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COE FAQS updated
How are COE standards evaluated? What does CHEA recognition mean? How does the COE differ from the accrediting bodies for medical and dental education? These questions and more are answered in the recently updated FAQs on the AVMA website.
Accreditation of distributive model programs
The distributive education model has a long history in the human medical education, but is relatively new to veterinary medical education. Consequently, the Council on Education (COE) placed rigorous requirements on its use from inception. Two accredited colleges, one in the U.S. and one in Canada, have completely distributed clinical training models; however, almost all domestic (U.S. and Canada) veterinary medical college use off-campus clinical sites to supplement and complement academic teaching hospital-based clinical training.
The Council has requirements (see sections 8.1 and 8.2 of the COE manual) in place for the implementation of the distributive veterinary clinical education model, with or without a veterinary teaching hospital on site.
Veterinary medical colleges without a veterinary teaching hospital on site must select clinical sites on the basis of specific criteria, and they must identify the specific areas of instruction occurring at each site (e.g. small animal medicine or cardiology). In addition, the college must designate which of these sites are to be considered primary instructional sites (core clinical sites). Core clinical sites are considered equivalent to an on-campus veterinary teaching hospital and must meet the requirements established for an on-campus teaching hospital. Any college using a distributive model must demonstrate that there are adequate numbers of clinical sites to provide an appropriate clinical educational experience for all enrolled students. Further, colleges are required to provide appropriate administrative and faculty oversight, student support, and regular review of the adequacy of these sites to achieve student learning objectives, and assure that sites meet required facility resource requirements.
Each clinical site should receive financial compensation from the college and is expected to have a formal written agreement that includes expectations for the site. The college is responsible for:
- the establishment of learning objectives for each site;
- providing each site with information on how student performance will be assessed, including documentation of the assessment, and how students will receive feedback from the site;
- ensuring that each site understands what the acceptable levels of student achievement are;
- ensuring that both students and clinical sites are aware of the expectation for security and safety at the site; and
- provision of regular supervision of instructional activities at the clinical site.
Practicing veterinarians supervising clinical training must receive appropriate training in clinical education and assessment, and student progress must be monitored closely during each required clinical rotation. Students are involved in clinical rounds on-site and/or virtual rounds with a veterinary faculty member. Each student must demonstrate an acceptable level of progress in meeting the specific learning objectives established for the rotation.
All core clinical sites must be visited by the site team or representatives of the site team (a minimum of two members) during each comprehensive site visit. The site team will meet with site personnel who supervise and evaluate the veterinary medical students and will evaluate the off-campus site in the same manner that on-campus veterinary medical teaching hospitals are evaluated. The evaluation may be tailored to the specific educational program at each location, but must be based specifically on all pertinent COE standards. The Distributive Model: Off-Site Inspection Guide is the form used by site visit teams to evaluate off-campus clinics. In order to visit each core clinical site the COE may increase the size of the site team and lengthen the time of the site visit to visit each core site.
In addition to visiting all core clinical sites for those colleges using the distributive model of clinical education, all veterinary medical colleges, with or without an on-site veterinary teaching hospital, are subject to the following guidelines regarding what locations must be included in the facilities tour for site visits. All areas (on or off-campus) where all of the students are required to go to for learning (core sites) or all areas where all students in a specific track are required to go for learning (core track sites) must be included in the facilities tour.
The sustainability of any educational model, including clinical training, is a central focus of the Council and each accredited college is monitored and must report how it continues to meet each standard at least annually. Any college planning a substantive change in its curriculum and clinical training program must receive Council approval before implementing the change. If the Council has concerns on compliance with the standards, a focused site visit may occur.
Accreditation requires the assessment of the entire veterinary medical educational program, including the outcomes of pre-clinical and clinical instruction. Standard 11, Outcomes Assessment, requires colleges to use a wide variety of direct and indirect measures of student achievement (outcomes), including the clinical competence of each student. The standards mandate that each college will use the information gathered in the assessment process to improve the veterinary medical educational program and that if a veterinary medical student does not achieve the required clinical competencies remediation will occur for that student.
Summarily, the Council has established requirements for off-campus core clinical training sites and for completely distributed clinical training programs that are regulated through regular review and assessment. These processes ensure integration of defined clinical learning outcomes, with an appropriate case load, contemporary and safe facilities and diagnostic equipment, direct supervision of student learning including active participation in client interaction and case management, and direct assessment of student competency, with regular institutional monitoring of program quality and training of supervising clinical instructors. The Council monitors the quality of clinical training programs through annual interim reports, regular accreditation site visits, and when indicated through focused site visits. As part of the Council’s commitment to continuous quality assurance, a subcommittee of the Council continues to review the requirements for the distributive clinical model to assure continued reliability and validity of this educational approach to clinical training. Finally, the Council is unaware of any objective evidence to document that the distributive educational approach to clinical training results in a veterinary graduate that is less prepared for entry level into the profession.