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 AssessmentOctober – December 2010

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 ConferenceSeptember 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 ConferenceObjectives

• 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

S2007 Guidelines 2.0

Please discuss the “effective date” and when schools will be

held accountable for new guidelines during reviews.

Dean-Submitted Question

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 self-study submissions

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?

Dean-Submitted Questions

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?

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

Accredited PharmD Programs*

* Inclusive of January 2011 Board Actions

• 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 Expansions

(* Distance campus = delivery of didactic curriculum to/from site)

Pharmacy School Graduation Trends

Source: AACP Fall 2010 Data and ACPE February 2011 Estimates

Num

ber

of G

radu

ates

Pha

rmac

y sc

hool

gra

duat

es 2

011–

2014

pr

ojec

ted

base

d o

n c

urre

nt e

nro

llmen

t an

d A

CP

E-e

stim

ated

att

ritio

n

Fact Check―

Are new colleges and schools of pharmacy primarily responsible for

this increase in pharmacy graduates since 2003?

Increase in Pharmacy Graduates Since 2003

Increase in Pharmacy Graduates Since 2003

• 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

ACPE Monitoring of Pharmacy Programs – Quality and Resources

NAPLEX Passing Rate for First-Time Candidates 2004–2010

Pre-1995 versus Post-1995 Programs

2010 NAPLEX Passing Rate Spread for Pre-1995 versus Post-1995 Programs

Per

cent

age

of P

rogr

ams

n =

1

n =

1

n =

12

n =

10

n =

3

n =

1

n =

2 n =

6

n=

23

The PharmD Program prepared me to:

Communicate with patients and caregivers

Gather and use specific information to identify patient medication-related

problems

Develop a patient care plan to manage each medication-related problem

Work with a health care team to implement the patient care plan

Manage the system of medication use to affect patients

Work with other stakeholders and resolve problems related to medication use

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

Promote the availability of health promotion and disease prevention

initiatives

Communicate with patients, caregivers, and other members of the

interprofessional health care team

2010 Faculty and Preceptor Survey Curriculum Responses (Faculty N = 2,604 / Preceptor N = 8,170)

Required Evaluations & On-site Visits for ACPE Accreditation of New Programs

Over 7 years: a New Program is evaluated by 24–36 individuals

Draft Application On-site Consultation (1 staff member)

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)

Consideration of Full Status (team of 4-5)

Evaluation for Continuation of Initial Full Status (team of 2-3)

New School Process

Paper review of draft application (team of 4)

Info

rmal

consu

ltatio

n with

ACPE

Initial expression of

interest by University

Founding Dean

hired and on-site

Recruit

leadership team

Draft application

report and fee

due January 15

On-site

consultatio

n by

ACPE staff

Final application

report April 1

Applicatio

n reviewed

by Applic

ation R

eview

Team

On-site

eva

luat

ion

appro

ved b

y Boar

d at

June

Mee

ting

Representatives

meet with ACPE

Board

± 9 months

Info

rmal

consultatio

n with

ACPE

Founding Dean

meets with ACPE

New School Process—Initial Contact to Possible Approval of On-Site

School Actions

ACPE Actions

Compre

hensi

ve o

n-

site

eva

luat

ion in

Fal

l

Pre-C

andid

ate

Statu

s gra

nted a

t

Januar

y m

eetin

g

Teleconference with

ACPE Board

Submit progress

report

Pre-C

andid

ate

Statu

s af

firm

ed a

t

June

Mee

ting

Admit first class in Fall

1 Year

Compre

hensi

ve o

n-site

eval

uatio

n in S

pring

Candid

ate

Statu

s

(2 Y

ears

) gra

nted a

t

June

mee

ting

Teleconference with

ACPE Board

On-site

eva

luat

ion

appro

ved b

y Boar

d at

June

Mee

ting

Meet with ACPE

Board

1 Year

New School Process—Approval of On-site to Candidate Status

Submit progress

report

School Actions

ACPE Actions

Full Acc

redita

tion (2

Years

initi

al te

rm) g

rante

d

by Boar

d at J

une M

eetin

g

Compre

hensi

ve o

n-

site

eva

luat

ion in

Sprin

g

Submit progress

report(s)

Continuat

ion o

f Can

didat

e

Statu

s (2

Yea

rs) g

rante

d at

June

mee

ting

2 Years

Focuse

d on-s

ite

eval

uatio

n in S

pring

Graduation of First Class

Candid

ate

Statu

s

(2 Y

ears

) gra

nted a

t

June

mee

ting

Teleconference

with ACPE Board

2 Years

New School Process—Candidate to Initial Full Status

Teleconference

with ACPE Board

Submit progress

report(s)

Teleconference

with ACPE Board

School Actions

ACPE Actions

Compre

hensi

ve o

n-

site

eva

luat

ion in

Sprin

g

Continuat

ion o

f Initi

al F

ull

Accre

ditatio

n?

June

Mee

ting

2 Years 4 Years

Continuat

ion o

f Full

Accre

ditatio

n?

June

Mee

ting

Full Acc

redita

tion (

2 Yea

rs

initi

al te

rm) g

rante

d by

Board?

June

Mee

ting

Submit

Comprehensive

Self-Study Report

Focuse

d on-s

ite

eval

uatio

n in S

pring

New School Process—Initial Full to Continuation of Full Accreditation

Teleconference

with ACPE Board

Submit progress

report(s)

Submit progress

report(s) School Actions

ACPE Actions

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

http://www.acpe-accredit.org/pdf/Threshold_Document.pdf

29 Point Threshold Rubric

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?

Dean-Submitted Question

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

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?

Dean-Submitted Questions

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)

Required APPETotal

APPEs in Setting

%Precepted by Full Time

Faculty

%Precepted by Adjunct

Faculty

Excess/(Deficit) Rotation Range

by Program

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%)

*Existing or new schools about to produce graduates

Experiential Education Standards –Evaluation Since S2007

(N=49 programs)

S2007 Standard CompliantCompliant

w/ Monitoring

Partially Compliant

Non-Compliant

Standard 14. Curricular Core—Pharmacy Practice Experiences

14 25 8 2

Standard 28. Practice Facilities

29 17 2 1

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

• 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?

Quality/Quantity – Manpower

Dean-Submitted Questions

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

Fact Check―

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

Health Profession/Accreditor

Accredited Programs 2000

Accredited Programs Plus Applications

(Net % Change) 2011

Medicine (LCME) 125 141 (+13%)

Osteopathy (AOA-COCC) 19 28 (+47%)

Nursing (CCNE) DNP = 0 (new degree) 58

Physical Therapy (APTA) 196 229 (+17%)

Occupational Therapy (OTA) 131 154 (+18%)

Dentistry (ADA CODA) 55 60 (+9%)

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

Dean-Submitted Question

NAPLEX Passing Rate for First-Time Candidates 2008 – 2010

Three-Year vs. Four-Year Programs

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?

Dean-Submitted Questions

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