B3.01a Part One

Welcome back, and I’m glad you’re joining me once again. Recently, I've been devoting these blog posts to discussing the 6th Edition Standards and some of the challenges PA programs face as they prepare for the new accreditation requirements.

One issue that continues to surface is clinical capacity, which should come as no surprise. Securing sufficient clinical sites and qualified preceptors has become increasingly difficult for programs across the country. We'll talk more about why that's happening in our next blog.

First, however, we need to understand exactly what ARC-PA expects programs to demonstrate under Standard B3.01a.

On the bright side, responding to B3.01a is much simpler than responding to the C1 Standards we’ve been discussing. Here, the fundamental questions are relatively straightforward: (1) Do you have enough qualified clinical sites and preceptors to provide the required experiences for your students; and (2) can you prove it?

Start With the Numbers

Under B3.01a, programs must demonstrate that they have sufficient clinical sites and preceptors to allow students to meet the program's learning outcomes.

This begins with some basic arithmetic.

• What Supervised Clinical Practice Experiences (SCPEs) does your program require?

• How many students need each experience?

• How many qualified placements have you secured?

• Are those placements sufficient for your current cohort?

• Do you have overlapping cohorts that create additional demands on particular sites or preceptors?

If you have 40 students who need a particular SCPE, you must demonstrate sufficient placement capacity for them.

For developing programs seeking Initial Provisional accreditation, the calculation becomes especially important because the program must demonstrate adequate capacity for its requested maximum class size.

This is where the rubber meets the road, as I often say. You need to know exactly how many placements you require—and exactly how many you have.

Evidence, Not Intent

For programs applying for Initial Provisional accreditation, ARC-PA's expectations are particularly clear: the Commission wants evidence that the clinical education component is ready to operate as proposed. Not plans or projects, and not sites you expect to develop before students begin their clinical year, but documented evidence.

At the time of the Initial Provisional review, programs should be prepared to demonstrate a realistic, well-developed, and adequately documented clinical education infrastructure sufficient to support the proposed curriculum and requested maximum class size.

That includes several important pieces.

Fully executed affiliation agreements. Programs must provide evidence of executed agreements for clinical sites in accordance with Standard A1.01. A promising conversation with a potential clinical partner is not the same as a completed agreement.

Documented placement sufficiency. Programs should be able to show how many placements are available across their clinical sites and demonstrate that the total is sufficient to provide all required SCPEs for the requested maximum class size. This is where the numbers matter. If you need placements for 40 students, your documentation needs to demonstrate that those placements actually exist.

Evaluated clinical sites. Sites must undergo an initial evaluation for PA student education and achievement of learning outcomes. That evaluation considers factors including patient populations, site resources, appropriate supervision, and whether the experience provides students with sufficient opportunities to meet the program's learning outcomes.

Qualified and evaluated preceptors. Programs must demonstrate that preceptors have been selected and evaluated in accordance with Standards A2.13 through A2.16 and are appropriately credentialed, qualified, and oriented to the program and its educational objectives.

There can be limited exceptions. Within a large hospital system, for example, a specific individual preceptor may not yet be identified for every placement. But that should represent a relatively small portion of the program's overall clinical plan, and not the foundation upon which the plan depends.

The important principle is this: the infrastructure should be demonstrable at the time of the site visit.

Programs may have opportunities to provide additional information later in response to observations, but that's not something I would recommend relying upon. Likewise, future recruitment or unverified preceptor assignments do not demonstrate that the program currently has sufficient clinical capacity.

When ARC-PA arrives, you want the paperwork to tell the same story your program is telling: we have the sites, we have the capacity, we've evaluated them, and we're prepared to educate the number of students we’re asking the Commission to approve.

Establishing that Preceptors are Qualified

Of course, sufficient capacity isn't simply a numbers game. Programs must ensure that clinical sites provide appropriate educational experiences and that preceptors are properly credentialed, qualified, evaluated, and oriented to the program and its educational objectives.

And here's an important point: even when someone else helps you locate a site or preceptor, the program remains responsible for vetting the experience.

External organizations may assist in identifying potential sites and preceptors, gathering documentation, facilitating agreements, or coordinating other aspects of the process. But ultimately, the PA program must determine that the site and preceptor are appropriate and that students will have the opportunity to achieve the required learning outcomes.

You can get help doing the work, but you can't outsource the responsibility.

Be Ready to Show the Paperwork

For established programs, deficiencies in clinical capacity can result in citations and relatively short timelines for demonstrating that the problem has been corrected. For developing programs pursuing Initial Provisional accreditation, which are the primary focus of this discussion, the stakes may be even higher.

I've worked with developing programs that intended to continue adding clinical sites and preceptors after their site visit. That's a dangerous assumption. Programs need to be prepared to demonstrate the required clinical infrastructure when ARC-PA evaluates the program.

In other words, don't walk into the site visit planning to explain what you're going to have. Be prepared to show what you already have.

Know your required rotations. Know your enrollment. Know your capacity. Make sure your preceptors have been properly vetted. Make sure your agreements and commitments are documented.

This is one of those areas where crossing the T's and dotting the I's really matters.

Looking Ahead…

Of course, understanding what B3.01a requires is one thing. Actually finding enough qualified clinical sites and preceptors to meet those requirements is another.

The clinical-placement landscape has changed dramatically over the past several years. Programs are competing for placements, healthcare systems have changed how they manage learners, and some traditional approaches to developing clinical sites simply don't work as effectively as they once did.

In a recent webinar, I had the opportunity to discuss those challenges—and some creative alternatives—with Starr Newman, PA-C, Vice President of Clinical Network Development at AMOpportunities.

Next time, we'll continue that conversation and explore different ways programs can approach building sustainable clinical capacity in an increasingly competitive environment.