Abstract
It seems like people start panicking about their upcoming Joint Review Committee on Education in Diagnostic Medical Sonography (JRC-DMS) site visit, about 2 weeks before it happens. I’ve been through three site visits, as a faculty member, for my own educational program (the initial, 3-year, 10-year, and now our next one is coming up in 2 years). In our program, we are not panicking because we have already begun to prepare. I am currently a site visitor for JRC-DMS and have done about a dozen site visits through the years, both pre and “post” COVID lockdown. I would like to offer some suggestions from the perspective of a person as a faculty member who has been through several site visits and as a site visitor having conducted these evaluations. Here are some of my personal tips that I hope will provide added assistance.
Stay on Top of Changes!
Recently, the Commission on Accreditation of Allied Health Education Programs (CAAHEP) has introduced new standards and guidelines for all the educational concentrations. The JRC-DMS site visitors are now looking at educational programs for evidence that those changes are implemented. I teach the cardiac and vascular educational concentrations, so as soon as the new guidelines came out, I quickly worked to incorporate them into my courses, labs, and clinical requirements, and this was implemented before the guidelines took effect. My intention was to apply these changes and see how it would all shake out, as well as their effect on the students, and clinical sites. I’m glad I made that “dry run” because things popped up that I anticipated, and some things happened that I didn’t anticipate, especially in the cardiac educational concentration. This editorial does not provide enough space to provide specific details, but the important point I want to make is not to wait until the last minute of the semester to adopt the new CAAHEP standards and guidelines. I had the unfortunate experience of conducting a JRC-DMS site visit for a program in which the faculty were unaware of the new CAAHEP standards and guidelines. Consequently, the program had not adopted any of these changes, which resulted in a lot of work for them after the fact.
Organize, Organize, Organize!
Let me once again emphasize, be organized! It is recommended to have a designated person, one faculty memeber, to be responsible for the site visit and accreditation activities, as this will ensure that things are organized. It may be the program’s director, a faculty member, the chair of the accreditation committee, or even someone from upper management that does this for all the programs in the school. As the saying goes—too many cooks spoil the broth. I’ve done site visits where people would look at each other and say, “I thought you were going to take care of that?” and then everyone scrambles around like chickens running to find materials or documentation.
Electronic documentation is much better than paper artifacts. Site visitors have even more documentation to review than previously; therefore, it is quite a feat to squeeze the review into the allotted time frame for conducting the site visit. I love educational programs that have converted to electronic clinical reporting systems like E-value or Trajecsys. It is so much easier for the site visitors to have electronic access, to the required evidence and documents, so it is ready for review rather than having boxes and boxes of paper to review (no matter how small the educational program). My own educational program changed from paper clinical books to an electronic reporting system about 10 years ago. Sure, there is a learning curve to everything, but as a clinical coordinator, I would not want to go back to looking for lost pages, missing signatures, or squinting at food or coffee-stained, half-ripped pages and try to figure out a student’s grade. As a site visitor, my heart sinks when I walk in and see a wall full of boxes stacked on tables in their conference room. In my educational program, we pass the cost of the electronic clinical reporting system to our students. We feel that this cost is about the same as buying a textbook. The feedback has been very positive from the clinical site preceptors and students who are actively using the electronic reporting system.
Review of Clinical Sites Used for Student Training
In my experience as a site visitor, the clinical staff often don’t understand why the site visitors are coming and what this means for them. They are so focused on themselves and their work that they forget this is about the student training experience. Sometimes they get this mixed up with the Intersocietal Accreditation Commission (IAC) or Joint Commission (JC). Here are some tips on the purpose of visiting the clinics, and what you can do to prepare for them.
First, the site visitors don’t want to interfere with clinical work; therefore, just conduct work normally (do what you do). The site visitor needs to spend a few minutes with the student’s preceptor and go through a list of questions to complete. While the site visitor is onsite, they will be looking at the equipment, the scanning rooms, talk with people who are involved with teaching the student, if they are available, and get a feel for their involvement with the student’s clinical coordinator. The site visitor wants to know how much time the student is getting to do exams and what is their clinical load. The site visitor will also interview the student and gauge how they feel the site is as a place to learn. There will also be questions for the staff about their perception of the school or program, if their students are hirable upon graduation, and how much support they have for the school.
Site visitors will visit sites that were chosen by the program, but they can also ask to be taken to sites that are not on the list. Sometimes, if the site is too far away, the site visitor will conduct a Zoom meeting or a phone conversation. Talking to a site business manager or anyone not involved with direct training of the student is never very productive. As stated above, this is not like a JC visit. The site visitors are only interested in the quality of the student experience at the clinical training site.
Site Visitors Are Sonographers Just Like You!
The JRC-DMS site visitors do not work for the organization and are not paid in any way. We are “peers who are volunteers.” However, site visitors are trained to do the site review by the JRC-DMS. Some volunteers have more experience than others, and, like anything, some site visitors are more experienced than others. I have found that every leader for the site visit team has their own way of conducting the business of slogging through all the required evidence. My personal experience is that I’ve never worked with the same volunteer site visitor twice, in 10 years of volunteering with JRC-DMS. Most of the time, I’ve never even met the other volunteer site visitor until arriving at the educational program, under review!
So, in a very short period, the team of site visitors needs to get to know each other, establish some working parameters, divvy up the chores, figure out what to concentrate on, and how the team is going to complete the review. Typically, these decisions are all made the night before the site visit begins. I’ve had to “learn to get along,” with some site visitor teammates, and I’m sure they have had to quickly learn how to put up with my quirks. It has been my experience that everyone I have worked with has been a fantastic colleague and volunteer. The cadre of JRC-DMS volunteers truly take the site visit process seriously and commit to this volunteer activity for the betterment and greater good of sonography education. I’ve learned so much from my colleagues, and I hope they have learned some things from me too.
Professionalism Rather Than Pettiness
A JRC-DMS site visitor’s job is to look for evidence that supports the submitted self-study. The purpose is to see that how the educational program runs is what was written in the submitted self-study. The site visitors are looking for what should be evident but unfortunately is missing, and they also conduct interviews with everyone involved with the program: school administrators, the medical director, the program director, the clinical preceptors, faculty, students, and anyone else associated with the program. My experience is that most programs have a certain level of drama that is occurring behind the scenes. Site visitors are human so they can’t help but pick up on some things that are obviously occurring, be it between faculty and students in the classroom, grievances among the faculty and the administration, and so on.
Regardless of this, the JRC-DMS site visitors must hold the educational program to the published standards and guidelines to adjudicate each program in assigning citations for missing or incorrect items. The personal drama is not a part of any of the educational program assessments. The site visitors illuminate deficiencies to truly help the educational program become better quality. It is also important to remember not to blame the site visitors. The site visit team does not determine whether the educational program maintains or becomes accredited. It is important to remember that educational programs can respond to any citations, as well as utilizing a grievance mechanism, if legitimate concerns are warranted. It is important to underscore that JRC-DMS site visitors are peer educators who are evaluating what is done in a sonography educational program and striving to increase the quality for the students and the profession.
Summary
Consider the JRC-DMS site visit as a mechanism to improve the overall quality of the educational program. The evaluation process is not meant to be an inquisition. The volunteer site visitors are not judging on how things are done in the classroom, rather they are just gathering evidence that the educational program adheres to the published standards and guidelines. How an educator goes about demonstrating compliance is uniquely up to them. Please consider programmatic accreditation as an ongoing process, not something that is done at the last minute every few years before site visitors arrive. I am always amazed at how many ways there are to successfully run an educational program. No two programs are exactly alike so that is something to be proud to demonstrate. On a personal note, I am a textbook nerd, so I enjoy looking at what textbooks’ faculty are using in their classes and why.
Another great way to prepare for a JRC-DMS site visit is to become a site visitor! If interested, please contact Gerry Maggot, at the JRC-DMS office and volunteer to start doing site visits. It is another great way to learn from colleagues about how they do things and incorporate those ideas into your own educational program. Becoming a JRC-DMS volunteer allows participants to learn about what to look for during a site visit, and how an assessment is conducted. I consider myself a people person, therefore my favorite part of conducting a site visit is the networking with colleagues, creating new acquaintances, and friendships across the country. Being a site visitor is a weird combination of fun and intense amount of volunteer work. The working lunches and dinners are truly times of hard work. As a volunteer, you will go home exhausted, but it creates a great feeling of accomplishment. A life of service is a life well lived, in my humble opinion. I am providing my best wishes for those preparing and completing the educational accreditation process, and I hope you pass with flying colors!