Task Force on Certificate Program Standards & Accreditation Members Present: Sophie Heyman (NJ), Chair; Paula B. Hinson (TN), Jeff Lurey (GA); Fred H. Mills, Jr. (LA). Others Present: Jerry Moore (AL), Executive Committee Liaison; Carmen A. Catizone, NABP executive Director/Secretary; Barbara Nepi, Melissa Madigan, NABP Staff. Invited Guests: Walter Morrison, University of Arkansas, College of Pharmacy; Daniel A. Nona, American Council on Pharmaceutical Education; Kimberly Werner, American Council on Pharmaceutical Education. Absent: Lori Bassinger (MA), Oren M. Peacock, Jr. (TX), Richard Penna, American Association of Colleges of Pharmacy. The Task Force on Certificate Program Standards & Accreditation (TFCPSA) met December 12-13, 1997, at NABP Headquarters in Park Ridge, Illinois. The Task Force was established by the NABP Executive Committee in response to Resolution No. 93-5-97, Standardization of Qualifying Criteria for Certification Programs, which was approved by the delegates to the Association's 93rd Annual Meeting in San Diego, California. Resolution 93-5-97 reads as follows: Whereas, certification programs in disease state management are proliferating; and Whereas, currently there does not exist an organized, national, or standardized process for certification program development; Therefore Be It Resolved that in order to protect the public health and ensure practice competence, NABP, in conjunction with any organization(s) this association deems appropriate, assemble a task force to develop certification standards and accreditation for certification programs in disease state management. Review of the Task Force Charge Task Force members reviewed their charge and agreed to expand its scope to include not only the review of certificate programs, but also the review of general-level pharmacy certification processes, such as those in disease state management. The amended charge reads: 1. Review the current status of pharmacy certificate programs and general-level, nonspecialty pharmacy certification processes, examining how they are being used and NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (P) 847/391-4406 (F) 847/391-4502 www.nabp.net
the impact of these programs on the public health; 2. Develop national standards and an accreditation process for certificate programs and certification processes; 3. Determine how the standards will be monitored. Task Force on Certificate Program Standards & Accreditation Recommendation #1 The Task Force on Certificate Program Standards & Accreditation recommends to the Executive Committee that: 1. NABP staff work with the American Council on Pharmaceutical Education to update the definitions for the term certificate programs as well as the guidelines for certificate programs developed at the 1989 American Association of Colleges of Pharmacy (AACP)/ACPE Conference on Certificate Programs for presentation to, and possible adoption by, the member boards of NABP at the 1998 Annual Meeting; 2. NABP share the updated definition and guidelines with other interested organizations, associations, and entities; 3. NABP participate with other organizations and associations in a national conference whose purpose is to develop specific standards and requirements for the recognition and implementation of certificate programs; 4. NABP ask ACPE to be responsible for the approval and monitoring of certificate program standards and providers. Task Force members discussed the myriad of certificate programs currently being offered to pharmacists and the confusion between the terms certificate program and certification. It was agreed that the Task Force should differentiate between these terms and define the term certificate program. Daniel A. Nona, PhD, executive director of ACPE, provided the Task Force with some background on the 1989 AACP/ACPE Conference on Certificate Programs, held in Washington, DC in May, 1989, the objectives of which included achieving a consensus regarding the definition of certificate programs, identifying various program models that certificate programs may use, and achieving a consensus regarding methods of building educational quality into certificate programs. He stated that although recommendations were made and guidelines established for certificate program developers to use in creating quality programs, conference participants did not pursue the establishment of an accrediting system for certificate programs themselves and, at that time, did not pursue the development of a special accrediting program beyond the existing ACPE provider approval program. He acknowledged that, although 1989 may not have been the appropriate time for a certificate program accrediting system to be established, the need for such a system now exists. Kimberly Werner, PharmD, associate executive director of ACPE, emphasized that the 1989 Conference defined certificate programs as programs that: 1. conform to a curricular format; 2. are academically rigorous; 3. require satisfactory completion of lessons and/or examinations; NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (P) 847/391-4406 (F) 847/391-4502 www.nabp.net 2
4. have an outcome focus generally oriented toward providing new practice competencies rather than providing information to assist practitioners to keep up in their practice areas; and 5. can qualify for academic credit. She further clarified that certificate programs are intended to educate and teach new skills to enable practitioners to develop predetermined practice competencies while certification is intended to grant formal recognition to the certified individual as having met predetermined qualifications and to signify to the public that the certified individual is competent to practice in the designated area of certification. It was also noted that the following Guidelines for Certificate Programs had been developed at the 1989 Conference: 1. Certificate programs must have competency-based outcome objectives. 2. Input from practitioners must guide the development of program objectives and content. 3. Outcomes must be measurable. 4. Programs must contain both didactic and experiential components, although simulation may be explored as an efficient substitute for experience. 5. Content must be current, reliable, and related to the stated objectives. 6. Programs must be accessible and contain self-paced characteristics. 7. Programs must contain appropriate rigor in relation to the program objectives. 8. Programs must be at a length and cost appropriate with program objectives. 9. Program and participant evaluations must be related to stated objectives. 10. Program quality must be maintained by periodic self-studies and external reviews. Task Force members agreed that the findings of the 1989 AACP/ACPE Conference on Certificate Programs provided an acceptable definition for the term certificate program, as well as acceptable guidelines for the development of such programs; however, because of the length of time that has passed since their development, the Task Force recommended that NABP and ACPE staff examine and, if necessary, update the definition and guidelines. Richard P. Penna, PharmD, executive vice president of the American Association of Colleges of Pharmacy (AACP), although unable to attend the meeting, asked that Task Force members be advised that AACP would support an independent organization, such as ACPE, serving as the entity which monitors and approves/accredits certificate programs and certificate program providers. He also indicated that the AACP Board of Directors voted recently to ask ACPE to co-sponsor a follow-up conference to the AACP/ACPE Conference on Certificate Programs. Drs. Nona and Werner indicated a willingness to bring to their association s executive board a proposal that ACPE assume the role of monitoring and approving/accrediting certificate programs offered by ACPE-approved providers. Task Force members agreed that ACPE was the most appropriate organization to take on the role of monitoring and approving or accrediting certificate programs. They suggested that its continuing education provider approval process could be expanded to approve or accredit certificate programs. NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (P) 847/391-4406 (F) 847/391-4502 www.nabp.net 3
TFCPSA Recommendation #2 The Task Force on Certificate Program Standards and Accreditation recommends that NABP develop guidelines for general-level, non-specialty pharmacy certification processes that assist the state boards of pharmacy in their role to protect the public health. The Task Force s second recommendation focused on the oversight of non-specialty pharmacy certification processes. Certification is defined as the process by which a nongovernmental agency or association grants recognition to an individual who has met certain pre-determined qualifications specified by that agency or association. Members acknowledged that processes designed to provide certification for pharmacists in a certain area of general pharmacy practice (e.g., diabetes care, asthma care, or at a more advanced level of pharmacy practice have proliferated in recent years. They expressed concern that, currently, a nationally accepted certification process or nationally accepted guidelines by which providers of certification may award general-level certification to pharmacists do not exist. Concerns regarding the quality and uniformity of these certification processes caused Task Force members to agree that the development of national standards or guidelines is necessary for effective oversight of certification processes and for the development of certified pharmacists who are able to provide patient-oriented care services. TFCPSA Recommendation #3 The Task Force on Certificate Program Standards and Accreditation recommends that guidelines for certification processes include predetermined practice competencies that will prepare practitioners to successfully complete an objective assessment mechanism of core practice competency expectations. Task Force members agreed that any certification guidelines developed should include predetermined practice competencies designed to prepare practitioners to successfully complete an objective assessment mechanism of core practice competency expectations. Members voiced strong support for ensuring that certification in a particular practice area or skill translates across all practice settings and is consistent among all practitioners and across all geographic locations, therefore assuring patients that all pharmacists possessing certification are competent to provide the particular level of care represented by that certification. The Task Force agreed that NABP, as part of its efforts to assist boards of pharmacy in protecting the public health, should be the organization to develop guidelines for providers of certification to follow in the development of their certification processes. Additionally, the Task Force suggested that perhaps certification providers could adopt NABP s Pharmacist Continued Competency Assessment Mechanism (PCCAM ) as a component of their offerings so as to allow pharmacists the opportunity to assess their core knowledge of practice competencies pre- and post-completion. In doing so, providers would address the recommendation of the Task Force concerning the objective assessment of whether or not core NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (P) 847/391-4406 (F) 847/391-4502 www.nabp.net 4
practice competency areas had been addressed by the particular program or certification. Doing so would also maintain certification programs in the context of generalist pharmaceutical care practice and not specialty practice, which is developed and measured by different processes and mechanisms. TFCPSA Recommendation #4 The Task Force on Certificate Program Standards and Accreditation recommends to the Executive Committee that NABP work with organizations and associations interested in certification to organize an independent organization to monitor general-level, non-specialty certification processes to assure compliance with the above-mentioned guidelines, and to award certification to practitioners who successfully complete an objective assessment mechanism that measures competency in the area of practice addressed by the certification process. The Task Force recommends further that, if other organizations do not accept NABP s invitation to establish a separate, independent organization, NABP assume the responsibility for monitoring compliance with certification process guidelines, developing an objective assessment mechanism to measure competency in a particular program s area of learning, and awarding certification to practitioners who satisfy established program and assessment criteria. Task Force members agreed that the establishment of an independent pharmacy organization for the purpose of monitoring compliance with established non-specialty certification process guidelines and measuring the competence of practitioners seeking such certification would be the most effective long-term method by which to deal with the concerns regarding the quality and uniformity of general pharmacy practice certification processes. Support for the concept of an independent organization measuring the competence of practitioners seeking non-specialty certification was found, not only among all Task Force members, but also in a recent article authored by American Pharmaceutical Association staff members Susan Winckler and Lucinda Maine. Those authors acknowledged the need for some mechanism to measure the competence of a pharmacist who has been through a particular program and argued that competency [m]easurement at a national level by a single agency, one which does not provide training and re-engineering programs, provides this objective measure. 1 They further noted that the [e]stablishment of a national-level certification program by the profession diffuses some of the confusion stemming from the availability of different training programs and that a national certification program should preempt managed care organizations from creating their own assessment processes. 2 The Task Force recognized that for NABP to undertake the responsibility for assuring compliance with certification process guidelines and for measuring whether or not a practitioner acquired the stated competencies in order to achieve certification in a certain area, it would require a tremendous expenditure of resources. Additionally, some members expressed concern with NABP becoming involved in monitoring certification processes, noting that accreditation could be perceived as some sort of advanced level of licensing, and that such a recommendation 1 Winckler SC, Maine LL. Certification is it right for pharmacy? J Pharm Care. 1997; Vol. 1, Art.2., citing US Dept of Health, Education, and Welfare. Credentialing health man-power. DHEW Publication No. (OS)77-50057, July 1977. 2 Ibid. NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (P) 847/391-4406 (F) 847/391-4502 www.nabp.net 5
may extend beyond the scope of the Task Force s charge. However, Task Force members were adamant in noting the urgency that some organization move forward and begin this critical task. The Task Force expressed its frustration with the way in which organized pharmacy has dealt with such issues in the past and its delay in responding to this crisis. It was acknowledged that a newly established organization created specifically for the purpose of monitoring compliance with established certification process guidelines and measuring the competence of practitioners seeking certification was the most appropriate solution. Members agreed that NABP should seek the cooperation of other interested groups. If, however, other groups attempted to stall action on this issue or assume responsibility for this activity for personal or financial gain rather than for the purpose of improving patient care, NABP should move forward on its own and establish itself as the standard-setting and certification organization. NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (P) 847/391-4406 (F) 847/391-4502 www.nabp.net 6