Greetings colleagues!
I hope that you all had a joyous holiday at home with your families and have gotten your new semester/quarter/trimester off to a great start. We know this is a busy time for everyone, so I appreciate anyone who takes the time to read this column.
I'd like to explore with you two parallel processes currently underway to redefine excellence in the field of healthcare management education, one at the undergraduate level and one at the graduate level. And I would ask you all to read the whole blog as I think that we can all learn from each other, regardless of the type of program in which you teach.
AUPHA staff and a dedicated group of volunteers known as the Undergraduate Criteria Review Committee have been hard at work revising the criteria for undergraduate review. Substantial changes in the criteria are proposed that will provide greater clarity to expectations and a more consistent approach to review. We have borrowed a great deal from the current CAHME standards in terms of defining the desired curricular design and required content. By providing greater definition and explanation around the curricular areas, the work of both the program in writing its self study and the review panel in reviewing it will be greatly simplified.
The proposed undergraduate criteria do not restrict the educational format in which a program is delivered. This means that a fully online program will have the option to stand for certification if it meets all of the eligibility requirements. Included in the eligibility requirements and criteria, though, are strengthened requirements regarding the number of faculty in a program relative to the size of the student population, the expectation that all certified programs have a minimum 120 hour supervised internship, and that at least 25% of a student's coursework be delivered by a full time faculty member employed by the university. The Committee believes strongly that while the mode of delivery of the curriculum does not impact the quality of the education, these other elements are fundamental to ensuring program quality and consistency between programs.
The proposed revisions to the criteria will be shared with the Board and the undergraduate program faculty in the coming weeks. AUPHA will hold a webinar in the spring to invite your feedback and exchange of thoughts. Please be on the lookout for the proposed revisions and take the time to respond.
Simultaneous with AUPHA's work in revising the undergraduate review criteria, CAHME's Standards Council has been working on a revision to the CAHME accreditation standards. These proposed standards revisions were shared with programs in January, and an excellent synopsis of the standards revisions and FAQs were sent out by CAHME in their Chronicle last week. I encourage all of you to read that if you haven't already.
Faculty and program directors will have several opportunities to share their thoughts on the proposed revised CAHME standards and AUPHA will be listening to your comments and compiling a response to CAHME on behalf of the field. I hope that you will all give careful consideration to what these revisions will mean not only to your program but also to the field of healthcare management education in general.
With the revised standards CAHME has sought to:
- streamline the programs’ data collection process;
- eliminate redundancies across the Criteria;
- reduce duplication of effort for dually accredited programs; and
- enhance the program’s flexibility in aligning their curriculum design with their program’s unique mission and vision, as well as feedback from their stakeholders.
The proposed standards eliminate the nineteen required content areas entirely, replacing them with one criterion that requires that, “The program curriculum will provide students with an appropriate depth and breadth of knowledge of the healthcare system and healthcare management.” While the content areas have never been intended to serve as a curriculum roadmap (it is not necessary to have a course in each of the 19 areas), they provide guidance to programs on what is essentially the core of a graduate degree in healthcare management, that which all CAHME accredited programs have in common, and that to which the program can point and say "our students know this stuff." Lacking a set of common competencies that have been adopted field-wide, graduate healthcare management education has, by default, been defined by those 19 curriculum areas.
While I recognize that the new standards may alleviate much of the burden of writing a self study from the program seeking accreditation, I am extremely concerned about what this move away from a core set of expectations around curriculum will mean to the field broadly. I fear that it won't be long before a student can graduate from a an accredited graduate program in healthcare management without ever being exposed to health IT, or ethics, or even finance. I also anticipate that it will be very difficult for site visitors to apply a consistent and credible approach to accreditation across programs and between teams. Without a framework of content to look for, how will these teams assess the quality of the overall curriculum? I can envision a time when CAHME accreditation, a brand which has made great strides in the last 5 years to represent the pinnacle of quality in graduate healthcare management education, will lose its potency because it will be impossible to define what all graduates of all accredited programs know and can do. Consistency of product is key to brand loyalty!
At the heart of it all, however, I worry that healthcare management, which AUPHA has sought long and hard to position as a profession, will come to be viewed by the practice community as nothing more than a set of skills and competencies that vary by individual depending on which program they have attended. Lacking any barrier to entry into the field of practice, if healthcare management is nothing more than a set of skills and competencies, without a framing foundation of knowledge, does the field need 100+ academic programs offering degrees in the subject? Healthcare management is already viewed by some as a vocation rather than a profession. The adoption and application of these new standards could go a long way to furthering that perception.
I have no doubt that CAHME has a plan to address these issues should the standards be approved. John and his team have done tremendous work over the last few years to add credibility and vitality to the accreditation process, and there is no doubt that programs value accreditation and the collegial process far more than they did in the past. But I fear that we are heading towards a slippery slope that could undo all of the good that has been done if we lose the consistency and transparency of the process that they have worked so hard to develop.
Perhaps there is a middle ground that would allow CAHME to achieve the objectives noted above while still preserving an agreed-upon definition of what a graduate degree in healthcare management represents. Perhaps there is a need for a widely-accepted single set of competencies that are adopted by all graduate programs. Or perhaps there is a greater role for AUPHA in defining the body of knowledge. All of these are issues that the AUPHA Board will explore as part of our strategic planning retreat in March.
These are my personal perspectives and do not represent a consensus of the Board. At the end of the day, my role is to listen to you, AUPHA's members and stakeholders, and allow you to speak with one unified voice. I look forward to hearing from all of you about your perspectives on this issue, and when the time comes, will present to CAHME a response that represents the membership, not my own thoughts. While I have no doubt that the revised standards present a significant improvement over the old at the individual program level, my job is to look at them from a field-wide perspective. My purpose with this blog is simply to get you thinking about the impact on the field and get your reaction to the issues I've raised.
I will be sharing this column over the Network and inviting a conversation on this topic, but invite you also to send me your thoughts directly if you wish to do so.
I hope to see many of you in March at the Leaders Conference!