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Accreditation Manual
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Introduction
This Accreditation Manual is intended to encourage an ongoing summative and formative evaluation process and as an accompaniment to the Essentials and Guidelines booklet, which is itself designed to give guidance to institutions seeking the European Board's accreditation for their education and training programmes in clinical perfusion sciences. The Manual will provide the opportunity for training institutions to carry out summative-evaluation of their programme as well as conducting formative tasks and assessment activities in preparation for the Site Visit. This will enable the institution to be better positioned to interact with the European Board of Cardiovascular Perfusion (EBCP) during the accreditation process. By evaluating and re-assessing its strengths and weaknesses, the institution will be able to provide the student with a higher standard of training programme and maximise its resources.
If the training programme is already accredited by an external Organisation, e.g. the government, medical school or university, clear and complete details of this should be submitted to the EBCP with the application for accreditation. In particular, if the government, or its department of health, decrees that graduation from the programme is a prerequisite to becoming a qualified clinical perfusionist, state this in the application for EBCP accreditation or at the time that this becomes a fact.
The Essentials and Guidelines
The Essentials and Guidelines are designed to give guidance to institutions seeking the European Board's accreditation for their education and training programmes in clinical perfusion sciences. There will inevitably be a variety of standards in training programmes within a single country, and from country to country. The object of these Essentials and Guidelines is not to set a maximum level for programmes to attain, but to set minimum criteria, recommended by the EBCP in consultation with all the below listed Institutions. These criteria must be achieved by the Institution, i.e. the school of perfusion, hospital or university where the programme is being offered, before the EBCP will grant accreditation. A list of accredited programmes will be published for prospective students, employers and the public.
It is recognised by the EBCP that few training programmes will, initially, be able to meet the full minimum criteria stated. The EBCP’s purpose is to accredit those programmes which have the desire and intention, over a given time span to be set by the EBCP, to achieve the minimum criteria and become an accredited training programme. The Accreditation Sub-committee of the EBCP, whose task is to oversee the accreditation process, will, on request, offer any necessary advice and assistance to the institution applying for the EBCP accreditation.
Definitions
For the purposes of this document, the term “Perfusion” means pumping blood through the whole body, and “Perfusionist” means a person who operates a heart/lung machine for cardiopulmonary bypass and uses related techniques.
Site-visit party
Representatives of the Academic Committee, which includes members from the Accreditation Sub-committee and the Certification Sub-committee of the EBCP, will form the site-visit party.
Re-accreditation
The Accreditation Sub-committee will periodically visit all Institutions holding the EBCP's Accreditation for the purpose of re-accrediting the programme. Any programme no longer meeting the required minimum criteria will lose its accreditation. The Institution may appeal against any such decision, or, re-apply for accreditation.
In this document, words importing the masculine gender shall include the feminine gender.
Part One - General Requirements for EBCP Accreditation
In all the following text "Institution" shall be understood to mean the centre at which the Training Programme is based and in whose name the application for accreditation is made.
1. Suitable Establishment
The Institution, e.g. the school of perfusion, hospital, university or other acceptable educational establishment where the programme to train perfusionists is being offered, and any collaborating organisation, must be a suitable establishment for the teaching of perfusion sciences and the training of perfusionists.
In the application for accreditation, the collaborating organisations and the co-ordinating Institution must be clearly identified and, with the role and responsibilities of each institution, documented as a formal agreement.
The general administration and day to day running of the programme shall be the responsibility of the Institution. The Institution shall also be responsible for the appointment of teaching staff and the general welfare of students.
Suggested evaluation and recommended written response:
Simply give the full name and address of the Institution and give its status, e.g. school of perfusion, university, hospital, college , annual statistics of the institution and it's affiliates etc.
b) Identify the person with whom the EBCP should correspond concerning the accreditation of the programme and all other day to day administrative matters. (This person would normally be the Principal, or Director of the Programme).
State the person’s full name and address. If another person is responsible for general correspondence and administrative matters, then enter his full name and address also. In both cases their job title should also be stated.
c) Identify the names and addresses of all other, if any, institutions which are affiliated to this main institution and are collaborating in the training of perfusionists as part of the training programme applying for EBCP accreditation.
State the full names and addresses of any affiliated institutions and provide current documentary evidence of their participation in the training programme. Provide current documentary evidence (contracts etc.) which clearly shows the agreed roles of each institution and demonstrates their commitment as a joint collaborator to the programme.
d) Identify the names of those at the Institution, and affiliated institutions, who have the responsibility for maintaining the academic and training standards for the perfusion training programme of that institution. Identify the person/s who co-ordinates the training between the Institution and its affiliates. There should be a clearly defining schedule for this function.
State the names of those at the institutions who are responsible for maintaining the academic and training standards for the perfusion training programme and state also their job title as well as their qualifications. State the full name and address, job title and position of the person/s who co-ordinates the training between the Institution and its affiliates. Provide documentary evidence that shows how the co-ordinator/s perform this task.
2. Responsibility for the Programme
Suggested evaluation and recommended written response:
a) Identify the person who holds the title of Principal, or Director of the Programme. It would be expected that this person has appropriate qualifications to hold this position and plays an active role in the teaching or administration of the training programme.
State the full name and address, job title, academic and professional qualifications of this person and the role they play in the programme.
b) The Institution, and any affiliates, must ensure that the students on the course are legally covered against any financial, or other, claims arising while they are on site.
Submit copies of documents or official statements from the Institution which confirms this.
3. Academic Committee
There must be a course team to supervise the day to day management of the pre-clinical studies and a course team to supervise the day to day management of the clinical studies. Both teams must comprise appropriately qualified personnel and should include at least one clinical perfusionist on each.
The Academic Committee and two course teams must meet on a regular basis with the Board of Management, at least twice a year, to discuss and revise the programme and to discuss the individual students' progress. Counselling for students having difficulties with the course must be available to all students.
Suggested evaluation and recommended written response:
State the full name and address, job title and position of all members of the board/committee. State how these members are elected to the board/committee.
b) A training programme should have an academic committee, which is responsible for the academic standards of the programme. There should be members from the two course teams on this committee. Student representation on this committee is to be encouraged and the student should be selected by his fellow students.
State the full name and address, job title, academic and professional qualifications of the members of the academic committee (It is not necessary to name the student member).
c) A suitable course team could comprise as little as three people. Both the pre-clinical and clinical course teams may include a surgeon and an anaesthesiologist and should meet individually and jointly on a regular basis. Both course teams should have a European Board certified (ECCP) senior clinical perfusionist as part of the regular team. Their role would be to advise the non perfusionist teachers on such matters as the perfusion environment, its technology and the expected knowledge of perfusionist. The two course teams must liase closely and interlace their individual programmes for optimising a successful course.
State the full name and address, job title, academic and professional qualifications of each course team member and identify the role that each member plays. Show documentation detailing how a student on the course has access to the committee to express their views and those of the other students.
4. Supervising Perfusionists
Suggested evaluation and recommended written response:
The supervising clinical perfusionist must be suitably qualified to instruct the trainee. The supervisor must be a qualified and experienced clinical perfusionist and should hold the European Certificate in Cardiovascular Perfusion. Qualified is taken to mean that he is able to understand the natural anxieties of a trainee perfusionist operating the life support equipment and can assume control in a stressful situation.
State the full name and usual working address of the supervisor. State also his experience and brief review of his curriculum vitae.
5. Finance
The financial status of the programme must be secure. Proper accounts of financial dealings must be kept, and retained for at least three years. All fees and other charges likely to be incurred by the students must be clearly documented prior to commencement of the course. No charges for damaged equipment must be made to the students, except where malicious damage occurs.
Suggested evaluation and recommended written response:
a) At the beginning of a programme there must be clear evidence that there is adequate funding available to sustain the programme. A situation where students could be abandoned during the course because of insufficient funds is to be avoided at all cost.
Provide documentary evidence that the total cost of running a course is available at its commencement. Include documentation which clearly shows how the programme is funded.
b) All fees and other charges likely to be incurred by the students must be clearly documented prior to commencement of the course. Students should not be presented with extra fees after they have enrolled for the course, e.g. any registration or examination fees must be clearly stated to the students before they enrol. Sometimes an external validating Organisation will impose a registration fee on each student enrolling for a course validated by them, which is in addition to any charged by the Institution offering the course. The student must be made aware of this before enrolling.
Submit a copy of the documentation presented to students confirming the cost they have to bear.
6. Equipment and Facilities
Equipment used in the teaching of the course must be reasonably up to date, lecture rooms must be designed for such and adequate teaching aids must be available. Instructional aids, e.g. audio-visual aids and video, must be provided to assist in the instruction where necessary.
Suggested evaluation and recommended written response:
a) It may not always be possible for the Institution offering the programme to have all the latest equipment on site. However, students must be made aware of the latest equipment available and must be told that what is being shown is not up to date equipment. In most cases simple reference to how the equipment has been updated may be adequate, or audio-visual material may be necessary.
State the type and approximate age of equipment used for teaching the students at your institution.
b) Lecture rooms must provide the students with a comfortable environment which is adequately ventilated and relatively free of external noise. There should be a surface on which the students can rest their notebooks for writing.
Describe the lecture rooms which your institution offers for the course.
c) Audio-visual aids and video equipment must be maintained in proper working condition, and adequate material for teaching and learning must be available for the students’ use during the course.
State how your Institution provides these facilities. List the equipment available and who maintains it.
7. Library
An easily accessible library containing all material relevant to the curriculum must be available to the students during working hours, evenings and weekends. Perfusion literature should be frequently updated together with periodicals in cardiothoracic surgery and other related subjects. Adequate funding must be provided to meet these requirements.
Suggested evaluation and recommended written response:
An ideal library should have a section devoted to the perfusion training programme. Where popular books are in demand by the students for study during the course, there should be duplicate copies of the books to go round. Students should be able to access the library at all reasonable times.
Show documentary evidence that the relative books and perfusion journals are available and that adequate funds have been set aside for the purchasing and maintenance of books and journals.
8. Maintaining Teaching Standards
The programme must actively encourage updating education for the course tutors and instructors. Areas of study should include 'methods of teaching' together with advanced perfusion topics.
Suggested evaluation and recommended written response:
There will be course tutors, teachers and lecturers on the course who are not trained in perfusion technology and may know little, or nothing at all, about the work of the perfusionist. It is essential that meaningful dialogue exists between the course perfusionists and teachers in an on-going manner. The teachers and lecturers should be encouraged to read perfusion books and literature so that they can target their teaching more specifically towards the perfusionists’ needs.
Describe the structure in place to ensure that all those involved in teaching are made aware of the perfusionists’ specific requirements in an on-going manner.
9. Students’ awareness
Students should be made aware of higher education and training programmes available to them after successfully completing the programme.
Students must be made aware of an appeals procedure in the event of examination failure or any disciplinary action that may be taken against them. A member of the course team should be identified to the students should they need guidance with the course work.
Suggested evaluation and recommended written response:
a) Students entering perfusion are unlikely to be aware of possible higher education and training programmes available to them when they have completed the training programme course. Where these higher courses do exist they should be made known to the student by the time they graduate from the course.
State if your programme director is aware of any such courses and how this information is made known to the students.
b) There must be an appeals procedure for students who fail the examination or have disciplinary action taken against them. It is most important that the students are fully aware of this procedure and who the contact person is.
Describe the structure in place for the appeal procedure and state the full name and address, job title and position of the contact person who will handle the students appeal. Submit a clear protocol which shows how appeals are handled once they are made.
c) Students sometimes feel despondent when they are struggling on a course and this can often lead to rapid deterioration in their performance and perhaps resigning from the course. The course tutor, or other senior member of the course team, should be identified to the students as the person to whom they can consult in times of such need. Once a problem has been identified, maintain documentation of ongoing developments.
State the full name and address, job title and position of the contact person who is available to the students having problems with the course work. Show how, once a problem has been identified, maintenance of documentation and developments are ongoing.
10. Students’ Welfare
Student intake to the programme should be based on the students' considered ability to cope with the designed course and must not be influenced by the students colour, race, creed, age, sex, national origin or handicaps that would not prevent them from becoming a competent perfusionist.
Students must not be used as an extra pair of hands in the clinical environment. Any arrangements whereby students on the programme may be offered remunerated work must be clearly stated to them, in writing, before they commence the course.
A record of the student’s admission to the programme, their attendance, grades and a list of any certificates awarded must be kept by the Institution.
The number of students on any one course must be determined by the staff to student ratio, equipment available and clinical caseload.
Suggested evaluation and recommended written response:
a) Student intake to the programme should be based on the students' considered ability to cope with the designed course and must not be influenced by other factors that would not prevent them from becoming a competent perfusionist.
Describe the protocol used in student selection which determines suitable students for the course. Submit any documents which support your selection process.
b) Unless a written agreement is presented, and agreed by both parties, detailing any clinical or research work that may be expected from the students, and which states clearly any remuneration for this work, the students must not be used as an extra pair of hands.
Submit documents which clearly show that students will not be used as an extra pair of hands unless the proper agreement has been reached as described above.
c) All registration documentation, the students record of attendance, documentation of their course work and certificates awarded must be kept by the Institution.
Describe how this information is stored by the Institution.
d) While it may be attractive and more cost effective to enrol a large number of students to the course, this can have undesirable effects when the staff to student ration rises above a manageable level. It is particularly detrimental and stressful during the clinical phase of the course when too many students have to enter the operating room during a particular session. Great care and consideration needs be given to the number of students on any one course.
State the maximum number of students enrolled for any one course; how many students are permitted entry into the operating room at any one time?
Part Two - The Course
Entry requirements for a student wishing to enter a programme should include school leaving certificates in physics, chemistry, biology, mathematics and the national language, as the minimum acceptable to any programme. Institutions offering a programme of short duration, e.g. one year, based on an entry requirement of a science degree, or equivalent qualification, must ensure that the degree, or its equivalent, is appropriate and of sufficient standard.
Suggested evaluation and recommended written response:
The Institution responsible for the training programme, and in whose name accreditation is awarded, will assume responsibility for student admission to the programme and for the students welfare for the duration of the course. Entry requirements for a student wishing to enter a programme should include school leaving certificates in appropriate science subjects, e.g. physics, chemistry, biology, mathematics and the national language, as the minimum acceptable to any programme. If the Institution is offering a programme of short duration, e.g. one year, based on an entry requirement of a science degree, or equivalent qualification, then the Institution must ensure that the degree, or its equivalent, is appropriate and of sufficient standard. It should be remembered that the EBCP examination, for the European Certificate in Cardiovascular Perfusion (ECCP), is the same examination for all countries. Therefore, a student who successfully passes a national examination may find the EBCP examination more difficult if they do not have a sound basic science background.
State the full entry criteria for your programme. Submit documentation literature that supports this statement. Show evidence that the Institution assumes responsibility for the admission and welfare of students.
2. Duration of Course
The duration of the course will be determined by the entry requirements set, the intensity of the programme and the degree of clinical exposure which must constitute a minimum of 40% of the course, e.g. twelve months could be an acceptable time span for a course which sets, as its basic academic level of entry, an appropriate university science degree, or equivalent qualification, and has a clinical programme in which the student will take part in a significant number of perfusions. A two-year course may be necessary where an institution sets a lower entry level and cannot offer the high exposure of clinical cases. A compromise of these two would not be acceptable.
A logbook, in which is kept a record of the student's progress and achievements, will be made available for inspection by the Certification Sub-committee of the EBCP.
Students successfully completing the course will be identified as graduates of that EBCP accredited programme.
Suggested evaluation and recommended written response:
a) There can be no limit set by the EBCP as to the duration of a course. In some instances a course may span a three year period. A course that is of a short duration, e.g. 12 months, would not be deemed of adequate duration if the entry criteria were set to a low or basic level.
State the duration of your course and give the reasons for the chosen period.
b) The EBCP has produced a Logbook which is recommended for use by all EBCP accredited programmes. If the programme is considered to be already using an equally suitable logbook then there is reason why the programme should use the EBCP Logbook. It may be the case that the logbook in use is deficient in only one or two areas and additional sheets can be added to satisfy the EBCP requirement. In this case, after reviewing the programme’s logbook, the Certification Sub-committee of the EBCP will advise the Institution of this. Submit your logbook to the EBCP, or to the Secretary of the Accreditation Sub-committee, with your application for accreditation. If your programme is currently accredited by the EBCP, then send your logbook without delay to the Secretary of the Accreditation Sub-committee.
3. Exemption
The Principal, or Programme Director, should have the authority to exempt individual students from specific parts of the course if their previous training warrants this.
Suggested evaluation and recommended written response:
Typical examples of exemption would be: if a student applying for the course has a college or university degree in physiology it would not be expected that this person should partake in the physiology studies of the course. If the applicant is from a nursing or medical background then there may be several areas of the biological sciences part of the course which would not require him to study. The discretion of the course teams would be essential in deciding what exemptions may be reasonable.
If your programme offers its students exemption from part of the course, state the subjects from which each category of student background is exempt. Support this with any documentary evidence available, e.g. actual exemptions given.
4. The Syllabus
The syllabus for the programme must be clearly detailed in writing and adhered to; it must be included in the application for accreditation and any alterations to the syllabus must be forwarded to the Accreditation Sub-committee.
The syllabus must include: teaching of basic sciences, e.g. anatomy, physiology, pharmacology, pathology, haematology, microbiology, immunology, cardiopulmonary and vascular pathology, embryology, basic anaesthesia, instrumentation/basic electronics, computer studies, materials science, resource-management and a scientifc project. The clinical programme must include: perfusion management, haemofiltration, haemodilution, haemodialysis, hypothermia, autotransfusion, Extra-Corporeal Membrane Oxygenation, various extracorporeal circulatory techniques, paediatric perfusions, intra-aortic balloon pump, blood gas analysis, fluid and electrolyte balance, coagulation, blood pressure monitoring, electrocardiogram, cardiac catheterisation, myocardial preservation, organ preservation, ventricular assist devices, transplantation, cardiac surgery, cardiac investigation techniques, the basics of anaesthesia, cardiac anaesthesia and postoperative care. Student rotation through other cardiac units is encouraged.