1. 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

2. 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

3. 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

4. ACPE Communications Assessment October – December 2010 Key Issues Identified Process vs. Outcomes Assessments Quality vs. Quantity Transparency Consistency in Accreditation Review Collaborative Approach

5. 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

6. 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

7. ACPE Stakeholder Conference September 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

8. ACPE Stakeholder Conference Objectives 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

9. S2007 Guidelines 2.0 Please discuss the “effective date” and when schools will be held accountable for new guidelines during reviews. Dean-Submitted Question

10. 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

11. 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

12. 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

13. 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?

14. 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

15. 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)

16. Pharmacy School Graduation Trends Source: AACP Fall 2010 Data and ACPE February 2011 Estimates Number of Graduates Pharmacy school graduates 2011–2014 projected based on current enrollment and ACPE-estimated attrition

17. Fact Check― Are new colleges and schools of pharmacy primarily responsible for this increase in pharmacy graduates since 2003?

18. Increase in Pharmacy Graduates Since 2003

20. 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

21. NAPLEX Passing Rate for First-Time Candidates 2004–2010 Pre-1995 versus Post-1995 Programs

22. 2010 NAPLEX Passing Rate Spread for Pre-1995 versus Post-1995 Programs Percentage of Programs n = 1 n = 12 n = 10 n = 3n = 1n = 2 n = 6 n= 23

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

25. 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)

27. 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)

28. Informal consultation 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 consultation by ACPE staff Final application report April 1 Application reviewed by Application Review Team On-site evaluation approved by Board at June Meeting Representatives meet with ACPE Board ± 9 months Informal consultation with ACPE Founding Dean meets with ACPE New School Process—Initial Contact to Possible Approval of On-Site School Actions ACPE Actions

29. Comprehensive on- site evaluation in Fall Pre-Candidate Status granted at January meeting Teleconference with ACPE Board Submit progress report Pre-Candidate Status affirmed at June Meeting Admit first class in Fall 1 Year Comprehensive on-site evaluation in Spring Candidate Status (2 Years) granted at June meeting Teleconference with ACPE Board On-site evaluation approved by Board at June Meeting Meet with ACPE Board 1 Year New School Process—Approval of On-site to Candidate Status Submit progress report School Actions ACPE Actions

30. Full Accreditation (2 Years initial term) granted by Board at June Meeting Comprehensive on- site evaluation in Spring Submit progress report(s) Continuation of Candidate Status (2 Years) granted at June meeting 2 Years Focused on-site evaluation in Spring Graduation of First Class Candidate Status (2 Years) granted at June meeting 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

31. Comprehensive on- site evaluation in Spring Continuation of Initial Full Accreditation? June Meeting 2 Years 4 Years Continuation of Full Accreditation? June Meeting Full Accreditation (2 Years initial term) granted by Board? June Meeting Submit Comprehensive Self-Study Report Focused on-site evaluation in Spring 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

32. 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

33. http://www.acpe-accredit.org/pdf/Threshold_Document.pdf 29 Point Threshold Rubric

34. 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

35. 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

36. 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

37. APPE Preceptor Data (N=39 programs,* F2008–F2010) Source of PreceptorsProgram 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

38. APPE Preceptor Data (N=39 programs,* F2008–F2010) Required APPE Total APPEs in Setting %Precepted by Full Time Faculty %Precepted by Adjunct Faculty Excess/(Deficit) Rotation Range by Program Community5,0942%98% 0 – 1,299 (0 – 93%) Hospital/ Health-System 5,0078%92% 0 – 647 (0 – 84%) Ambulatory Care 4,98232%68% -65 – 307 (-30 – 88%) Inpatient/ Acute Care 6,64630%70% 0 – 443 (0 – 84%) *Existing or new schools about to produce graduates

39. Experiential Education Standards – Evaluation Since S2007 (N=49 programs) S2007 Standard Compliant Compliant w/ Monitoring Partially Compliant Non- Compliant Standard 14. Curricular Core—Pharmacy Practice Experiences 142582 Standard 28. Practice Facilities 291721

40. 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

41. 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

42. 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

43. 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

44. Fact Check― Do the accrediting bodies for other health professions dictate the quantity of schools or numbers of graduates?

45. Growth Trends in Education Among Other Health Professions Health Profession/ Accreditor Accredited Programs 2000 Accredited Programs Plus Applications (Net % Change) 2011 Medicine (LCME)125141 (+13%) Osteopathy (AOA-COCC)1928 (+47%) Nursing (CCNE)DNP = 0 (new degree)58 Physical Therapy (APTA)196229 (+17%) Occupational Therapy (OTA)131154 (+18%) Dentistry (ADA CODA)5560 (+9%)

46. 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

47. NAPLEX Passing Rate for First-Time Candidates 2008 – 2010 Three-Year vs. Four-Year Programs

48. 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

49. 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

50. 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

51. 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

52. “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