projected numbers)
2014
ACPE Monitoring of Pharmacy
Programs – Quality and Resources
• Comprehensive and focused accreditation
reviews
• Annual monitoring metrics (e.g., NAPLEX,
enrollments, progression/graduation, dismissals,
withdrawals, attrition)
• AACP standardized surveys (e.g., graduating
students, faculty, preceptors, and alumni)
• Launch of Assessment and Accreditation
Management System (AAMS) with AACP
• Identification of noteworthy practices
NAPLEX Passing Rate for First-Time
Candidates 2004–2010
Passing Rate
Pre-1995 versus Post-1995 Programs
100%
98%
96%
94%
92%
90%
88%
86%
84%
82%
80%
96.7%
7 Post-1995
Programs
97.0%
24 Post-1995
Programs
96.7%
95.6%
95.8%
93.0%
92.0%
95.1%
96.3% 96.5%
94.4%
94.1%
92.3%
85.9%
2004 2005 2006 2007 2008 2009 2010
Pre-1995
Programs
Post-1995
Programs
n= 23
40%
n = 10
n = 12
50%
10%
n=6
n=1
Post-1995
Programs
n=2
20%
n=1
Pre-1995
Programs
n=3
30%
n=1
Percentage of Programs
60%
n= 39
2010 NAPLEX Passing Rate Spread for
Pre-1995 versus Post-1995 Programs
0%
66 -70% 71 - 75% 76 - 80% 81 - 85% 86 - 90% 91 - 95%
96 100%
2010 Graduating Student Survey Results
Section I: Professional Competencies/Outcomes (N = 7,496)
ThePharmD
PharmD Program
preparedprepared
me to:
The
Program
me to:
Communicate with
patients and caregivers
Communicate with patients and caregivers
Gather and use specific information to
identify
patient
medication-related
Gather
and use
specific information
to identify patient
medication-related problemsproblems
Develop a patient care plan to manage
Develop a patient
care
plan to manage each medication-related
each
medication-related
problem
problem
54.5%
43.5%
54.4%
43.7%
50.0%
47.9%
1.7%
1.6%
1.9% Strongly Agree
Agree
Work with a health care team to implement
the patient
care
Work with a health care team to implement
the patient
careplan
plan
Manage the system of medication use to
affect
patients
Manage the system of medication use
to affect
patients
Work with other stakeholders and resolve
Work with
other stakeholders
to identify
and resolve problems
problems
related
to medication
use
related to medication use
Disagree/Strongly
43.4%
37.4%
41.3%
51.5%
55.7%
55.0%
4.6% Disagree
4.4%
3.2%
2010 Graduating Student Survey Results
Section III: Pharmacy Practice Experiences (N = 7,496)
My introductory pharmacy practice
experiences were valuable in helping to
prepare me for my advanced pharmacy
practice experiences
My introductory pharmacy practice experiences
permitted my involvement in direct patient care
responsibilities in both community and
institutional settings
In the community pharmacy setting, I was
able to apply my patient care skills
24.1%
48.5%
23.4%
47.5%
42.3%
21.4%
22.9%
47.8%
8.7%
Strongly Agree
In the ambulatory care setting, I was able to
apply my patient care skills
In the hospital or health-system pharmacy
setting, I was able to apply my patient care
skills
54.0%
39.6%
4.1%
Agree
Disagree/Strongly
Disagree
43.4%
47.2%
In the inpatient/acute care setting, I was able
to apply my patient care skills
48.5%
45.2%
Overall, my advanced practice experiences
were valuable in helping me to achieve the
professional competencies
46.9%
48.3%
8.3%
4.4%
4.0%
2010 Faculty and Preceptor Survey Curriculum Responses
(Faculty N = 2,604 / Preceptor N = 8,170)
The PharmD Program prepared
students to:
Develop and use patient-specific care
plans
Efficiently manage a patient-centered
pharmacy practice
Develop disease management programs
Manage the system of medication use
96.3%
97.5%
93.9%
93.6%
91.1%
89.9%
94.5%
93.7%
Promote the availability of health
promotion and disease prevention
initiatives
Communicate with patients, caregivers,
and other members of the
interprofessional health care team
Preceptor Strongly
Agree/Agree
95.4%
94.4%
96.8%
97.2%
Faculty Strongly
Agree/Agree
2010 Faculty and Preceptor Survey Curriculum Responses
(Faculty N = 2,604 / Preceptor N = 8,170)
The
PharmD
Program
prepared
The Pharm.D.
Program
prepared
students to:
students to:
Search the health sciences literature
Search the health sciences literature
96.7%
94.1%
94.2%
Evaluate the
Evaluate the
health sciences
literature
health
sciences
literature
Demonstrate expertise in the area of
Demonstrate expertise in the area of informatics
informatics
Apply state and federal laws and
Apply state and federal laws and regulations to the practice of
regulations to the
practice of pharmacy
pharmacy
90.6%
Preceptor
Strongly
Agree/Agree
92.0%
Faculty
Strongly
Agree/Agree
82.9%
96.6%
98.2%
97.9%
Maintain professional
competence
Maintain professional
competence
96.1%
New School Process
Required Evaluations & On-site Visits for
ACPE Accreditation of New Programs
Draft Application On-site Consultation (1 staff member)
Paper review of draft application (team of 4)
Evaluation for Precandidate Status (team of 4-5)
Evaluation for Candidate Status (team of 4-5)
Evaluation for Continuation of
Candidate Status (team of 2-3)
Over 7 years: a New Program is evaluated by 24–36 individuals
Consideration of Full Status (team of 4-5)
Evaluation for Continuation of Initial Full Status
(team of 2-3)
New School Process—Initial Contact to Possible Approval of On-Site
School
Actions
± 9 months
ACPE
Actions
New School Process—Approval of On-site to Candidate Status
School
Actions
1 Year
ACPE
Actions
1 Year
New School Process—Candidate to Initial Full Status
School
Actions
2 Years
ACPE
Actions
2 Years
New School Process—Initial Full to Continuation of Full Accreditation
School
Actions
2 Years
ACPE
Actions
4 Years
Site Team Composition
•
•
•
•
•
•
Dean
Pharmaceutical sciences
Pharmacy practice
Practitioner not affiliated with the school
Staff member from ACPE
Board or former Board member (based on
availability)
Individuals from curriculum and assessment
committees and with experiential oversight
are preferred
29 Point Threshold Rubric
http://www.acpe-accredit.org/pdf/Threshold_Document.pdf
Dean-Submitted Question
Proportion of Aspiring
Schools Accredited
• What is the percentage of colleges and
schools who have applied for precandidate
status since 2000 and have achieved this
status?
Proportion of Aspiring
Schools Accredited
• Programs have investigated establishment of
a pharmacy program with ACPE but
approximately 10 did not pursue application
• 40 programs were evaluated for
preaccreditation
– 3 programs were not authorized for a
precandidate visit
– 16 programs delayed at either precandidate,
candidate, or full accreditation (or a combination of
these) at some point in the process
Dean-Submitted Questions
Quality/Quantity of Clinical Sites
• How will the shortage of quality
experiential sites be addressed by ACPE
for new and existing schools?
• How will ACPE deal with schools that have
“lost sites” to new programs?
• Is ACPE considering some sort of public
opportunity for comment on the "impact" of
establishing a new school or is this just a
rumor?
APPE Preceptor Data
(N=39 programs,* F2008–F2010)
Source of Preceptors
Program Reported %
Full-time faculty
Mean: 24%
Range: (3 - 62%)
Contract/volunteer
faculty
Mean: 76%
Range: (38 - 97%)
*Existing or new schools about to produce graduates
APPE Preceptor Data
(N=39 programs,* F2008–F2010)
Total
APPEs in
Setting
%Precepted
by Full Time
Faculty
Community
5,094
2%
98%
0 – 1,299
(0 – 93%)
Hospital/
Health-System
5,007
8%
92%
0 – 647
(0 – 84%)
Ambulatory
Care
4,982
32%
68%
-65 – 307
(-30 – 88%)
Inpatient/
Acute Care
6,646
30%
70%
0 – 443
(0 – 84%)
Required APPE
%Precepted Excess/(Deficit)
by Adjunct Rotation Range
Faculty
by Program
*Existing or new schools about to produce graduates
Experiential Education Standards –
Evaluation Since S2007
(N=49 programs)
S2007 Standard
Compliant
Compliant
w/
Monitoring
Partially
Compliant
NonCompliant
Standard 14. Curricular
Core—Pharmacy Practice
Experiences
14
25
8
2
Standard 28. Practice
Facilities
29
17
2
1
Dean-Submitted Questions
Quality/Quantity – Manpower
• Will ACPE extend scope to include
applicant schools’ assessment of
manpower, need, quality of applicant pool,
impact on clinical and other resources?
• Discuss ACPE position on the oversupply of
pharmacists in certain parts of the country.
• Please project anticipated changes in
supply within the next 5 years with
proliferation of schools.
Dean-Submitted Questions
Quality/Quantity – Manpower
• Please discuss ACPE's interpretation (or
use) of the Pharmacist Demand Survey
(ADI) by Kathy Knapp
– Does ACPE utilize this survey to help
determine if a new schools application is
appropriate?
Manpower Issues Cannot Be
Considered in Accreditation
• Accreditation is designed to advance
quality – not restrict the market
• Sherman Antitrust Act of 1890 prohibits
restraint of competition
• PharmD is a nationally recruited applicant
pool with national employment
opportunities
Accreditation and Competition
• Accreditation decisions may affect the
marketplace
• Accreditation decisions are based strictly on
compliance with the standards
– Cannot consider the effect on the marketplace
• Consideration of the effect on the marketplace
in making accreditation decisions could subject
ACPE to prosecution under antitrust laws and,
potentially, jeopardize ACPE’s recognition by
the U.S. DOE
Do the accrediting bodies for other
health professions dictate the
quantity of schools or numbers of
graduates?
Growth Trends in Education
Among Other Health Professions
Accredited Programs
2000
Accredited Programs
Plus Applications
(Net % Change)
2011
Medicine (LCME)
125
141 (+13%)
Osteopathy (AOA-COCC)
19
28 (+47%)
DNP = 0 (new degree)
58
Physical Therapy (APTA)
196
229 (+17%)
Occupational Therapy
(OTA)
131
154 (+18%)
Dentistry (ADA CODA)
55
60 (+9%)
Health Profession/
Accreditor
Nursing (CCNE)
Dean-Submitted Question
Quality in Accelerated PharmD
Programs
• Has ACPE discussed a national unified
curriculum such that some programs with
accelerated programs are not allowed to
“degrade pharmacy education?”
– "Five-year PharmD" in some new schools
– Curriculum structuring accelerates the professional
and pre-professional years: morphing of 5 year BS
into 4 year PharmD
NAPLEX Passing Rate for First-Time
Candidates 2008 – 2010
Three-Year vs. Four-Year Programs
96.9%
99%
96.2%
95.7%
96.7%
94.4%
n = 90
n = 85
n=8
84%
n = 83
89%
n=7
94%
n=8
93.9%
Three-Year
Programs
79%
Four-Year
Programs
74%
69%
2008
2009
2010
Dean-Submitted Questions
Questions About Finances
• Please discuss how ACPE's financial
resources are made transparent to the
public.
• Please summarize the revenues derived
from schools and elsewhere and summarize
major categories of expenses.
– Schools are belt-tightening. What about ACPE?
• Are there ways to reduce accreditation
expenses?
Dean-Submitted Questions
Questions About Finances
• ACPE has "recommended" that some
programs add personnel (increasing school’s
expenses without generating additional
funding). Is ACPE sensitive to the critical
financial standing of some institutions
secondary to state budget cuts and unfunded
mandates?
• Discuss the issue of a dues increase. Is this on
the horizon?
Summary of Discussion
• ACPE is committed to assuring quality in
pharmacy education and encouraging
innovation
• ACPE wants to continue to engage in a
collaborative dialogue
• ACPE is committed to working with the
profession to ensure standards and
guidelines are reflective of emerging
evidence and practice needs
Summary of Discussion
• Expansion in the number of pharmacy school
graduates is a result of growth in both
existing and new programs
• Marketplace effects cannot be considered in
accreditation decisions
• Accreditation decisions are based strictly on
compliance with the standards
• ACPE is focused on careful use of resources
and ensuring good stewardship of Council
funds
“A coach is someone who can
give correction without causing
resentment.”
―John Wooden
ACPE’s desire is to be a coach
to colleges and schools of pharmacy