CCE Communication, Guidance & FAQs on COVID-19
UPDATED - 01/14/2021
Council Chair Memo - January 14, 2021
Council Chair Memo - July 10, 2020
CCE Communication - March 27, 2020
CCE Communication - March 12, 2020
Council Chair Memo - July 10, 2020
CCE Communication - March 27, 2020
CCE Communication - March 12, 2020
FAQs (click on question to review response)
Question 1: During the COVID 19 crisis, how do programs document compliance with the CCE 4,200 instructional hour requirement as it pertains to online synchronous instruction and asynchronous instruction? We are concerned as best practices in online instructional delivery do not align with having 8 hours a day of online synchronous instruction of faculty/sage on the stage delivery and we are looking to asynchronous methods like discussion board activity, writing papers, developing presentations, and projects as a means of meaningful instruction.
Question 2: Our program has a total of 45XX hours and the current class due to graduate has completed 4328 of these hours. A great majority of these students have completed all their patient encounter quantitative requirements and have a small amount of non-patient encounters that can be completed virtually. This includes being assessed on all 31 CCE outcome competencies. My goal is to have these students graduate as scheduled. Considering that all the students have met the hour’s requirements, but not all patient contact requirements, could we graduate these students?
CCE does not have quantitative clinical requirements (hours or procedures) which is a blessing in the COVID 19 era. The answer to your question truly aligns to the guidance that we have already put out. You may need to temporarily change your policy or requirements for graduation in concert with the COVID 19 issue. Documenting that temporary change may be important for future records.
From a programmatic accreditation perspective, considering that all the students have met the hours requirements, and competencies, but not all patient contact requirements, there would be no program non-compliance in graduating those students. However, not to make this more complex, there may be some states in the US where content-specific quantitative requirements are required. Please know that CCE and the ACC are meeting with these states to guide their processes with CCE accreditation requirements.
From a programmatic accreditation perspective, considering that all the students have met the hours requirements, and competencies, but not all patient contact requirements, there would be no program non-compliance in graduating those students. However, not to make this more complex, there may be some states in the US where content-specific quantitative requirements are required. Please know that CCE and the ACC are meeting with these states to guide their processes with CCE accreditation requirements.
Question 3: Can a Chiropractic College that has quantitative requirements for clinical completion, create some flexibility in those requirements during this crisis as long as qualitative requirements (specifically, the institution can show that the intern has met all required Meta-competency outcomes) are met?
The CCE Accreditation Standards (Standards) identifies the minimum requirements to achieve accreditation; each program is responsible for identifying and establishing what requirements are necessary for a student to graduate from their program. In essence, whatever the program requires is what is needed to graduate (providing they at least cover the minimum requirements), the standards only set the minimum requirements that a program must adhere to when graduating their students.
There are no quantitative requirements (hours or procedures) for patient care listed in the Standards nor are there any quantitative requirements (hours or procedures) contained in the meta-competencies. In this situation, it is the program that is the final determining factor of what is required to graduate from their respective college/university.
During the COVID 19 pandemic, an education program may temporarily change or suspend these requirements and remain compliant with CCE Standards that are competency-based. The rationale for this temporary change is to align withthe fact that patient care opportunities have been shut down or are running at reduced capacity due to the crisis. Moreover, with a gradual return to normalcy, it may take considerable time for educational clinics to be fully functioning. Forcing students who have met qualitative requirements to also complete quantitative requirements in this environment may unnecessarily delay their completion and burden students with unexpected additional negative implications, such as additional tuition, student loans, rent/lease, delayed licensure and capacity to being employed, to name a few. However, chiropractic education programs may also need to inquire with relevant state regulatory agencies regarding these temporary alternative methods to ensure continued compliance.
There are no quantitative requirements (hours or procedures) for patient care listed in the Standards nor are there any quantitative requirements (hours or procedures) contained in the meta-competencies. In this situation, it is the program that is the final determining factor of what is required to graduate from their respective college/university.
During the COVID 19 pandemic, an education program may temporarily change or suspend these requirements and remain compliant with CCE Standards that are competency-based. The rationale for this temporary change is to align withthe fact that patient care opportunities have been shut down or are running at reduced capacity due to the crisis. Moreover, with a gradual return to normalcy, it may take considerable time for educational clinics to be fully functioning. Forcing students who have met qualitative requirements to also complete quantitative requirements in this environment may unnecessarily delay their completion and burden students with unexpected additional negative implications, such as additional tuition, student loans, rent/lease, delayed licensure and capacity to being employed, to name a few. However, chiropractic education programs may also need to inquire with relevant state regulatory agencies regarding these temporary alternative methods to ensure continued compliance.
Question 4: Probably the same question everyone has - how much leeway do we have in finding creative solutions to assessing metacompetency components in the absence of live patient encounters?
As a temporary measure, in response to the COVID 19 pandemic, CCE is encouraging programs to be as flexible and creative as possible in finding solutions in the assessment of metacompetency outcomes. The standards do require "best practices" in the evaluation of metacompetency outcomes; however, the standards are not prescriptive about using specific evaluation tools or methods. In these challenging times, programs have some flexibility in "best practices". In normal times, as appropriate to the specific metacompetency outcome, the majority of assessments of student competency should be performed in the context of the clinical workplace in a patient care setting. Taking a "what's the next best option?" approach, if we don't have patients, programs may include items such as patient recordings, patient simulations, student demonstrations, clinical case studies, review of patient files, clinical rationale discussions, and other scenarios as determined to be the next best option for the specific metacompetency outcome evaluated.
Question 5: Many components can be assessed through written and oral examinations but skill components can be challenging. As an analogy, how are blind medical students assessed for surgery skills? - generally by describing in detail what they would do if they could see. Is this an appropriate accommodation for clinical skill assessment if the Covid-19 clinic closures go on for an extended period of time?
This may be one of the methods used, depending on the specific metacompetency outcome.
Metacompetency outcomes 2.4, 7.1, 7.2, 7.4, 7.5 are probably the most challenging to evaluate remotely. This is where CCE is allowing programs to be temporarily flexible and creative in their assessment plan and practice.
Metacompetency outcomes 2.4, 7.1, 7.2, 7.4, 7.5 are probably the most challenging to evaluate remotely. This is where CCE is allowing programs to be temporarily flexible and creative in their assessment plan and practice.
Question 6: Will it be necessary to submit a substantive change if transitioning a significant number of courses online or to hybrid format?
No. See the March 12, 2020 communication from the CCE President regarding temporary changes made in response to the COVID 19 pandemic.
Question 7: Will it be necessary to submit a substantive change if decreasing the number of credit or clock hours required to complete the program?
Substantive changes are not required as programs can temporarily modify their graduation requirements during the crisis period (See questions 2 and 3 of the FAQs Programs must document modifications to their graduation requirements and/or policies in conjunction with their COVID 19 response plans. Programs should ensure that modifications to the number of clock hours remain at or above the 4200 instructional hour minimum as outlined in the CCE Accreditation Standards, Section 2.H. If a program is unsure whether the temporary modifications would place the program below the required 4200 instruction hours minimum, please contact CCE.
Question 8: How will changes in national board exam schedules and the potential impact on Policy-56 be addressed by CCE?
CCE is monitoring the schedule for the NBCE examinations. It is too early, at this point in time, to declare any temporary changes to CCE Policy 56. However, the Council will likely look at this issue at its July 2020 semi-annual meeting, prior the August 1 posting requirement. It is possible that an extension of the 6-month post-graduation period for this spring may be necessary, depending on the degree of postponement of examinations.
Question 9: The accreditations standards do not require specific number of hours to be completed in clinical education, but do require that students should be supervised at a DCP managed clinic site (see below). Would online education provided by clinical faculty (synchronous + asynchronous) be considered “supervised student experience at a DCP clinic site”?
Yes, if the managed clinic sites where clinical education typically takes place are closed, clinical education provided by faculty members using distance education methods would temporarily be considered as supervised student experience during the pandemic.
Question 10: What types of curricular accommodations would CCE allow the DCPs to make in order to maintain student graduation date? OR, in other words – What types of accommodations would CCE NOT allow the DCPs to make in order to maintain student graduation date?
As referenced in the March 12, 2020 communication from the CCE President, within the reasonable and temporary nature of the flexibility described, programs must continue to remain compliant with all accreditation standards. In reference to a potential change in programmatic requirements for graduation, CCE has not waived the minimum 4,200-instruction hour curriculum requirement. In addition, in order to maintain compliance with CCE Standards 2.H.1. and 2.H.2., programs must continue to demonstrate evidence that each metacompetency objective has been taught and that each graduating student has achieved a successful level of competency for all metacompetency outcomes. If a program is unsure whether a proposed temporary modification of the DCP curriculum or its policies would remain in compliance with the CCE standards, please contact Dr. Little in the CCE Office.
Question 11: The March 12 Communication indicated that temporary changes would be allowed for distance education without the need to have CCE approving those changes. How long would you consider those "temporary changes" allowed? The shelter in place periods are being extended, which may result in longer periods of distance education - do you have a maximum allowed time that DCPs can make those changes?
As there is fluidity in shelter in place periods, there is no established date for closure of the temporary condition granting programs flexibility in the use of distance education. As programs are working to accommodate students whose enrollment would otherwise be interrupted as a result of COVID-19, the temporary changes will continue. If still enacted, the temporary period will be reviewed by the Council at its July 2020 semiannual meeting. The period for temporary changes will be transparently communicated to programs as conditions change. No one anticipates a sudden or dramatic return to normalcy at this time.
Question 12: Are you planning to maintain the calendar dates for site visits this year?
CCE is maintaining the accreditation process for interim and residency evaluation in the Spring 2020 by means of virtual site visits. Spring 2020 comprehensive site visits have been moved to fall 2020. Future process or schedule changes will be announced if circumstances warrant but at this time fall 2020 site visits will remain as scheduled. CCE will remain in constant communication with all programs regarding all accreditation processes and any anticipated changes.
Question 13: How do we handle pass/fail and CLEP credits that are increasingly present as students complete their undergraduate degree/pre-requisites during the COVID-19 crisis? While it’s not unusual for us to accept credits from pass/fail courses, such courses have no quality points and do not contribute to the overall GPA, and the number of such courses could affect the accepting GPA of an applicant. In addition, many students are completing classes without the laboratory component due to COVID.
Standard G outlines the minimum requirements for regular admissions and Policy 7 outlines the minimum requirements for AATP admissions. With an increase in undergraduate pass/fail, CLEP credits and waiving of lab requirements for science courses, the DCPs may experience a larger percentage of their applicants in the AATP category, since Policy 7 allows for a GPA of 2.75 or higher for the 90 semester credit hours and no minimum credit requirement for science labs.
With regard to how to apply pass/fail and CLEP credits towards the 90 semester hours, 24 hours of science, and GPA requirements, DCPs should have internal procedures or policies, which guide consistent application of these areas in their admission processes. Alterations to these procedures and/or modifications to broader admission policies in response to the COVID 19 circumstances should be documented with start and end dates.
Moreover, the DCPs should document special circumstances in admissions and subsequent categorization of traditional and AATP students. For example, if the program admits a student who has met all the admission requirements as applicable under Standard G with the exception of meeting the lab requirements, this student is admitted under AATP. Then, if at a later date the student is able to demonstrate the lab requirements, the DCP may shift the student’s categorization from AATP to traditional admissions. Accurate record keeping of these types of activities will be important for Policy 7 and PEAR requirements.
With regard to how to apply pass/fail and CLEP credits towards the 90 semester hours, 24 hours of science, and GPA requirements, DCPs should have internal procedures or policies, which guide consistent application of these areas in their admission processes. Alterations to these procedures and/or modifications to broader admission policies in response to the COVID 19 circumstances should be documented with start and end dates.
Moreover, the DCPs should document special circumstances in admissions and subsequent categorization of traditional and AATP students. For example, if the program admits a student who has met all the admission requirements as applicable under Standard G with the exception of meeting the lab requirements, this student is admitted under AATP. Then, if at a later date the student is able to demonstrate the lab requirements, the DCP may shift the student’s categorization from AATP to traditional admissions. Accurate record keeping of these types of activities will be important for Policy 7 and PEAR requirements.
