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Accreditation Policies and Procedures of the AVMA Council on Education (COE)
Revised April 2008

7. Development of Accreditation Standards

In developing standards, all committees of interest within the COE are substantially involved in the process. Outside input comes through the House of Delegates, the Executive Board, councils and committees of the AVMA, practitioners, and other interested parties. Suggested changes in the standards are placed on the AVMA website (in the public section) requesting comments from the profession and the public. All college deans, regional accreditors, and selected specialized accreditors are provided the opportunity to comment on proposed standard changes by direct notification. Comments are received by the staff to the Council for a period of two weeks; comments received are considered by the COE in suggesting changes to the standards. Recommendations to the AVMA Executive Board for approval of standard changes reflect the input from all groups of interest. The process culminates in the adoption of standard requirements which are published in the Accreditation Policies and Procedures of the AVMA COE Manual. The Manual is updated annually.

1. A proposal for revising a standard is developed.
2. The COE Academic Affairs Committee considers the revision in relation to changing educational processes, demographics, impact on the profession, impact on the students and faculty, impact on the colleges, and expected outcome for students. Recommended revisions are approved by the Council.
3. Approved revisions are circulated to deans of veterinary colleges and others (as described in 7. above) for input.
4. Adopted changes are approved by the AVMA Executive Board and reviewed by the House of Delegates and conveyed to the colleges and the profession.

Initiation of action for revision of a standard(s) will occur within 12 months of the determination by Council that a revision is needed.

Each year, four standards for accreditation are comprehensively reviewed by the COE Committee on Academic Affairs. As a result of this review, standards may be revised or refined for clarification, undergo no change, be dropped, or be subjected to comprehensive revision resulting in a more effective means of assessing the veterinary medical programs. Using the above-noted system, review of the 11 standard requirements occurs approximately every four years, to coincide with the Survey of Stakeholder Groups in the validity and reliability assessment.

When modification occurs, the revision is approved by the AVMA Executive Board and reviewed by the AVMA House of Delegates. Deans of colleges of veterinary medicine are notified of the change and given instruction on implementation. Finally, the veterinary medical community is notified of the change through publication in the Journal of the American Veterinary Medical Association.

7.3. Assessment of Revised Standards
The COE believes a minimum time span should elapse between the adoption of new or revised standards and their implementation. While the COE believes some time is necessary to allow colleges to understand and adjust to the new or revised standard(s), rapid implementation is necessary so that colleges can gain experience each year of the curriculum. Assessment of new or revised standards will be initiated at the end of one year.

7.4. Application of Standards
Accreditation decisions are based on a program's substantial compliance with the Council's published accreditation standards. Ideally, all standards will be met or exceeded for the Council to grant full accreditation. In reality however, compliance with a given standard(s) may be partial. The Council may determine through its evaluation process that full compliance can be achieved within six months to two years. If minor deficiencies are identified, the Council may determine that a college is in substantial compliance and note those standards with which the college is not in full compliance. In these cases, the Council shall notify the college of the deficiencies, suggest remedies, set a time frame for the changes to be made, direct that needed changes be made, require that a report of correction be sent to the Council. If the college fails to comply with the standard(s) for cause, the COE may extend substantial compliance for no more than two years. If the college fails to comply with the standard(s) within six months to two years, the college will be placed on terminal accreditation status. Further recommendations to bring the program into full compliance may result from the response.

7.5. Review of Standards
In order to assure that the Standards of Accreditation meet the needs of students in colleges offering educational programs in veterinary medical education and the resultant practitioners in the profession, the adequacy and relevancy of the standards must be assessed on an ongoing basis. For the purpose of definition, adequacy is a measure of quality in outcome (preparation for practice) while relevancy measures the consistent application and interpretation of the standards. In order for standards to be adequate, they must be relevant.

The evaluation process for the standards consists of seven components: (1) a survey of relevant groups to assess the adequacy of all components of each standard; (2) an evaluation of the North American Veterinary Licensing Examination (NAVLE) scores to verify adequacy and relevancy through student outcome; (3) a survey of the college site visit participants to assure the consistency in application of the standards; (4) the annual review by the COE Academic Affairs Committee evaluating four standards, and when necessary, changing or eliminating standards (process described elsewhere); (5) encouraging COE members to read current literature in veterinary practice; (6) database retrieval for application of the standards; and (7) the provision of training all COE members annually and for novice site team members to assure consistent understanding and application of the standards.

To assure confidentiality in survey results and the NAVLE scores in relation to colleges, the AVMA Statistical Research Group (SRG) within the AVMA Communications Division distributes, collects and analyzes materials from all participants or organizations.

When changes in standards are proposed by the Council, comment is welcomed from the profession and the public. Input from deans of colleges is collected by direct mailings and input from the profession and public is collected through the AVMA website. Proposed changes are listed on the AVMA website in the public sector and a time limit for comment is indicated. The Council considers all comments before finalizing proposed changes in the standards. Recommendations to the AVMA Executive Board for approval of standard changes reflect the input from all groups of interest.

7.6. Annual Review of Standards
Annually, four standards are reviewed in depth by the Academic Affairs Committee. The review consists of carefully reading the standard for content, clarity, and contemporary need. Since all members of the committee serve as site team members, the evaluation of the standard includes that experience. Further, the committee considers comments from any source, paying particular attention to third party and student comments (if any); the survey of education consumers (see below); outcomes of the site visit surveys; and any other available resources. The full Council considers recommendations from the Academic Affairs Committee and initiates the process to make changes where deemed necessary.

7.7. Survey
The process employed to evaluate the adequacy of the standards is based on the system of Parks and Hendrick, international experts in evaluation accreditation standards. The questionnaire was developed by reducing each standard to its simplest components. Assessed in this format are the ease and consistency of interpretation of the components of each standard; and a measure of the level of contribution of each component to the preparation of graduates.

A survey is conducted every four years. The survey sample includes 500 veterinary practitioners, 100 members of state veterinary medical associations, 250 faculty members in veterinary colleges, 250 currently enrolled students in veterinary colleges, and deans from 28 veterinary colleges. The sample represents approximately 1.9% of the profession.

Data collected is analyzed and summarized by the AVMA SRG; the analysis is presented to the COE. The Committee on Academic Affairs evaluates the survey analysis for impact on the standards and presents appropriate recommendations to the COE, based on its evaluation. The Council may request further analysis if the responses related to 1) ease of interpretation, or 2) the level of importance as a contributor to the education of veterinary professionals for any standard component is below 70%. Proposed revision to the standards is initiated when the review of the analysis is complete.

7.8. Review of NAVLE Scores
The North American Veterinary Licensing Examination (NAVLE) assesses entry-level competency for licensure to practice veterinary medicine.

The SRG evaluates NAVLE results annually, by noting significant changes in scores and passing rates over time, and significant differences in scores or passing rates among graduates from different veterinary colleges. Decreasing scores may indicate a reduction in the adequacy of the standards, while significant differences among graduates from different colleges may suggest the standards are not relevant.

During the fall meeting, the Academic Affairs Committee reviews the SRG analysis. Recommendations from this committee are used to assess the potential for needed changes in or application of the standards. Processes are initiated by the COE to make necessary changes.

7.9. Survey of Site Visit Participants
Following a site visit, the dean is asked to distribute an evaluation form to each faculty member, student, and administrator. The SRG conducts an analysis of the survey according to frequency and distribution of response, and prepares a report to the COE. The COE Committee on Evaluation studies the report and makes recommendations to the Council regarding changes to be made in the site visit process. During its fall meeting, COE reviews the recommendation and initiates necessary changes to improve the site visit to assure that the standards are applied in a reliable manner.

7.10. Database
A database system is used to log the conditions of accreditation evaluation and decision outcomes. The data are employed at each site and COE meeting to assure equitable and consistent application of the standards. Inconsistencies are noted by AVMA staff and the committee chair who provide guidance in accreditation discussions.

Additionally, all COE members have access to current practice literature through their AVMA membership, or in the case of public members a complementary subscription to the Journal of the American Veterinary Medical Association. The Journal provides full text, and article and interpretative summaries of the most recent scientific findings in veterinary clinical practice. The COE members are encouraged to read the information as a benchmark of current clinical practice and education, and to apply the knowledge to program evaluation. Further, a strong awareness of current clinical practice is important in the critical review of the standards for adequacy and relevancy.

In summary, adequacy of the standards is assured by the results of the questionnaire which survey appropriate groups, analysis of the NAVLE examination, and the COE process used to routinely review each standard. The relevancy of the standards is assured by the make up of the team (see elsewhere), training of COE and novice site team members, ongoing review of the standards as applied, database utilization, literature review, and by the survey of the college site visit participants.

7.11. Distributive Model Clinical Site for Colleges with Teaching Hospitals

1. A site where integral/fundamental (core/required) education is provided in either a track or standard curriculum.
   
   
2. The site is externally located from the main campus and is (usually) not administratively associated with the degree granting institution.
   
   
3. Professional staff providing education are not employees of the degree granting institution but may be receiving remuneration as a contractor, fee-for-service provider, etc. for time/effort devoted to the educational program.
   
   
4. The site must be visited during each student rotation by an appropriate college faculty member to ensure that appropriate student services, including safety, are provided and that physical facilities are adequate and the educational program is being delivered appropriately.
   
   
5. 5There must be a written description of the educational objectives expected to be achieved at the site and a mechanism for assessing the success of the educational process, i.e. proof that educational objectives are being met.
   
   

7.12. COE Guidelines for Implementation of a Distributive Veterinary Clinical Education Model

1. The clinical sites selected by a college to serve in a distributive clinical educational model should receive appropriate financial remuneration per student from the college in order to help ensure that students receive on-site supervised clinical instruction, with formal written contract of expectations.
   
   
2. The college must prepare and distribute appropriate materials for clinical site educators that detail objectives of the program, expectations of the site coordinators, clinical site educator training materials, instructions concerning the format the college wants used to evaluate student performance and provide feedback to students on progress/deficiencies associated with site experience.
   
   Additionally the college must provide to the students, and clinical site educators alike, the expectations of the college for student safety and security while the student is on site.
   
   
3. Distributed clinical sites must be selected on the basis of specific criteria and identified for instruction in precise disciplines (defined by the college) such as, but not limited to: Food Animal/Equine/Small Animal Medicine; Food Animal/Equine/Small Animal Surgery or Food Animal or Equine or Small Animal Medicine and Surgery; Dermatology, Imaging (radiology, etc.), Neurology, Cardiology, Critical Care Emergency Medicine, etc.
   
   For distributed clinical sites the college must take steps to ensure that the educational objectives and anticipated outcomes are thoroughly promulgated and understood by students and clinical site coordinators alike.
   
   
4. The college must designate to the COE what clinical sites are considered as primary instructional sites as defined by Standard 9 (c) and these will be considered by COE as core instructional sites. These sites must be in compliance with AVMA-COE Standards.
   
   
5. The college must document/assess that students and educators clearly understand how evaluation and grading practices will be conducted at each clinical site including clinical competencies.
   
   
6. Veterinarians must be licensed and technicians should be certified, licensed, or registered as appropriate to that jurisdiction.
   
   
7. The college must document that students are fully informed concerning their ability to report any and all safety, physical, and emotional concerns to the college.
   
   
8. The college must put in place a system to regularly monitor/supervise the instructional activities at each clinical site and report this system with any subsequent changes and outcomes to the COE.
   
   
9. Each clinical site educator must abide by a process devised by the college to provide a written evaluation of the performance of each student.
   
   
10. Students must provide the college with an evaluation of each site (after the respective rotation) including an evaluation of teaching at the site and the student's opportunity to perform hands-on procedures at the site. The college must summarize this information for the COE.
    
    
11. COE may inspect clinical sites at any time students are present; these inspections, including travel and per diem costs, will be at the expense of the college.

The college must put in place a system to measure and document clinical competencies outcomes at clinical sites as specified by the COE (Policy and Procedures Manual section 21.11.3) to assess clinical sites.