Application for Initial Programmatic Accreditation for a Surgical Technology Program

Application for Initial Programmatic Accreditation for a Surgical Technology Program

APPLICATION FOR INITIAL

PROGRAMMATIC ACCREDITATION For A

sURGICAL tECHNOLOGY pROGRAM

***THIS APPLICATION IS APPLICABLE ONLY TO ABHES-ACCREDITED INSTITUTIONS***

Please review carefully and provide all of the information requested as applicable to theinstitution/program. Incomplete applications (i.e., blank areas requiring information) will be returned for resubmission, which could delay the accreditation process.

1. GENERAL INFORMATION:

NAME OF SPONSORING INSTITUTION: / Main, Non-Main or Satellite Campus
ABHES ID: / ID I-###-## / EXPIRATION DATE: / Month Year /
ADDRESS: / enter address /
CITY: / enter city / STATE: / enter state / ZIP: / enter zip /
PHONE #: / (###) ### - #### / FAX #: / (###) ### - #### /
WEBSITE ADDRESS: / enter website address /
NAME OF ON-SITE ADMINISTRATOR(SPECIFY DR., MR., MS., MRS.): / enter name / TITLE: / enter title /
EMAIL ADDRESS: / enter email address / DIRECT PHONE #: / (###) ### - #### /
NAME OF PROGRAM MANAGER
(SPECIFY DR., MR., MS., MRS.): / enter name / TITLE: / enter title /
EMAIL ADDRESS: / enter email address / DIRECT PHONE #: / (###) ### - #### /

NOTE: The Accrediting Bureau of Health Education Schools (ABHES) provides official correspondence and updates via e-mail. Contact ABHES immediately should there be any changes to the contacts and e-mail addresses identified above.

Based upon review of the basic requirements outlined in the Accreditation Manual, Chapter II, Section B, Programmatic Eligibility, our Surgical Technology program meets the criteria of the Accreditation Manual; and, therefore, an application is being submitted in pursuit of an initial grant of programmatic accreditation by the Accrediting Bureau of Health Education Schools (ABHES).

2. SEPARATE CLASSROOM:

DOES THE CAMPUS OPERATE A SEPARATE CLASSROOM FOR ANY PORTION OF THE SURGICAL TECHNOLOGY PROGRAM?

☐Yes☐No

Refer to Chapter II, Section B of the ABHESAccreditation Manualfor the definition of a separate classroom.

If yes, provide the following information for the separate classroom:

(If more than one, hover then click on the plus sign [ + ] at bottom right corner of the table below to add additional classroom locations.)

STREET ADDRESS: / Address
CITY: / City / STATE: / State / ZIP: / Zip /
PHONE #: / (###) ### - #### /

1. Distance from the non-main or satellite campus to which it is assigned:

/ Distance in miles. /

1. Are the activities at this separate classroom limited to instruction?

/ ☐Yes / ☐No

1. Is only part of a program of instruction provided (i.e., a complete program is NOT provided at this facility)?

/ ☐Yes / ☐No

1. Are administrative and support services offered through the non-main or satellite campus?

/ ☐Yes / ☐No

1. Are all permanent records maintained at the non-main or satellite campus to which it is assigned?

/ ☐Yes / ☐No

1. Is the separate classroom within customary and reasonable commuting distance of the non-main or satellite campus to which is it assigned?

/ ☐Yes / ☐No
If answered “NO” to any of the questions a-e above, explain: Click or tap here to enter text.

3. APPROVALS:

Listthe state and any other agency(ies) providing approval required to operate the surgical technology program(s).

NOTE: The institution must provide evidence of such approval for those agencies listed below, including from that it is licensed, chartered, or approved to provide education beyond the secondary level under the laws and regulations of the state(s) or territory(ies) in which it operates.

(Hover then click on the plus sign [ + ] at bottom right corner of the table below to add more rows.)

Agencies/Organizations / Expiration Date

DOES THE INSTITUTION OPERATE* THE PROGRAM(S) IN A STATE(S) OTHER THAN THE STATE IN WHICH THE SPONSORING CAMPUS IS PHYSICALLY LOCATED?

☐Yes ☐No (If no, skip the section below and continue to question #4)

*Note: The regulatory definition of “operate” varies by state, as do licensure and authorization requirements. Some states require approvals for any institution delivering educational programs within their state (including via distance education), regardless of on-ground presence; other states require approvals based upon on-ground triggers, such as student participation in clinical experiences or interest meetings, employment of local faculty, or placement oflocal advertising, among others. Lack of applicable state authorization may impact a student's ability to become credentialed in certain professions. It is the responsibility of the school to determine when it is necessary to obtain approvals from the states in which it is operating, as applicable.

Ifyes, is the institution a member of the National Council for State Authorization Reciprocity Agreements (NC-SARA)?

☐Yes ☐No

If yes, identify the Date of Expiration:MM/DD/YYYY

Ifno, the institution is not a member of NC-SARA, complete the chart below:

(Hover then click on the plus sign [+ ] at bottom right corner of the table below to add more rows.)

Identify the state(s) where the institution/program *operates: / Does the state require authorization to *operate the institution/program? / If yes, identify the date the state approval was awarded:
☐Yes ☐No
☐Yes ☐No

4. DISCLOSURES:

A. HAS THE INSTITUTION (MAIN, NON-MAIN, AND/OR SATELLITE CAMPUS) EVER HAD ITS STATE APPROVAL REMOVED, WITHDRAWN, SUSPENDED, OR REVOKED?

☐Yes☐No

If yes, explain:Click or tap here to enter text.

B. HAS THE INSTITUTION (MAIN, NON-MAIN, AND/OR SATELLITE CAMPUS) EVER HAD ACCREDITATION DENIED, REMOVED, WITHDRAWN, SUSPENDED, OR REVOKED BY THIS OR ANY OTHER ACCREDITING AGENCY?

☐Yes☐No

If yes, explain:Click or tap here to enter text.

An applicant must also describe below any current, previous, or final action for which it is the subject, including probationary status, by a recognized institutional accrediting agency or state agency potentially leading to the withdrawal, suspension, revocation, or termination of accreditation or licensure. Action on the application will be stayed until the action by the other accrediting agency or state agency is final. Include a copy of the action letter from the agency with this application. Further, the institution must provide evidence of compliance with ABHES requirements and standards relative to the action.

C. HAS THE INSTITUTION (MAIN, NON-MAIN, AND/OR SATELLITE CAMPUS) EVER RELINQUISHED OR ALLOWED ACCREDITATION TO LAPSE/EXPIRE?

☐Yes ☐No

If yes, explain:Click or tap here to enter text.

D. HAS A LAWSUIT BEEN FILED AGAINST THE SPONSORING INSTITUTION DURING THE PAST 24-MONTH PERIOD?

☐Yes☐No

If yes, explain (including an explanation of its status): Click or tap here to enter text.

5. PROGRAM INFORMATION:

Complete the table below for each Surgical Technology program credential level.

(Hover then click on the plus sign [ + ] at bottom right corner of the table below to add more rows.)

Program Name / In Class Clock Hours / Recognized Outside Hours* / Total Clock Hours / Number of
Instructional Weeks
(D-Day; E-Evening; &/or Weekend-W)Instructional Weeks
(D-Day; E-Evening; &/or Weekend-W) / Academic Credit:
☐Quarter
☐Semester / Delivery Method**
(residential; blended; or full distance) / Credential Awarded
(Diploma, Certificate, or Type of Degree)
Do not use abbreviations

*Recognized Outside Hours:The ‘Recognized Outside Hours’ (i.e., student preparation, homework)column is NOT applicable to clock-hour only programs; thus, the column must be marked ‘N/A’, and the hours noted in the ‘In Class Clock Hours’ column and in the ‘Total Clock Hours’ column must be the same.

IMPORTANT: Recognized outside hours are based upon required academic clock-to-credit-hour conversions described in standard IV.G.1 of the ABHES Accreditation Manual. For institutions awarding credit for outside class hours will be required to provide a detailed analysis of how these hours were derived, how they complement the given coursework, and how students benefit from the respective assignments during the on-site evaluation visit.

**Delivery Method: See definitions in the Glossary of the Accreditation Manual.

IDENTIFY THE APPROPRIATE SIX (6) DIGIT CLASSIFICATION OF INSTRUCTIONAL PROGRAMS (CIP) CODE PER THE U.S. DEPARTMENT OF EDUCATION FOR THE SURGICAL TECHNOLOGY PROGRAM(S). TO VIEW LIST OF CIP CODES,CLICK HERE.

(Hover then click on the plus sign [ + ] at bottom right corner of the table below to add more rows.)

Program Name / CIP Code

6. ADDITIONAL PROGRAM INFORMATION:

Please complete the table below.

(Hover then click on the plus sign [+ ] at bottom right corner of the table below to add more rows.)

Program Name / Projected Program Start Date / Date when students are anticipated to complete 50% of the program or 25% of the core coursework / Date when students are to start clinical/externship

7. ABHES WORKSHOP:

Has a representative employed by the institution, preferably overseeing the surgical technology program(s),attended an ABHES Accreditation Workshop within the past 12 months? (See Chapter III of the Accreditation Manual for details regarding the Accreditation Workshop attendance policy).

☐Yes☐No

If no,see the listing of upcoming workshops and to register online atABHES Workshop Listing

If yes, identify participants in the table below:

(Hover then click on the plus sign [+ ] at bottom right corner of the table below to add more rows.)

Attendee Name / Title / Campus (City & State) / Date of Workshop Attended

8. CONFIRMATION AND SIGNATURE

The information and data submitted in this application are correct and current to the best of my knowledge. I adhere to the ABHES Bylaws contained in the ABHESAccreditation Manual.

Authorized Institutional Representative [Original] Signature:

Date: MM/DD/YYYY

Disclosures

Once approved, if the surgical technology program(s) does not commence enrollment within 90 days of the anticipated start date disclosed in this application, the institution must notify ABHES of the change in writing. Any approved program that has not been in operation for a continuous 12-month period is considered discontinued and reapplication is necessary (see Chapter III. B., Subsection 4.C.b. and Glossary definition, Discontinued Program, Accreditation Manual).

Any approved program that has not been in operation for a continuous twelve-month period is considered discontinued and reapplication is necessary (see Chapter III (B), Subsection 4(C)(b) and Glossary definition, Discontinued Program, Accreditation Manual).

ABHES approval to start the Surgical Technology program does not mean that the program is programmatically accredited by ABHES as such a grant of accreditation is pending receipt of a completed Self Evaluation Report (SER), completion of an on-site team visit, and Commission consideration at an upcoming meeting.

Surgical Technology is a field where graduates may elect to sit for a third party credentialing examination offered by the NBSTSA. It is our understanding that this particular credential may be required by some states or other governing authorities, which may also include employers, to become gainfully employed in the program field. In addition, it is understood that a prerequisite for sitting for the NBSTSA credential is completion of an educational program accredited by an accreditor acceptable to the NBSTSA; ABHES is one such accreditor. Please note, however, that ABHES cannot address NBSTSA requirements as these are defined and mandated by the NBSTSA. As such, the institution must verify the credentialing requirements with NBSTSA, as necessary.

Please note the NBSTSA requires the accreditor to conduct a comprehensive on-site evaluation as part of the review process leading to accreditation and it is to the institution’s advantage for ABHES to review the program as soon (and as reasonable) as possible. Lastly, please be reminded that only those student graduates who have completed an accredited program or those enrolled in the program at the time of the comprehensive on-site evaluation may be eligible to sit for the certification examination. The institution is advised to provide notice in this regard to students so that they are aware of these requirements and is reminded that it may not yet reference or advertise that the program is programmatically accredited by ABHES at this time. This position, again, is to safeguard the institution and the accreditation process.

NOTE: Standard, ST.A.3. of the Accreditation Manual states in part The program administers to each cohort of students the Certified Surgical Technologists (CST) examination, after completion of curricula content and prior to graduation. The exam serves as the program’s quality indicator by producing relevant, first time attempt score data which assess curricular quality and overall achievement in the program. Programs must demonstrate 100% examination participation and a 70% pass rate. The exam program is proctored consistent with the credentialing agency’s requirements.

Both currently accredited programs and initial applicants must administer such an examination to evidence compliance with the standard. As such, ABHES provides the National Board of Surgical Technology and Surgical Assisting (NBSTSA) basic demographic information regarding the program to allow initial applicants’ access to the Secure CST Practice Examination. The NBSTSA may contact via email the program chair identified in the application process to provide important instructions regarding access to the examination. Should the program need further assistance or additional information, contact Ben Price from NBSTSA via email at .

APPLICATION SUBMISSION INSTRUCTIONS

Please review carefully and ensure the application has been completed in its entirety and submitted with original signature. Incomplete applications (i.e., blank areas requiring information) will be returned for resubmission, which could delay the accreditation process.

The following must be submitted with this Application:

A copy of the approval letter(s) from the state and any other agency(ies), where the institution (main, non-main, and/or satellite campuses) operates the surgical technology program(s), preferably to include approved program length(s);

Completed (with original signature) Attestation of Responsibility; and

Application fee payment. Payment must be in the form of a check made payable to ABHES. For application fee details, viewthe Fees Appendix of the Accreditation Manual.

ABHES requires that this application along with noted attachments are submitted electronically via e-mail to . All documents must include the required original signatures where applicable.

For each email attachment, a separate file should be made and appropriately labeled (see screenshot). The total number of attachments is dependent on the application plus the number of exhibits to accompany the application.

Each attachment/file should be named according to its content (e.g.,“Application for Programmatic Institutional Surgical Technology”,“State Approval Letter”, “Attestation of Responsibility”, etc.).

If you have any questions regarding the application, please contact India Tips, Assistant Executive Director at 703-917-9503 or .

REVISED: July 11, 2018ACCREDITING BUREAU OF HEALTH EDUCATION SCHOOLS (ABHES)

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