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

21. Appendices

21.1 Appendix A – Conflict of Interest / Confidentiality Statements
All site team members are required to sign a Conflict of Interest Statement/Confidentiality Statement.

21.2 Appendix B — Accreditation Decision Tree (PDF)

21.3 Appendix C — Guidelines for COE site visit teams – Isolation Facilities/Procedures

Principles:

• It is possible for colleges/schools of veterinary medicine to meet Standard 3, Physical Facilities and Equipment, with a wide range of isolation facilities.
• Other standards are also involved: Standard 9, Curriculum (patient management and care including intensive care, emergency medicine and isolation procedures) and Standard 11, Outcomes Assessment (clinical competencies - health promotion, disease prevention/biosecurity, zoonosis, and food safety).
• The top priority is to educate students on infection control in a safe environment; students must understand the principles and characteristics of an ideal isolation facility.
• It may be possible to mitigate physical facility limitations through the use of effective procedures; emphasis will be placed on implementation of an effective program:
  • Infection control plan must be appropriate for caseload and effectively mitigate facility deficits.
  • Faculty, students, and staff must have an in-depth knowledge and understanding of the infection control plan.
  • Evidence of program effectiveness must be available, for example, nosocomial infection rate, results and analysis of microbial surveillance.

Facilities – "Ideal" General Characteristics:

• Separation from high traffic areas and other animals which might be infected
• Single purpose use
• Equipment and materials dedicated to this area
• Negative pressure air flow
• Ante room
• Easily cleaned and disinfected surfaces
• Other characteristics?

Procedures Must:

• Ensure personnel follow infection control policies related to personal hygiene, patient care, and disinfection of equipment facilities
• Include method(s) to identify potentially infectious diseases upon entry to the hospital
• Address various types of infectious diseases
  • Respiratory – viral
  • G.I. – viral, bacterial, parasitic
  • Zoonotic diseases
• Include workflow and traffic patterns to reduce risk of cross contamination
• Include disposal procedures for potentially infective material, bedding, and animals to limit the potential for cross contamination
• Include appropriate surveillance methods to ensure procedures are effective

Questions for the Site Team to Explore:

• How often are patients placed in isolation in comparison to the total case load?
• Do clinicians and students apply risk assessment to all patients admitted to the veterinary teaching hospital (VTH) - such as risk of spreading disease, zoonotic potential, increased risk of some types of patients in the VTH (immunocompromised, young, non-vaccinated animals, etc.)
• Does the VTH have a method/system to track disease transmission?
• Does the VTH monitor or track potential antimicrobial resistance in their patients?
• Is there a method/procedure to segregate or not admit animals suspected of a specific infectious disease such as:
  • Canine parvo virus, or other types of viral diseases
  • Feline upper respiratory disease
  • Neonatal ruminants with cryptosporidiosis
  • Any animal with Salmonella
• Does the VTH have a biosecurity report that is shared with faculty, students, and staff?
• Is there an active educational process to inform all members of the VTH on issues of biosecurity?
• Are there easily accessible and understood procedures for infectious disease control and is there evidence that the procedures are effective?

21.4 Appendix D — Participation of Site Visit Observers

As a principal goal of accreditation is to improve educational outcomes, we recognize that observation of the practices of the Council of Education as they conduct veterinary accreditation site visits is of value to certain individuals. To facilitate this process, the following policies have been established.

Observers are welcome to participate in COE site visits if the following conditions are met.

1. Each observer must be a(n):
   1. Dean of an accredited school or college of veterinary medicine or
   2. AVMA Executive Board member or
   3. Dean of a non-accredited school or college of veterinary medicine or
   4. Veterinarian or professional educator serving in a leadership role in a veterinary accrediting body with which the AVMA has established a working relationship (the COE will determine when such a relationship exists) or
   5. Recently appointed COE member.
2. The chairperson of the site team and the Dean of the host institution must agree to each proposed observer^*.
3. A total of two observers (from all sources) may be accommodated on each site visit. Observers will be selected on a first come, first served basis within the constraints of the priority list in Item 1 (see above).
4. Observer requirements
   
   All observers must:
   1. Arrange to pay the full costs of their participation in the site visit.
   2. Assume full liability for personal safety during the site visit.
   3. Be competent in spoken and written English.
   4. Attend all functions of the site visit.
   5. Sign a COE confidentiality statement.
   6. Sign a COE conflict of interest statement.
   7. Prepare for the site visit by reading information provided.

21.5 Appendix E — Philosophy and Interpretations of the COE

Introduction

This section of the manual is included to provide a sense of the philosophy and interpretations expressed by various Councils over the years relative to specific accreditation matters. Items included herein do not represent any official Council or AVMA policy. They may be revised, added or deleted on the basis of Council action.

This is in contrast to the main body of the manual which represents official Council and AVMA policy on matters relating to accreditation.

Admission
The Council encourages schools to utilize appropriate individuals (qualified Psychologists) within the university to aid admissions committees in defining and developing improved parameters for selection of students based on the objectives of the school and the needs of society. Studies to aid in defining entering characteristics of students should also assist in planning more flexible educational programs and resources for effective learning.

Admission committees should emphasize in the selection of candidates evidence of scholarly endeavor, acceptable writing skills, analytic skills, and ability to learn independently.

Animal Ownership
The Council encourages the inclusion of instruction in responsible companion animal ownership in the veterinary curriculum. This should include concern for overpopulation, injuries to human beings, environmental pollution, zoonotic disease transmission, nutrition, and prevention of injury and disease.

Caged Bird Medicine
The veterinary profession has a responsibility to provide service in the treatment of disease and maintenance of health in caged birds. Because graduates need to be prepared to meet the demand for such service, colleges should include pertinent material in the curriculum.

Canadian Representative
The Council on Education has agreed that a representative from the Canadian Veterinary Medical Association will be a member of the evaluation teams at US, Canadian, and foreign colleges of veterinary medicine, the expense of the representative to be borne by CVMA.

Site visit teams assigned to evaluate Canadian colleges will include two representatives of the Council and three members appointed and funded by CVMA. A sixth member will represent the provincial veterinary medical association of the province where the college is located and will be funded by AVMA. AVMA staff will organize the evaluation proceedings, provide secretarial service in developing the report of evaluation, and accompany the site visit team. AVMA accreditation policies and procedures will be followed.

One of the representatives of the Council will be appointed chair of the team. At least one representative from each country will represent clinical science and at least one representative from each country will represent basic science.

Consultation
The Council welcomes inquiries relative to further interpretation of the "Standards of an Accredited College of Veterinary Medicine" as published. AVMA staff will respond willingly to solicitations for advice and guidance in the solution of the individual problems of a college of veterinary medicine as they may relate to accreditation.

Cooperative Programs in Veterinary Medicine
A Cooperative Program in Veterinary Medicine consists of a federation of two or more accredited colleges which have affiliated to provide specifically defined components of the educational program of the cooperating institutions. Its purpose is to provide innovative comprehensive programs which may be shared by multiple colleges in an effort to enhance the quality and depth of the instructional process of the specific component, and the efficiency in utilization of specialized resources.

Implementation of such a program may result in economic savings to the participating institutions, contribute to the development of creative educational approaches, provide efficient utilization of facilities, equipment, and specialized faculty, and increase the overall quality of graduates of the professional program.

Consideration for establishment of a cooperative program in veterinary medicine should include:

1. A cooperative administrative plan agreed upon by all of the institutions involved in the program.
2. Well-defined and diligently practiced procedures for accommodating the relocation of students participating in the program.
3. A mechanism which provides for evaluation of the Cooperative Program in relationship to the accreditation process for each of the participating colleges.

Curriculum
The Council encourages the development of institutional individuality and the achievement of excellence without the establishment of uniformity. It is recognized that state, regional, national, and international needs may differ and that only a few schools may need to offer certain unique programs.

1. In its evaluation of the professional curriculum, the Council will consider the stated objectives and performance criteria of the school and how well they appear to meet the needs of the student, society, and the profession.
2. Curriculum planning should reflect:
   1. The results of research on learning and teaching.
   2. Results of studies to determine critical performance requirements for veterinarians.
   3. Efforts to design and provide learning experience that are consistent with the objectives of the curriculum.
   4. Recognition that students learn at different rates and in different ways.
   5. The application of fundamental principles of evaluation to each student's progress in terms of stated performance criteria or objectives.
3. The Council wishes to foster innovation and experimentation in curriculum planning and development with the following basic guidelines:
   1. Such experiments should be planned in consultation with experts in criterion evaluation of learning to provide objective and subjective criteria for periodic evaluation of the changes.
   2. Revisions to provide for elective programs, multiple options, track systems, or areas of concentration within the professional curriculum should be designed to maintain a core of performance criteria to assure that the graduate veterinarian will be able to serve society in the several generally accepted areas of veterinary medical responsibility; that he have fundamental habits of learning and basic skills and knowledge to continue development as a specialist in one or more areas through graduate and continuing education.
   3. Schools intending to make significant revision of the curriculum, their objectives, or major learning experiences, are requested to consult with the AVMA staff during the planning of such changes, so that the Council is kept informed and may respond in an appropriate manner.
4. Curriculum should be under continuing review and revised as deemed necessary to meet the changing needs of students, society and the profession. Learning experiences should be designed to develop habits of self-education and self-assessment.
   1. In view of changes occurring in food animal medicine and the increased emphasis on preventive medicine and herd health programs, schools should review the learning experiences in these educational programs and revise them as appropriate. In addition, the relationship of food animal medicine and food safety should be an integral part of the curriculum.
   2. The Council also wishes to encourage learning experiences for students in work-study programs utilizing public and private practitioners of veterinary medicine as preceptors. Preceptorship or extern programs can augment and enhance learning experiences for students in specialized as well as more general types of public and private practice. These programs should be carefully planned and evaluated in accordance with the objectives of the program and resources available.

The professional degree curriculum should emphasize the acquisition and development of skills, values, and attitudes at least as much as the acquisition of knowledge. Didactic instruction should be limited to provide unscheduled time for independent study and problem solving activity. Evaluation should include the measurement of analytic skill as well as the ability to recall facts.

The curriculum as a whole should encourage humane stewardship of animals, contribute to improved understanding of animal needs, and provide opportunities to consider the scientific, ethical, philosophical, and moral values associated with the use of animals in teaching, research, safety testing, and commercial production.

Over the past several years the AVMA has held numerous task force meetings which have considered all aspects of the profession. These meetings have identified several critical areas necessary for the success of entry-level veterinarians. Many of these issues have a common basis in business and interpersonal management skills.

Integration of the following items throughout the curriculum is believed to be important to the success of new veterinary graduates. Time management, organizational behaviors, communications skills, the time value of money, personal financial management, personal work ethic and contemporary business are necessary in order to succeed in today's professional environment. Additionally, the aforementioned concepts should be extended to externships in the form of written objectives.

Degrees
The Council on Education considers the use of the words "Veterinary Medicine" or "Veterinary Science" in any academic degree below the professional level to be undesirable. The award of such degrees is discouraged because of the danger of confusing the public as to who is, and who is not, capable of delivering professional veterinary service.

Diagnostic Laboratories
The Council recognizes that diagnostic laboratories constitute a very important educational resource, and strongly encourages each accredited college of veterinary medicine to develop and maintain a close working relationship with an appropriate diagnostic laboratory.

Faculty
The Council emphasizes the need for faculty to have and maintain a knowledge of:

1. Learning theory.
2. Results of research on learning and teaching.
3. New developments in the use of technology and learning resources.

The Council will evaluate:

1. Curriculum planning.
2. The general development of educational resources and their use.
3. The general use of instructional objectives, including performance criteria, and
4. Methods and criteria used for evaluation of students' learning.

Veterinary Public Health & Food Safety
A significant societal need is the assurance of a safe and wholesome food supply. Veterinary medical education should provide veterinary students learning experiences which will enable them to assure that animals utilized for food are free of disease and unacceptable drug or chemical residues.

It is equally important to provide veterinary students learning experiences, which emphasize the relationship of zoonotic disease and human health and the actions required to prevent the transmission of these conditions.

For the ongoing benefit of society, continuing education and motivation in relation to these responsibilities following graduation should be an important goal of veterinary medical education and the profession.

Foreign Animal Diseases
Foreign animal diseases and the indigenous "look-a-likes" should be adequately covered in required courses in the curriculum. Students need to learn that foreign animal diseases are constant threats to animal and human health in this country.

Human/Animal Bond and Animal Behavior
The Council on Education recognizes the existence of the Human-Animal Bond (HAB) and its importance to client and community health, that the HAB has existed for thousands of years, and that the HAB has major significance for veterinary medicine because, as veterinary medicine serves society, it fulfills both human and animal needs. The Council has reviewed documents on and surveys about the status of veterinary medical education in the areas of human/animal bond and animal behavior. The Council will continue to review, monitor, and promote the improvement of these subject matter areas in the veterinary medical curriculum.

Laboratory Animal Medicine
The Council on Education encourages humane care, treatment, and handling of laboratory animals. It evaluates in a concerned manner the adequacy of laboratory animal facilities, compliance with the guidelines for the Care and Use of Laboratory Animals and the education program in laboratory animal medicine during visits to each institution. The ideal, of course, is accreditation by the Association for Assessment and Accreditation of Laboratory Animal Care (AAALAC) or, in Canada, the Canadian Council on Animal Care (CCAC). However, the Council does not perceive AAALAC or CCAC accreditation of the laboratory animal program as being absolutely essential for a program in veterinary medical education. The Council evaluates each school as it complies with the published standards of an acceptable veterinary medical school without regard to whether it has been accredited by the various specialty organizations.

Learning Disabilities
The Council on Education expresses its concern that persons with disabilities, including learning disabilities, receive appropriate consideration as required by the Americans with Disabilities Act of 1990 (ADA) in both education and testing situations. In particular, the Council wishes to inform licensing agencies, e.g., National Board Examination Committee, state licensing boards, of the need to comply with this act (ADA) which requires that examinations (and the application process) for licensure/certification/credentialing be accessible to persons with disabilities. Thus the policies of such licensing/testing agencies must comply with this law. Organizations or persons desiring more information about these requirements for testing accommodations are referred to the publication "Exam Accommodations Reference Manual" which is available from the Association on Higher Education and Disability, 107 Commerce Center Drive, Suite 104, Huntersville, NC 28078, Phone 704/947-7779 (website: http://www.ahead.org).

Libraries
The Council does not plan to establish any standards for libraries in colleges of veterinary medicine beyond those listed in the "Standard Requirements."

The Council does not plan to develop a list of recommended publications or books for veterinary college libraries, since such a list tends to become a maximum as well as a minimum requirement, thereby serving to reduce rather than expand the acquisition of new information.

Objectives
The Council encourages each school to develop well-defined educational and outcomes criteria. Such objectives and outcomes criteria should serve as the basis for evaluation of learning by students in the professional curriculum.

Postdoctoral Education
The term "postdoctoral education" includes post DVM/VMD learning experiences which contribute to an increase in knowledge and competence of veterinarians, including, but not necessarily limited to:

1. Internships or residencies with or without the objective of board certification.
2. Graduate programs leading to a master's degree or another doctoral degree.
3. Formal academic courses without degree objectives.
4. Seminars, short courses, conferences, with or without award of certificates, academy credit, and/or Continuing Education Units (CEU).
5. Other college-sponsored or recognized learning experiences with or without award of CEU or other credit.
6. School motivated learning experiences recognized as continuing education which add to knowledge and competency of veterinarians.

Preceptorship
The Council recognizes the value of preceptorship programs to broaden students' knowledge of various modes of veterinary practice.

Relation to Other Colleges
Veterinary medicine occupies a unique position as a bridge between medicine, agriculture, and biology. Colleges of veterinary medicine that enjoy close geographical and functional relations with schools of medicine and agriculture and with departmental or other groupings in the biological sciences are greatly strengthened.

Role of State & Canadian Veterinary Medical Associations

1. Each site visit team designated by the Council on Education to evaluate a college of veterinary medicine in the accreditation process includes a representative of the Canadian Veterinary Medical Association and a representative of the state veterinary medical association of the state in which the college is located. These members are designated by the organizations they represent. Other members of the committee are elected members of the Council on Education or site team associates, assigned to the committee by action of the Council. The dean of the college concerned has the right to challenge the appointment of any member of the committee and request replacement.
2. Team members representing CVMA and the state veterinary medical association are considered to be full voting members of the site visit team. They will be expected to:
   1. Review the self-evaluation report and other material provided by the college, and note any apparent discrepancies with the Standard Requirements of an Accredited College of Veterinary Medicine.
   2. Accept assignments by the committee chair of specific parts of the evaluation report for which they will have primary responsibility.
   3. Participate in all phases of the site visit. When the site visit team is divided into clinical and preclinical groups, the CVMA and state VMA representatives are free to choose which group they will join. They will be welcome to ask any pertinent questions during the various meetings included in the visit, and are expected to take notes of the information gathered at those meetings.
   4. Serve as resources for information and attitudes from their organizations. The representative of the state VMA particularly will be expected to provide input concerning the relationships of the college to the general public and the veterinarians in the state.
   5. Participate in the development of the evaluation report. This function will begin at the executive sessions during the visit, and continue through the review of whatever number of drafts are circulated by mail during the ensuing weeks.
   6. Terminate their service with the committee upon completion of the report of evaluation. They will not attend the meeting of the COE at which the report is reviewed and acted upon.
   7. Observe the confidentiality of the information obtained during the evaluation process. The findings and opinions of the review committee and the site visit team are not to be discussed with anyone outside those bodies. The content of the evaluation report is disclosed only to the college, its parent university, and the COE. Great damage can be done to the college and to the Council by the dissemination of isolated facts without the total background. Strict observance of confidentiality by the committee is the key to getting full and uninhibited disclosure from the college.
   8. Recognize that the site visit is a fact-finding mission, and is neither an instructional nor a social occasion. When administrators, faculty, or students want advice, they ask. It is not appropriate for team members to volunteer personal opinions or references to procedures at other colleges.
3. With the exception of foreign veterinary colleges, the AVMA reimburses state VMA or provincial representative participant expenses, and the CVMA pays the expenses of their participant(s) on accreditation site visit teams.

Safety of Animals and Handlers
Members of the COE place a great deal of emphasis on safety of animals and handlers, students, and faculty members. In standard 3 (physical facilities and equipment) and standard 9 (curriculum), mention is made of humane care and treatment of animals as well as a mandate to maintain clinical equipment to allow examination and treatment. A prime consideration of the site visitors is the issue of safety as related to physical facilities and equipment, personnel, and animals.

Specialty Education

1. Definitions
   Internship – An internship shall be one year of flexible rotating clinical training in veterinary medicine beyond the professional degree.
   Residency – A residency shall be advanced, structured, clinical training in a specialty in veterinary medicine taken after completion of an internship or its equivalent.

Veterinary graduates should have:

1. An understanding of the importance of quality control (peer-evaluation) in the generation and dissemination of new knowledge (i.e., to distinguish between what is known, what is anecdotal, and what is unknown).
2. An ability to read and critically evaluate the scientific (veterinary medical) literature.
3. An ability to generate, record, standardize, evaluate, manage, and retrieve high quality data.
4. An understanding of the ways in which the research enterprise links veterinary medicine to other sciences, such as animal behavior, drug safety and development, animal science and husbandry, human medicine, etc.
5. An ability to apply the scientific thought process (hypothesis testing) to individual case evaluation.
6. An ability to apply new knowledge to the practice of veterinary medicine (i.e., apply a new surgical technique).
7. An ability to define the current limit of knowledge, and therefore identify priorities for where new knowledge is needed.
8. An ability to educate clients and the public regarding the current status and need for new knowledge in veterinary medicine.

^* Observers from the RCVS require only approval by the dean.