Joint Review Committee
On Education in Cardiovascular Technology ~ JRC-CVT
Self-Study Report Format
For Programs Seeking
Initial Accreditation
For additional information about JRC-CVT and accreditation services visit:
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INITIAL-ACCREDITATION SELF-STUDY REPORT(ISSR)
FOR A CARDIOVASCULAR TECHNOLOGY PROGRAM
INSTRUCTIONS
02/11/2014
02/11/2014
Each program conducts a self-study (process), which culminates in the preparation of a report. The JRC-CVT will use the report and any additional information submitted to assess the program’s degree of compliance with the Standards and Guidelines for Cardiovascular Technology Educational Programs of the Commission on Accreditation of Allied Health Education Programs (CAAHEP) [ The JRC-CVTExecutive Office will review the ISSR and any additional documentation for completeness and forward them to the Readers for analysis.
In preparing the self-study report, please respond to the questions carefully and completely. One, combined self study report can be submitted for all concentrations: Invasive Cardiovascular Technology (I), Adult Echocardiography (N), Pediatric Echocardiography (P), Non-Invasive Peripheral Vascular Study(V) and Cardiac Electrophysiology (E). Submit three (3) completed copies.
Electronic copies must be submitted onCD or flash/thumb drive in the format set forth in this document and must include all supporting documents. No paper copies will be accepted.
FEES:
The Application fee, Self StudyReport Review fee, and Site Visit Administration fee are all due with submission of the ISSR (see
REPORT FORMAT:
- Type the text of the response for each question.
- Consecutively number each page of the report, including appendices.
- Create separate files on the CD/USB drive for supporting materials. Make sure that the filename is readily recognizable for its content and where it fits in the ISSR.
CAAHEP REQUEST FOR ACCREDITATION SERVICES
Programs must electronically file the CAAHEP Request for Accreditation Services at the time the Initial Accreditation Self Study Report (ISSR) is submitted.
02/11/2014
Ctrl-Click here to go to the on-line form. (Internet connection required.)
02/11/2014
Submit the CDs/USB drives (and fee payment) to:
Joint Review Committee on Education
in Cardiovascular Technology
1449 Hill Street
Whitinsville, MA 01588-1032
TIMING OF INITIAL ON-SITE REVIEW:
An initial on-site reviewwill be scheduled approximately 4-6 months after approval of the ISSR and additional requested materials, if applicable.The JRC-CVT Site Visit Dates Request form must be completed, copied on to each CD/USB drive, and emailed to the JRC-CVT Executive Office.
02/11/2014
Ctrl-Click here for the link to the page with the on-line form.
02/11/2014
TITLE PAGE
1
1.Concentration(s) (check all that apply):
Invasive Cardiovascular Technology (I)
Adult Echocardiography (N)
Pediatric Echocardiography (P)
Non-Invasive Vascular Study (V)
Cardiac Electrophysiology (E)
2.Type of Sponsor:
3.Type of award upon program completion:
(Note: post-secondary academic institution sponsor must award a minimum of an associate degree)
4.Name and address of the sponsoring institution:
Name
Address
City/State/Zip
VoiceFAX
5.Name and contact information of administration and programkey personnel (i.e., Program Director, Medical Director, and Clinical Coordinator, if applicable):
a.Chief Executive Officer(to whom all correspondence will be directed)
Name
Title
Address
City/State/Zip
VoiceFAX
b.Dean or Comparable Administrator
Name
Title
Address
City/State/Zip
VoiceFAX
c.Program Director:Concentration(s): I N V E
Name
Title
Address
City/State/Zip
VoiceFAX
Is the Program Director employed full-time by the sponsor?Yes No
Program Director (if applicable)Concentration(s): I N V E
Name
Title
Address
City/State/Zip
VoiceFAX
Is the Program Director employed full-time by the sponsor?Yes No
d.Clinical Coordinator(if applicable)Concentration(s): I N V E
Name
Title
Address
City/State/Zip
VoiceFAX
Is the Clinical Coordinator employed full-time by the sponsor?Yes No
Clinical Coordinator(if applicable)Concentration(s): I N V E
Name
Title
Address
City/State/Zip
VoiceFAX
Is the Clinical Coordinator employed full-time by the sponsor?Yes No
e.Medical Director(s)Concentration(s): I N V E
Name
Title
Address
City/State/Zip
VoiceFAX
Co-Medical Director(if applicable)Concentration(s): I N V E
Name
Title
Address
City/State/Zip
VoiceFAX
6.a.Start date of first class ever
b.Graduation date of the first class:
c.Next graduation date of current class:
7.Name and phone number of person(s) responsible for the preparation of the report:
Name:
Title:
Phone #:
FAX #:
Email:
Name:
Title:
Phone #:
FAX #:
Email:
TABLE OF CONTENTS
Foreach PART,Appendix, and Attachment indicate the page number.
Copy on to the CD/USB drives:CAAHEP Request for Accreditation Services form and JRC-CVT Site Visit Dates Request form.
Section / Page / Section / PagePART A:Standard I / PART D:Standard IV
1. / 3.
2. / 4.
3. / 5.
4. / 6.
5.
6. / PART E:Standard V
1.
PART B:Standard II / 2.
1. / 3.
2. / 4.
3. / 5.
4. / 6.
5. / 7.
6. / 8.
7. / 9.
8.
9. / PART F: Supplemental
10. / 1.
2.
PART C:Standard III / 3.
1. / 4.
2. / 5.
3. / 6.
4. / 7.
5. / 8.
6.
7. / Appendix A
8. / Appendix B
9. / Appendix C
10. / Appendix D
11. / Appendix E
12. / Appendix F
13. / Appendix G
14 / Appendix H
Appendix I
PART D:Standard IV / Appendix J
1. / Appendix K
2. / Appendix L
Appendix M
1
PART A:Sponsorship (Standard I)
1.State the legal name, full address, telephone number, FAX number, and web site address of the program sponsor:
2.State the type of sponsor institution, its current institutional accreditation status, dates of the most recent institutional accreditation, dates of the next institutional accreditation review, and the name of the institutional accreditor:
3.If the sponsor is a consortium:
a.Describe generally the role of each institutional member of the consortium.
b.State the accreditation status, dates of accreditation, and accreditor of each participating institution.
c.Place a copy of the consortium agreement in an electronic folder named Appendix J.
d.Describe the enrollment status of cardiovascular technology students in the educational institution.
4.List the other health professions programs offered by or within this institution.
5.Quote the mission of the sponsoring institution.
6.Briefly discuss the historical development of the program. Include the year the program started and major events that occurred since that date. The major events should include changes in the communities of interest that have had an impact on the goal(s) and/or curriculum of the program.
PART B:Program Goals (Standard II)
1.List the communities of interest served by the program as specified in Standard II.A and any additional communities of interest of the program. Describe the needs and expectations of each of the communities of interest.
2.Describehow the program concentration(s) is/are responsive to the demonstrated needs and expectations of the communities of interest. Describe each concentration separately.
3.List of the individuals and the communities of interest that they represent on the program advisory committee (must include at least one representative from each group stated in the list) (for individuals not on the drop down list, use rows 14-18):
Member Name / Community of Interest1. / Student
2. / Graduate
3. / Faculty
4. / Sponsor Administration
5. / Employer
6. / Physician
7. / Public
8. / Select Student Graduate Faculty Sponsor Administration Employers Physicians Public
9. / Select Student Graduate Faculty Sponsor Administration Employers Physicians Public
10. / Select Student Graduate Faculty Sponsor Administration Employers Physicians Public
11. / Select Student Graduate Faculty Sponsor Administration Employers Physicians Public
12. / Select Student Graduate Faculty Sponsor Administration Employers Physicians Public
13. / Select Student Graduate Faculty Sponsor Administration Employers Physicians Public
14.
15.
16.
17.
18.
4.Standard II.C. states the minimum expectation goal as: “To prepare competent entry-level cardiovascular technologists in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains for [each concentration].”
Are there any additional goals to be reviewed for accreditation? Yes No
If yes, describe the methods/process by which the stated goal(s) weredeveloped/adopted:
5.Indicate and describe the methods by which the programensures that the goal(s) and learning domainswill continue to meet the needs and expectations of the communities listed.
Advisory Committee
Employer Surveys
Graduate Surveys
Other, please describe:
6.Describe how the goal(s) and learning domains are utilized in program planning and implementation.
7.Has the advisory committee met at least once?Yes No
If No, please explain:
8.List the dates of all advisory committee meetings in the last 3 calendar years:
9.Place in an electronic folder named Appendix M, a copy of the Minutes of all Advisory Committee meetings in the last 3 years.
10.Describe any special considerations that impact your program characteristics.
PART C:Program Resources (Standard III)
1.Complete at least the first four (4) columns of the Resources Assessment matrix named Appendix A in this document.
2.Place in an electronic folder named Appendix B, a programmaticorganizational chart of the sponsoring institution (or consortium) that portrays the administrative relationships under which the program operates. Start with the chief administrative officer. Include all program Personnel and faculty, anyone named in the self-study report, and any other persons who have direct student contact except support science faculty. Include the names and titles of all individuals shown.
3.Explain any relationship in the programmatic organizational chart, which is other than direct line.
4.Place in an electronic folder named AppendixCa CV for each of the program Personnel and any other specialty concentration (track)didactic, laboratory, and clinical faculty members (no support course faculty). Limit to two pages, include education, credentials, and years of professional experience. Delete all publications. Also, include in the Appendix the job descriptions of the Program Director, the Medical Director, and Clinical Coordinator (if applicable).
5.Describe the teaching and administrative loads of each cardiovascular technology faculty member. List the actual number of lecture, laboratory, and/or clinical hours each faculty member teaches in each semester or quarter of the curriculum, as well as any assigned administrative time.
6.For each concentration (as applicable), completethe form named Program Course Requirements Table in Appendix D in this document to list all courses required in the curriculum. For a third concentration, complete the supplemental form from the JRC-CVT web site and place in an electronic folder named Appendix D.
7.How many total active clinical affiliates are used by the program?
Complete a Clinical Affiliate Institutional Data form for each active affiliate in Appendix E in this document. (Use onepage for each clinical affiliate. For more than two affiliates, use the supplemental forms from the JRC-CVT web site. The supplemental Appendix E file contains 5 forms. Insert or copy to the CD/USB drive in a folder named Appendix Eas many files as necessary to report on all affiliates.)
8.Completethe Student Hospital / Clinical Matrix form for each applicable concentration in Appendix F in this document.
9.List the evaluation methods and the results of those methods by which the program has determined that the content of the curriculum meets the minimum expectations goal and learning domains. (i.e. comparison with the appropriate national guidelines).
10.Analyze/discuss the results of those methods and describe the action plan(s) implemented or projected to be implemented to improve unsatisfactory results.
11.Place in an electronic folder named AppendixGa copy of the syllabi(containing at least the components specified in Standard III.C) of all didactic, laboratory, and clinical courses required in the program curriculum.
12.Describe instructional methodologies utilized and how their appropriateness is ascertained for each type of course in the specialty concentration (track) curriculum. (didactic, laboratory, and clinical).
13.Describe how the instruction is an appropriate sequence of classroom, laboratory, and clinical activities and how the clinical and laboratory activities are integrated with the didactic portion of the program.
14.Describe the type and amount of all planned physician instructional involvement in the program. (not required to be answered)
PART D:Student and Graduate Evaluation / Assessment (Standard IV)
1.Describe the type and frequency of evaluations of students that are conducted in the didactic, laboratory, and clinical components of the program.
2.Describe how student progress is tracked through the didactic, laboratory, and clinical courses and how students are regularly informed of their academic status throughout the program.
3.Describe the process by which the program will track retention/attrition for each entering cohort of students?
4.Describe how the program will survey its graduates using the JRC-CVT survey items within 6 to 12 months after graduation of each graduating cohort?
5.Describe how the program will survey the employers of its graduates using the JRC-CVT survey items within 6 to 12 months after graduation of each graduating cohort?
6.Describe how the program will utilize the outcomes data (i.e. retention, graduate surveys, employer surveys, credentialing examinations) in program evaluation and revision (if warranted)?
PART E:Fair Practices (Standard V)
1.Place in an electronic folder named AppendixH a copy of the most recent college catalogue and any other documents that make known to applicants and students the information specified in Standard V.A.2. Complete the following table listing the location(s) of the disclosures:
Disclosures / Source Document(s) / Page#
Accreditation status of the sponsor with mailingaddress, web address, and phone number
Accreditation status of the program with mailing address, web address, and phone number
Admission policies and practices
Technical standards (when used)
Policies on advanced placement
Policies on transfer of credits
Policies on credits for experiential learning
Number of credits required for program completion
Tuition, fees, and other program costs
Policies and procedures for student withdrawal
Policies and procedures for refunds of tuition/fees
Link to on-line catalogue, if applicable:
2.Place in an electronic folder named AppendixI a copy of additional material to be provided to enrolling students that makes known the information specified in Standard V.A.3 and Standards V.B and V.C. Complete the following table listing the location(s) of the disclosures:
Disclosures / Source Document(s) / Page#
Academic calendar
Student grievance procedure
Criteria for successful completion of each segment of the program
Criteria for graduation
Policies and procedures for performing clinical work while enrolled in the program
Non-discrimination policy for student admissions
Non-discrimination policy for faculty employment
Policies and procedures for processing faculty grievances
Policies and procedures to safeguard student health and safety
Link(s) to on-line additional materials, if applicable:
3.a.Describe the current and consistent information about student/graduate achievement that is maintained by the program, and provided upon request.
b.Which of the following outcomes assessments are included in the information described in question E,3,a? (check all that apply)
national credentialing examinations performance
programmatic retention/attrition
graduate satisfaction
employer satisfaction
job (positive) placement
programmatic summative measures
4.Describe methods to be utilized to select or admit students to the program.
5.Describe the assessment(s) by which the program determines that the admissions process is non-discriminatory; is appropriate to the needs of the program, and selects students who will be successful in the curriculum.
6.a.Does the institution have policies and procedures to
ensure compliance with the ADA?...... Yes No
b.Does the cardiovascular technology program disclose technical
standards in compliance with ADA?...... Yes No
c.When are students informed of the program’s technical standards?
7.Is there a faculty grievance policy/procedure?...... Yes No
8.Are grades and credits for courses recorded on a student
transcript and permanently maintained?...... Yes No
9.Is there a formal affiliation agreement or memorandum of
understanding with all other entities that participate in the
education of the students?...... Yes No
Copy to the CD/ flash drivein an electronic folder named Appendix L, a signed copy of the agreement for each activeclinical affiliation:
Appendix L – number of affiliation agreements submitted:
PART F:Supplementary Information / Materials
1.Program Information
Invasive / Non-Invasive /Echo / Vascular / Electro-physiologya. Maximum class size (capacity)
b. Enrollment 1st year students
c. Enrollment 2nd year students
d. Number of classes enrolled per year
e. Month(s) classes are enrolled(e.g. Sep)
f. # of paid full-time CVT faculty
g. # of paid part-time CVT faculty
h. # of unpaid CVT faculty
i. # of clinical affiliates
2.Are students instructed in ionizing radiation? Yes No
3.Are students monitored for exposure to ionizing radiation?Yes No
4.Any incidences of excessive exposure of students? Yes No
5.Are students instructed in contact precautions? Yes No
Program Strengths & Limitations
6.List the program’s areas of strength:
7.List the program’s limitations (areas that need improvement):
8.Describe the action plans developed to correct deficiencies for all areas in need of improvement (i.e. listed in question 7 above):
9.Insert the completed Faculty Evaluation SSR Questionnaires from each paid faculty member (didactic, laboratory, and clinical) and the Medical Director(s) in an electronic folder named Appendix K.
10.Student Evaluation SSR Questionnaires: JRC-CVT will notify each of your students of the availability of an on-line questionnaire that will provide the JRC-CVT with their perspective on various aspects of your program(s). The steps in the process are:
STEP 1:You send an email to with the names and email addresses of each of the students enrolled in each concentration. Group them by concentration, as applicable.
STEP 2:You explain to the students that they will receive an email from with the link to the online questionnaire, and to please complete the questionnaire promptly.