The ultimate purpose of educating health professionals is, of course, to benefit patients. With that in mind, when deciding what and how to teach health professions, someone has to examine the curriculum of any particular school and decide if it is acceptable. Some colleges and universities have independent committees which examine and approve curricula. The recognition or approval of educational programmes is often referred to as accreditation. Hence, a college or university may accredit its programmes internally. There may also be an organization outside of the school which can accredit programmes. Accreditation by an outside body can be voluntary for a school, or it might be compulsory.
In Japan, the curricula of health sciences programmes are determined by the Ministry of Education, Culture, Sports, Science and Technology. The approval of programmes does not require input from either the public or from bodies representing the various health professions. Traditionally, bureaucrats gain no benefit from being creative, and are not responsible to the public for their actions. Consequently, health care education in Japan tends to be outdated, and slow to adapt to the changing demands of the health care environment. A number of Japanese university programmes now voluntarily undergo external evaluation by bodies such as the Japanese University Accreditation Association. This provides an independent accreditation of a school, and so ensures an honest and more informed assessment of a school's strengths and weaknesses.
In many other countries, external accreditation is the norm, and may replace the government-based accreditation that we have in Japan. For example, the nursing or physiotherapy professional associations may establish independent committees to examine how well schools' programmes are designed and implemented. If a programme is judged to be inadequate, the graduates may not be allowed to receive a license to practise their profession. This system puts a lot of pressure on schools to continuously improve their programmes.
The licensing of health professionals is a separate matter, but is obviously related to accreditation. Accreditation is approval of a programme, licensing is approval of an individual graduate. Hence, a person may graduate from an acceptable programme, but not personally be knowledgeable or skillful enough to pass licensing examinations. In Japan, the licensing of health professionals is the responsibility of the Ministry of Health, Welfare and Labour. The Ministry is managed principally by medical doctors and other bureaucrats who have a poor history of protecting the health of the Japanese public. Their licensing procedures for medical doctors have a history of being lax, and they tend to use outdated standards for licensing health professions in general.
In many other countries, the licensing of health professionals is controlled by independent bodies which have been established by the professions themselves, or by the governments in cooperation with the professions. This encourages strong standards, which protect the public, and recognizes the special rights and responsibilities which the health professions have earned.
Situation 1:Two recent graduates are studying together for their upcoming licensing examinations.
Tom: I've prepared some notes on neurological examination. I thought we should go over that.
Andy: Good, that's on the examination every year. Have you thought about the format of the questions on the exam?
Tom: The written exam is mostly multiple-choice questions, so I thought we should practise that style. I have taken some questions from old exams that I found in the library.
Andy: Great. I've found some questions from old OSCE's and I've made up some new questions using the same format.I thought we might do orthopedics first, and then do neurology next. Is that okay with you?
Tom: Sure, they overlap a lot, anyway.
Andy: The OSCE isn't until next week, so I thought maybe we should practise the multiple-choice questions first.
Tom: That's fine with me. They can ask you a lot of theoretical questions during the practical exams, so we should really study that first.
Andy: Did you hear about the trouble over at U of T?
Tom: I heard that their accreditation got suspended. Are the kids going to be able to take the licensing exams?
Andy: What I heard was that the school got put on probation. I heard that this year's graduates will be able to write the exams, but next year, if the school doesn't raise its standards, the graduates won't be able to sit the exams.
Tom: If I were a U of T student, I would be thinking about transferring.
Andy: I was thinking the same thing.
Tom: Well, let's hit the books!
Patterns:
* I thought... we should go over that
... we should practise that style
... we might do orthopedics first
... maybe we should practise the multiple-choice questions
* Have you thought about
... the format of the questions@
* I have
... taken some questions from old exams
* I've
... prepared some notes on neurological examination
* I've
... found some questions from old OSCE's
* I've
... made up some new questions using the same format
* I heard
... that their accreditation got suspended
... that this year's graduates will be able to write the exams
* What I heard was
... that the school got put on probation
...this year's graduates will be able to write the exams
... the graduates won't be able to sit the exams
* Are the kids going to be able to
... take the licensing exams
Discussion:
1. Do you think that you should have to write licensing examinations after graduation, or do you think that your school graduation examinations should be enough? Why?
2. What are the good and bad points about multiple-choice questions?
3. Have you ever had an OSCE-style examination? What are the good and bad points about this style of examination?
4. Do you think that someone who graduates from an unaccredited programme should be able to write licensing examinations? Why?
5. If a school loses its accreditation, what do you think would happen to its students?
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