17. Quality Assurance
17.1. Development of Accreditation Standards
The COE is charged with developing, adopting, and implementing standard requirements for the accreditation of veterinary colleges and schools, leading to the degree of DVM, VMD, or equivalent. The COE reports the development of new standards or changes to existing standards to the AVMA Board of Directors; and that action is reported to the AVMA House of Delegates.
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 Board of Directors, 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. Notification of the open comment period to the profession and the public will be via AVMA communication modalities, e.g. blogposts, electronic newsletters, and by posting on the AVMA website (in the public section). All college deans, regional accreditors, and selected specialized accreditors are provided the opportunity to comment on the 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. Changes reported to the AVMA Board of Directors 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 Council on Education manual. The manual is updated semi-annually, as needed.
17.2. Review of Established Standards
The Council's ongoing review of the standards results in their evolution, based upon changes in the educational and professional community. Requests for modifying the standards are received from a variety of sources, and action on these suggestions is the result of broad input by the profession, reporting to the AVMA Board of Directors, and review by the AVMA House of Delegates. Two forms of revision are used: the revision of an existing standard to meet evolving educational and professional needs; and developing a new standard in response to changes in contemporary education, or professional needs or processes. As a result of these processes, standards may be revised, added, or deleted.
17.3. Adding or Revising a Standard
- A proposal for revising a standard is developed.
- The COE Committee on Academic Affairs 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.
- Approved revisions are circulated to deans of veterinary colleges and others (as described in 17.1 above) for input.
- Adopted changes are reported to the AVMA Board of Directors 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 of 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 reported to the AVMA Board of Directors 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 JAVMA and on the AVMA web site (in the public section), and through AVMA communication modalities (e.g. blogs, electronic newsletters).
17.4. 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.
17.5. Application of Standards
The evaluation process for the application of 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 NAVLE scores to verify adequacy and relevance through student outcome; (3) a survey of the college site visit participants to ensure 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 in Section 17.3); (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 site team members to ensure consistent understanding and application of the standards.
To ensure confidentiality in survey results and the NAVLE scores in relation to colleges, the AVMA Statistical Research Group (SRG) within the AVMA Marketing and 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. Changes reported to the AVMA Board of Directors reflect the input from all groups of interest.
17.6. Ongoing Review of Standards
In order to ensure 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.
17.7. 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 COE members and site team observers, 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.
17.8. Survey Process
The Council uses a short survey to evaluate the adequacy of the standards as a whole in conjunction with a larger survey based on the system of Parks and Hendrick, international experts in evaluation accreditation standards. The larger survey instrument 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 5200 veterinary practitioners, the executive director of each state veterinary medical association, 2400 faculty members in US veterinary colleges, 1700 currently enrolled fourth-year veterinary students in US veterinary colleges, and deans from the 30 US veterinary colleges. Sample sized for veterinary practitioners, veterinary faculty and senior students were selected to provide a minimum confidence level of 95% +/-5. At the same time the statistical survey is being completed, a survey instrument assessing the ease and consistency of interpretation of each of the standards and a measure of the level of contribution of each standard to the preparation of graduates will be posted on the AVMA website (in the public section). This survey will be open to the profession and the public for the same time frame as the statistical survey is open.
Data collected are analyzed and summarized by the AVMA survey research group; 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 80%. Proposed revision to the standards is initiated when the review of the analysis is complete.
17.9. Review of NAVLE Scores
The 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.
17.10. Survey of Site Visit Participants
Following a site visit, the dean is asked to provide each faculty member, student, and administrator information to access an on-line evaluation form. Site team members also complete the post-site visit evaluation form. 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, the COE reviews the recommendation and initiates necessary changes to improve the site visit to ensure that the standards are applied in a reliable manner.
17.11. Data Collection
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 ensure 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 complimentary subscription to the JAVMA. 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 ensured 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 ensured by the make up of the team (see Section 18), training of COE and site team members, ongoing review of the standards as applied, database utilization, literature review, and by the survey of the college site visit participants.