Development of TCM Program Accreditation Standards

Accreditation means an education program has been assessed by an independent third party to determine the extent to which it meets recognized standards of quality and safety. When the standards are rigorous and the process is thorough, achieving accreditation indicates a program is committed to providing its students with a sound, professional curriculum, delivered by qualified instructors, in a supportive learning environment. In many fields, including healthcare, accreditation drives continuous quality improvement and is a fundamental part of the journey to excellence. Accreditation is a process of learning and growing, with a view to ongoing improvement and a particular focus on quality, safety, and ethics and is not intended to be an audit or an enforcement mechanism.

A national accreditation process for TCM/A that is based on the Entry-level Occupational Competency Profile (2018), that embeds the performance indicators, and that emphasizes competency-based learning outcomes, is an important step in raising the profile of TCM/A as a credible and professional health modality.

Institutional accreditation means the entire school (e.g., university, college, or private school) is accreditated. When an institution is accredited it adds a level of credibility to the institution as a whole. In contrast, program acreditation focuses on accrediting individual programs within a school, rather than the whole institution. CARB-TCMPA is developing standards for program accreditation.

It is important to note that it is possible for a program to be accredited and be delievered at an institution that is not. Institutional accreditation can be quite costly and challenging, and many schools may choose to accredit individual programs instead.

CARB-TCMPA engaged Facilitated Improvement for Corporate Success, Inc. (FICS), a professional accreditation development organization, to facilitate the process. Then, an Accreditation Requirements Advisory Committee was convened to provide subject matter expertise on the content of the standards. This group consists of 14 members who have demonstrated experience in the field of TCM/A, including knowledge of occupational competencies, regional regulations, educational programming and leadership, and best practices in TCM/A and education.

From the inception of the accreditation project, CARB-TCMPA has been firmly committed to ongoing and in-depth dialogue and consultation with a wide variety of stakeholders, including owner/operators of private education programs and senior administrators of public programs. In January 2021, the first draft of the standards was put out for national consultation to all TCM/A stakeholders, including owners and senior administrators. Respondents were asked to rate each criterion and provide narrative comments if they so chose.

National consultation results

Over 500 respondents provided their input on the draft standards. The majority of respondents were from Ontario, Alberta, and British Columbia, with the majority being practicing, qualified TCM/A professionals. A total of 28 respondents reported that they were either owners or senior administrators of TCM/A education programs and 19 reported that they were educators in TCM/A programs.

The feedback was extensive and thoughtful. Overall, there was great support for the value of national accreditation and third-party oversight in TCM/A education. Some respondents felt that accreditation should be mandatory if it is to be effective. Each comment was carefully considered in light of how it fit with the overall goal of improving TCM/A education through accreditation and the extent to which it mirrored other comments. This detailed content analysis helped identify several key themes and issues, as follows:

• The potential burden (time, effort, and cost) on private or smaller schools, especially if the standards go beyond regulatory requirements
• Faculty hiring and qualification processes
• Teaching materials
• Practical exam
• Online courses

Based on this analysis, the standards were amended, with a particular focus on reducing the potential burden on private/smaller education programs. They were prepared for presentation to the Accreditation Requirements Advisory Committee along with a detailed list of the changes.

Beyond the program-specific issues listed above, there was also feedback about the use of vague language, such as “regularly,” in the standards. To clarify, the standards deliberately take a non-prescriptive approach. Rather than dictating what a term like “regularly” means (e.g., annually, monthly), the education program is asked to define it based on its own needs, provide a rationale, and show how its definition meets the needs of the program and the students. The effectiveness of its approach is then assessed during the tracer through conversations with staff, students, and others.

To fully determine the extent to which the education program meets the standards, assessors visit the program to observe it in action, and conduct wide-ranging interviews with students, staff, alumni, and many others who may have insights to offer. This process is called a tracer, and it is the heart of the accreditation process. Tracers help create an all-around picture of the whole program, identifying areas where it shines and where it needs to improve.

Canadian TCM/A education programs that want to be accredited by CARB-TCMPA and that are legally permitted to operate as an educational institution in their province.

The accreditation process is flexible enough to accommodate education programs that are public or private, large or small. For instance, consider the requirement about mental or physical health services for students. A public program would likely have an on-campus health centre to which referrals could be made, while a smaller, private school might provide students with an up-to-date list of local health services. Or, to meet the requirement for access to academic resources, the larger program might have a physical library as well as online resources, while the private program might have purchased access to online databases or other such resources. In either case, the requirement is achievable. While the mechanics to meet it are different, based on the nature of the program, the intent – that students can access mental or physical health services or academic resource materials – is fulfilled.

Yes, it is recognized that a period of transition will be necessary. CARB-TCMPA will work with education programs to help them understand the requirements and determine what they need to do to start their quality improvement journey.

Once the Accreditation Requirements Advisory Committee evaluates the national consultation results and reviews and approves the next draft of the standards, the changes will be reviewed with key stakeholders, including education program associations and senior administrators. The standards will then be pilot tested at a variety of education programs – large, small, public, private—from different provinces, and the pilot results will be used to make further refinements to the standards and the process. In addition, assessors, all of whom will be familiar with and committed to improving TCM/A education through accreditation, will be recruited and trained.