Dr. Paula TropelloThe Experience of Serving as a Visiting Scholar at the ACEN (Spring 2017)

by Dr. Paula Dunn Tropello

During this spring sabbatical, the immersion into the ACEN has indeed been far beyond what I have experienced as a nurse administrator in preparing and writing for accreditation of programs, serving on site visit teams, or attending Self-Study Forums. The importance of being able to see and work behind the scenes with systems and regulations/policies and to learn the necessary interactions of the ACEN with other accreditors, regulatory agencies (e.g., U.S. Department of Education), and to attain Department recognition of an accrediting agency, was paramount. Those in academia likely do not realize the steps involved in the processes that give the ACEN recognition are similar to their own journey towards accreditation, but even more high-stakes because the USDE recognition lasts five (5) years and keeping up with requirements is an ongoing effort. The sheer amount of nursing programs requiring ACEN visits and accompanying reports with multiple edits to arrive at the final compliance decision is now something I can appreciate in scope; though, how it is done with so few ACEN staff members is, simply put, an organizational feat! True dedication and expertise I suspect are the basic ingredients; plus, the organization’s approach and teamwork, with regularly planned meetings and electronic group calendars get the job done.

Somehow the highly valued peer review aspect of accreditation, which has been in existence for over a century, continues despite the federal and public pressures for more regulations. Increased skepticism of higher education with proliferative changes such as non-traditional institutions and innovational learning/teaching approaches, requires more quality assurance to the public served through accreditation. While an accreditation review often yields good suggestions from peers for a college to improve the educational quality of its program, some have come to feel that accreditation is burdensome (e.g., increasing paperwork, requests for more information, or more frequent reviews) too costly, and forces some institutions to make choices about the use of resources. From my perspective, the pressures are felt from the top down; from institutions to programs to faculty and students who want to do well in the accreditation process. (Those in the practice domain of health care also might relate to the high-stakes JACHO and Magnet status preparation and recognition with employees and patients reaping the benefits, which also translates into nursing students and faculty selecting good clinical learning experiences). However, I might even add that the pressures are also placed on the accrediting agencies themselves as a result of more regulations, which was made clear working at the ACEN and seeing many agencies themselves endeavoring to maintain or achieve recognition with federal or national entities. The addition of regulations on accrediting agencies and programs seeking accreditation poses two (2) important questions: What purpose do these regulations serve; and, Are there better ways to regulate programs, institutions, and accrediting bodies?

I believe the ACEN is a leading agency looking at some of these issues, and it continues to refine its processes towards consumer satisfaction, such as development of the soon-to-be-implemented AMS, an online accreditation management system for interacting with the ACEN for processes such as submission of data and Site Visit Reports (SVR), which should increase the seamlessness of necessary accreditation processes. Its implementation will begin in Fall 2017.

Another example includes refining Standard 2 on faculty qualifications, taking into account both regional workforce and advanced education access. Simplifying Standard 6 Outcomes, which was challenging for many programs, has been a positive change for programs to utilize in planning curriculum development and assessment of program effectiveness. Most recently, the ACEN implemented having a peer observer on a site visit team, with the host program’s approval, to provide purposeful insight into the accreditation process. The ACEN even offers in-person and electronic advisory reviews, information-intensive nurse administrator forums, and comprehensive accreditation forums several times annually in a variety of locations to serve its constituencies. Staff attend as many professional conferences at all educational levels and areas of expertise as possible in order to stay up-to-date with changes in education and health care.

From my viewpoint, increasing transparency of the entire process serves as a signal that these high-stakes mandates are really partnerships between accreditors and programs. Effective peer evaluation leads to initial or continuing accreditation from a recognized leader in accreditation and well-regarded agency such as the ACEN. ACEN accreditation through its standards for educational quality specific to nursing education provides students and the public with assurance of a good return on their investment. It also assists program graduates in admission to institutions for further educational endeavors or in job attainment and tends to also foster administrative/faculty buy-in. The ability to have an open dialogue with an accrediting body, such as the ACEN staff provide, is a win-win for decreasing institutional and program costs by increasing understanding and more successful first-time peer review processes.

I also feel that the accreditation process itself has been made more transparent during my short tenure here and could be a continued value-added initiative of offering more visiting scholar opportunities or internships for students desiring to conduct research of nursing education accreditation. The demystification of any high-stakes activity serves to add value and decreases skepticism of what is sometimes thought of as an unwanted compliance process fraught with fear of the unknown. A standing message I promote as an ACEN peer evaluator to the faculty and administration during a site visit is “we are here to clarify, verify and amplify, and not terrify!”

I have also learned more about the need to further educate programs about the cyclical process, from the original Self-Study Report (SSR), to the site visit and SVR, to the Nurse Administrator Response Form regarding the SVR, to the Evaluation Review Panel (ERP), which program faculty can attend virtually or in-person, and finally to the decision made by the peer-elected ACEN Board of Commissioners (BOC). This multi-layered review by 30+ peers can seem like a long journey from site visit to receiving the decision letter. In other words, the peer evaluator-shared governance process used by the ACEN is even less understood by faculty and nurse administrators, so it is helpful to know there are professional staff/colleagues at the ACEN with whom they can speak. Better yet, more faculty and nurse administrators need be become ACEN peer evaluators and participate in this important and rewarding work. I have also learned during my visiting scholar opportunity that everyone on staff is more than ready to speak with anyone who calls the ACEN office, and that the staff are always accessible, knowledgeable, and professional, and all exhibit a remarkable work ethic.

I also appreciated being involved in the day-to-day planning of other important work such as leading a breakout session at the Self-Study Forum in Atlanta, discussing the first annual ACEN Accreditation Conference in its initial planning stages, and being considered in discussions on policy change or substantive issues. The ACEN made me feel welcomed and immersed in part of the ACEN’s daily operations and partaking in the same comprehensive work professional staff do has deepened my understanding of accreditation and the necessary systems and people to run such a well-regarded accrediting agency. I now also have a better global understanding of how these processes are about continuous quality improvement above all else.

In the U.S., academia sometimes defines visiting scholars as fellows and post-docs who are on sabbatical or serving at a host institution in the summer months in order to teach or do research in a field in which the individual is expert or interested in, which mutually benefits the host site as well as the scholar. I feel that there is genuine openness at the ACEN for scholars to conduct research, in light of all the meta-data it collects and houses. Perhaps some of the abstracts presented for the new ACEN Accreditation Conference might be spinoffs for research to answer some of the daily issues faced in the nursing profession or with nursing education and accreditation, or new initiatives inspired by a rapidly changing healthcare system that accreditors must respond to if they are to be valued in their roles as the experts.

The ACEN is not just an accreditation agency but a real “people place” that I have enjoyed getting to know. From the CEO to professional staff to other staff members, all are a team that interact regularly during business hours (8:00 a.m. to 5:00 p.m.) and well after, until the work is complete and reports are finalized. Accreditation cycles occur twice annually in the fall and spring semesters, and the team at the ACEN is ready! My life experiences have been about people, and the ones at the ACEN care about nursing students and programs and their success and attempt to assist site visit teams in every way to prepare for their upcoming site visits, just as the ACEN tries to aid programs in achieving initial and continuing accreditation. At the same time, the standards are high for the organization and for the ACEN-accredited programs. Since I believe in quality of life, and think that a healthy, enjoyable workplace is one (1) that will thrive and keep good employees, this is a sabbatical experience I have truly enjoyed. I plan to continue to be involved with this important work that signifies quality in nursing education to the consumer and ultimately produces excellence in nursing, which is hopefully then translated into better health care and healthier populations.

Thank you to the ACEN. I wish them continued success in being the leading authority for nursing education accreditation!