Unit 1 - Accreditation

You are a professor at one of our nation's dental schools. The Dean has just sent out an email announcement to the faculty indicating that you have recently been named a Site Visitor to the Commission on Dental Accreditation.

In this role you will be part of a team who conducts site visits to other dental education programs. In her message to the faculty she congratulates you on this appointment and indicates you are the only faculty member serving as a Commission Site Visitor. She further comments that the experience you gain can prove helpful to the school as it anticipates its own self-study scheduled to begin in two years, followed in 18 months by the site visit.

That afternoon you receive a telephone call from a young woman who just recently completed an advanced dental education program and is in the first year of her appointment as a tenure track assistant professor in the school. She asks if she can schedule a luncheon appointment to discuss "accreditation" with you.

At the luncheon engagement, your young colleague introduces the topic by saying she realizes that you are the individual in the school most knowledgeable about accreditation. She indicates that she is very ignorant about the matter, but realizes that it is an important issue for her as a dental educator and relevant in her desire to advance professionally. She further indicates that someday she too would like to be considered by her peers to be worthy of being named a Site Visitor to the Commission on Dental Accreditation.

She asks you to tell her about accreditation: What is the purpose of accreditation? What does it mean to be accredited? Do you have to be accredited? Is the government involved? Who accredits? What is the Commission on Dental Accreditation? When did it start? What is the process of becoming accredited and staying accredited? What did the dean mean by a "self-study?" How is one selected to be a Site Visitor to the Commission? What does a Site Visitor do?

Can you answer these questions for your young colleague? Actually, they are questions every thoughtful and informed faculty member should be able to answer. This module will assist you in answering these questions.

Objectives

After reading the materials in this unit the Site Visitor will be able to:

1. Describe the functions of higher education accreditation
2. Outline the procedures of accreditation
3. Explain the relationship of the Commission on Dental Accreditation to the United States Department of Education (USDE)
4. Describe the responsibilities of the Commission on Dental Accreditation (CDA, sometimes referred to as the Commission)
5. Describe the relationship of the Commission to the American Dental Association
6. Summarize the structure of the Commission

Learning Resources

Websites

http://www.ed.gov/admins/finaid/accred/accreditation.html#Overview

http://www.chea.org

http://www.aspa-usa.org

Appendices

1.1 CHEA Chronicle

1.2 Accreditation at a Crossroads

1.3 Recognition Chronology - Dentistry

1.4 Rules of the Commission

Accreditation in higher education is a collegial process based on self and peer assessment. Its purpose is the improvement of academic quality and public accountability. This continuing quality control process occurs usually every five to ten years.

Accreditation is a term covering both the initial and ongoing approval of a school, postsecondary institution, or program offering as meeting the standards established by a nationally recognized accrediting association for membership in the association. Accrediting associations are voluntary membership organizations that undertake to monitor the academic and administrative quality of their members, which are either entire institutions or components.

Accreditation is a uniquely American invention. In other countries, ministries and statutory laws grant recognition afforded to schools and higher education institutions. Accreditation is the United States' equivalent of this recognition. The validity of accreditation for such purposes is recognized by state governments, the federal government, and generally by other countries and international organizations. Most institutions attain eligibility for federal funds by holding an accredited status with one of the accrediting agencies recognized by the Secretary of the USDE.

The United States Department of Education provides the following overview of accreditation: The United States has no federal ministry of education or other centralized authority exercising single national control over postsecondary educational institutions in this country. The states assume varying degrees of control over education, but, in general, institutions of higher education are permitted to operate with considerable independence and autonomy. As a consequence, American educational institutions can vary widely in the character and quality of their programs.

In order to ensure a basic level of quality, the practice of accreditation arose in the United States as a means of conducting non-governmental, peer evaluation of educational institutions and programs. Private educational associations of regional or national scope have adopted criteria reflecting the qualities of a sound educational program and have developed procedures for evaluating institutions or programs to determine whether or not they are operating at basic levels of quality.

Functions of Accreditation:

1. Certifying that an institution or program has met established standards
2. Assisting prospective students in identifying acceptable institutions
3. Assisting institutions in determining the acceptability of transfer credits
4. Helping to identify institutions and programs for the investment of public and private funds
5. Protecting an institution against harmful internal and external pressure
6. Creating goals for self-improvement of weaker programs and stimulating a general raising of standards among educational institutions
7. Involving the faculty and staff comprehensively in situational evaluation and planning
8. Establishing criteria for professional certification and licensure and for upgrading federal assistance

Review and Practice 1.1: Define the higher education accreditation process and describe its purpose and functions in your own words.

The Accrediting Procedure:

1. Standards: The accrediting agency, in collaboration with its communities of interest, establishes and periodically revises standards and policies.
2. Self-study: The institution or program seeking accreditation prepares an in-depth self-study that measures its performance against the standards established by the accrediting agency.
3. On-site Evaluation: The association selects a team of external academic and administrative experts from other similar institutions or programs. The team reviews the self-study and visits the institution or program to determine first-hand if the applicant meets the established standards. The evaluation team issues its report of findings enumerating any conditions that need to be met before full positive approval may be given.
4. Publication: The association's members of the Board of Commissioners vote on the status of the candidate or member, and publish the names and information about successful candidates and re-accredited members in the next annual edition of its official approved list.
5. Reevaluation: The accrediting agency periodically reevaluates each institution or program that it lists to ascertain whether continuation of its accredited or pre-accredited status is warranted.

Types of Accreditation

There are two basic types of educational accreditation: one identified as "institutional" and one referred to as "specialized" or "programmatic."

Institutional accreditation normally applies to an entire institution, indicating that each of an institution's parts is contributing to the achievement of the institution's objectives, although not necessarily all at the same level of quality. The various commissions of the regional accrediting associations, for example, perform institutional accreditation, as do many national accrediting agencies.

Specialized or programmatic accreditation normally applies to programs, departments, or schools that are part of an institution. The accredited unit may be as large as a college or school within a university or as small as a curriculum within a discipline. Most of the specialized or programmatic accrediting agencies review units within an institution of higher education that is accredited by one of the regional accrediting commissions. However, certain accrediting agencies also accredit professional schools and other specialized or vocational institutions of higher education that are freestanding in their operations. Thus, a specialized or "programmatic" accrediting agency may also function in the capacity of an "institutional" accrediting agency.

In addition, a number of specialized accrediting agencies accredit educational programs within non-educational settings, such as hospitals.

The Commission on Dental Accreditation is a specialized accrediting body established by the American Dental Association to ensure the quality of institutions or programs graduating individuals as dental professionals. The CODA grants accreditation to dental, advanced dental and allied dental educational programs. The disciplines include:

• predoctoral dental
• dental hygiene
• dental assisting
• dental laboratory technology
• dental therapy
• dental public health
• oral and maxillofacial pathology
• oral and maxillofacial surgery
• pediatric dentistry
• prosthodontics
• orofacial pain
• endodontics
• oral and maxillofacial radiology
• orthodontics and dentofacial orthopedics
• periodontics
• general practice residency
• advanced education in general dentistry
• dental anesthesiology
• oral medicine

The Commission on Dental Accreditation is recognized as the accrediting agency for dental and dental-related educational programs. Authority to function as a nationally recognized accrediting agency is granted to the Commission through its recognition by the United States Department of Education (USDE).

United States Department of Education

The authority and recognition responsibility of the USDE is governed by the Higher Education Act (HEA) of 1965, as amended. This legislation is periodically re-authorized, usually every five years. Following each reauthorization, the Department promulgates new Procedures and Criteria for Recognition of Accrediting Agencies. The HEA was most recently re-authorized in 2008.

The Department of Education does not award accreditation status; it recognizes and maintains a listing of reliable authorities concerning the quality of education offered by institutions of higher education. An updated listing of all specialized accrediting agencies can be found at: https://www2.ed.gov/admins/finaid/accred/accreditation_pg7.html

The Secretary of Education requires the Commission to submit to the USDE the standards, policies, and procedures used in its evaluation program. Periodic reviews by the USDE are conducted to determine the Commission’s continued eligibility for recognition.

Eligibility for federal funding is linked to recognition by the USDE. Statutory restrictions mandate that educational institutions or programs must be accredited by a USDE-recognized accrediting agency in order to be eligible for federal funding.

Since 1952, the Secretary of the USDE has recognized the Commission on Dental Accreditation as the agency responsible for the accreditation of dental and dental-related educational programs.

Non-Governmental Agencies

In addition to the USDE, non-governmental agencies have also developed to promote and ensure the quality and diversity of postsecondary education. They recognize, coordinate, and periodically review the work of member-accrediting agencies. In the past, the Commission has participated in a series of organizations (COPA, CORPA) established to represent institutions of higher education. These organizations have now evolved into a third organization called the Council on Higher Education Accreditation (CHEA).

At its January 1999 meeting, the Commission considered a report on the Council on Higher Education Accreditation and its Recognition of Accrediting Organizations Policy and Procedures, effective January 1999. The Commission noted that accreditation agencies are eligible to apply for recognition by the CHEA if the majority of the accredited programs are degree granting. Because less than 50 percent of Commission-accredited programs grant degrees, the Commission is not eligible for recognition by the CHEA. The Commission determined not to request an exception to the Eligibility Policy but will continue to monitor issues being addressed by the higher education community through attending the CHEA conferences. The Commission may consider pursuing CHEA recognition at a later date.

More information on CHEA may be found at: http://www.chea.org/.

Two articles containing historical perspectives and commentaries on the accreditation process are included in Appendices 1.1 and 1.2.

Member of the ASPA

The Commission on Dental Accreditation is a member of the Association of Specialized and Professional Accreditors (ASPA). The ASPA is the only organization whose members are specialized and professional accreditors. ASPA-member accreditors set national educational standards for entry into about 45 specialized disciplines or defined professions. The ASPA, a 501(c)(3) association, works with higher education and government officials to enhance education and accreditation and functions as the only national voice for this important constituency.

The Association of Specialized and Professional Accreditors is an autonomous nonprofit corporation organized under the District of Columbia Nonprofit Corporation Act exclusively for educational, scientific, research, mutual improvement and professional purposes, and shall have the necessary and incidental powers to carry out its corporate purposes, among which shall be to:

1. Promote quality and integrity in non-governmental specialized and professional accreditation of post-secondary programs and institutions
2. Provide a forum for discussion and analysis and a mechanism for common action for those concerned with specialized and professional accreditation
3. Address accreditation issues in educational, governmental, and public policy contexts, and communicate with the public about accreditation
4. Facilitate collaboration among programs, institutions and accreditation organizations
5. Provide a mechanism for continuing education for individuals and organizations with accreditation responsibility

As an accrediting organization holding membership in the Association of Specialized and Professional Accreditors, the Commission on Dental Accreditation abides by the ASPA Code of Good Practice, adopted March 21, 1995 (April 2013):

An accrediting organization holding full membership in the Association of Specialized and Professional Accreditors:

1. Promotes the development of educational quality:

1. Focuses accreditation reviews on the development of student knowledge and competence in light of specific institutional and programmatic missions, goals, objectives, and contexts.
2. Conducts reviews in a spirit that recognizes that teaching and learning are the primary purposes of institutions/programs.
3. Places educational quality in accreditation reviews above special interests, politics or educational delivery models.

2. Exhibits integrity and professionalism in the conduct of its operations:

1. Maintains autonomy and integrity in governance and operations through appropriate relationships and practices.
2. Creates, documents and implements scope of authority, policies, and procedures to ensure objective decision making under a rule of law framework that includes attention to due process, systems of checks and balances, conflict of interest, confidentiality, expedient response to appeals and complaints and consistent application of standards.
3. Develops, reviews and revises standards and accreditation procedures with the participation of communities of interest.
4. Maintains sufficient financial, personnel, and other resources to carry out its operations effectively, while ensuring efficient and cost-effective accreditation processes for institutions/programs.
5. Cooperates with other accrediting organizations as appropriate to avoid conflicting standards and to minimize duplication of effort by the institution/program.
6. Provides thoughtful analyses to assist institutions/programs to find their own approaches and solutions, making a clear distinction between requirements for accreditation and recommendations for improvement.
7. Provides accurate, clear, and timely information in a professional manner to the higher education community, to the professions, and to the public about standards and procedures for accreditation and the accreditation status of institutions/programs.
8. Maintains a thorough and effective orientation, training, and professional development program for all accreditation personnel.
9. Ensures that site teams have the appropriate expertise and experience for each specific review.
10. Conducts evaluations of the accreditation process with institutions/programs that have experienced the accreditation process.
11. Encourages institutions/programs to provide public information that is appropriate to their specific communities of interest.

3. Respects and promotes institutional independence and freedom in academic decision making:

1. Encourages institutional independence and freedom to make academic decisions in light of the commitment to mutual accountability implied by participation in accreditation.
2. Applies standards and procedures that respect the rights and responsibilities of institutions/programs to identify, designate and control their respective: missions and goals; educational and philosophical principles and methodologies; content; agendas and areas of study pursued through scholarship, research, and policy developments; administrative structures and staffing configurations; and methodologies and timing of tests, evaluations and assessments.
3. Has standards and review procedures that allow for experimentation, encourage innovation, and promote thoughtful change that meets the needs and conditions in the profession and the communities served.

More information about the ASPA and its members may be accessed on the ASPA web site http://www.aspa-usa.org.

Review and Practice 1.3: What is the role of the USDE in the accreditation process?

Historical Perspective

The 1973 American Dental Association (ADA) House of Delegates approved establishment of the Commission on Accreditation of Dental and Dental Auxiliary Educational Programs (Appendix 1.3). Inherent in this action was the transfer of the dental profession’s accreditation program from the Association’s Council on Dental Education to the newly formed Commission, effective January 1, 1975. The 12 members of the ADA Council on Dental Education also served on the 20-member Board of Commissioners.

The 1979 House of Delegates voted to change the name of the Commission on Accreditation of Dental and Dental Auxiliary Educational Programs to the current name – Commission on Dental Accreditation.

In 1996, the ADA House of Delegates adopted two resolutions (84H-1996 and 142H-1996) calling for restructuring of the ADA’s Council on Dental Education and the Commission on Dental Accreditation. Specifically, members of the Council on Dental Education no longer serve concurrently on the Commission. The Council and Commission became two agencies with separate memberships at the adjournment of the 1997 ADA House of Delegates.

The Commission’s Position in the American Dental Association’s Organization

The duties and responsibilities of the Commission on Dental Accreditation are limited to matters relating to accreditation of programs for dental, advanced dental and allied dental education. The Commission has autonomy and final authority in matters relating to program evaluation, accreditation status and accreditation policies and guidelines. In addition, the Commission has authority for developing and approving accreditation standards for the disciplines (listed previously) under its purview. By reciprocal agreement, programs that are accredited by the Commission on Dental Accreditation of Canada are also recognized by CODA.

The disciplines identified as being within the purview of the Commission’s accreditation authority include:

• Predoctoral Dentistry
• Dental Public Health
• Endodontics
• Oral and Maxillofacial Pathology
• Oral and Maxillofacial Radiology
• Oral and Maxillofacial Surgery (Residency and Fellowship)
• Orthodontics and Dentofacial Orthopedics (Residency and Fellowship)
• Pediatric Dentistry
• Periodontics
• Prosthodontics
• General Practice Residency
• Advanced Education in General Dentistry
• Dental Anesthesiology
• Oral Medicine
• Orofacial Pain
• Dental Assisting
• Dental Hygiene
• Dental Laboratory Technology
• Dental Therapy

Review and Practice 1.4: What is the relationship of the Commission to the American Dental Association?

Commission Responsibilities

The Bylaws of the American Dental Association describe the duties of the Commission on Dental Accreditation:

• formulate and adopt requirements and guidelines for the accreditation of dental, advanced dental and allied dental educational programs
• accredit dental, advanced dental and allied dental educational programs
• provide a means for appeal from an adverse decision of the accrediting body of the Commission to a separate and distinct body of the Commission whose membership shall be totally different from that of the accrediting body of the Commission
• submit the Commission’s annual budget to the Board of Trustees of the Association

The Rules of the Commission on Dental Accreditation was first approved by the House of Delegates in 1973. Revisions to the Rules were approved in 1982, 1987 1997, 2002, 2010, 2012, 2015, 2017, 2018, 2019, 2020, and 2021. (Appendix 1).

Criteria for Accountability

Recognition criteria ensure that accrediting agencies are responsive to public needs and are representative of those groups affected by the accreditation program. Each accrediting agency must be structured to: a) provide adequate representation and autonomy at the decision-making level, and b) provide a mechanism whereby due process is afforded the participating educational program. The following principles of accountability and due process have been applied in structuring the Commission:

• providing appropriate representation from groups affected by accreditation decisions - Accountability within dental education demands that the accrediting agency include representation from dental, advanced dental and allied dental organizations, the consumer or lay public, and students
• establishing sufficient autonomy to render impartial decisions
• establishing responsibility and authority to develop and approve educational standards and policies related to accreditation
• providing the educational institution or program every opportunity to participate in the decision-making process prior to reaching a decision on accreditation status
• ensuring that accreditation actions are not arbitrary, but based on full disclosure of all information pertaining to or affecting the accreditation decision
• establishing an effective appeal process

Composition of the Commission on Dental Accreditation

Organizational representation of four positions each

• American Dental Association (ADA)
• American Association of Dental Boards (AADB)
• American Dental Education Association (ADEA)
• Public

Organizational representation of one position each

• American Academy of Oral and Maxillofacial Pathology (AAOMP)
• American Academy of Oral and Maxillofacial Radiology (AAOMR)
• American Academy of Pediatric Dentistry (AAPD)
• American Academy of Periodontology (AAP)
• American Association of Endodontists (AAE)
• American Association of Oral and Maxillofacial Surgeons (AAOMS)
• American Association of Orthodontists (AAO)
• American College of Prosthodontists (ACP)
• American Dental Assistants Association (ADAA)
• American Dental Hygienists’ Association (ADHA)
• American Student Dental Association/American Dental Education Association (Student)
• National Association of Dental Laboratories (NADL)
• Special Care Dentistry Association (SCDA) and American Dental Education Association (ADEA)
• American Society of Dentist Anesthesiologists (ASDA)
• American Academy of Oral Medicine (AAOM)
• American Academy of Orofacial Pain (AAOP)
• American Association of Public Health Dentistry (AAPHD)

Total - 33 appointments

Commission members are selected by and represent a broad community of interest. Each participating organization has the responsibility for selecting its representative(s), within criteria established by the Commission. All dentist Commissioners must be ADA members. The representatives of the ADAA and the NADL must be certified dental assistants and laboratory technicians respectively, and the representative of the ADHA must be a licensed dental hygienist. Representatives selected by the discipline specific dental organizations must be board certified in their respective special area of practice as appropriate.

Terms of Office

Commissioners serve a single four-year term, except for the student member who serves one two-year term. Consumer or public representatives to the Commission are selected from an appropriate national business, union or similar organization and serve one four-year term.

Chair’s Term of Office

The chair is elected annually by the Commission members and, like all dentists who serve on the Commission, must be a member of the ADA.

Review Committees of the Commission

Preliminary program review and consideration of other accreditation matters is a function of Commission Review Committees. The committees are:

Review Committee Abbreviation and Committee Names

•  Predoc RC
  — Review Committee on Predoctoral Dental Education
• PGD RC
  — Review Committee on Postdoctoral General Dentistry Education ,
• DA RC
  — Review Committee on Dental Assisting Education
• DH RC
  — Review Committee on Dental Hygiene Education
• DLT RC
  — Review Committee on Dental Laboratory Technology Education
• DENTANES RC
  — Review Committee on Dental Anesthesiology Education
• DPH RC
  — Review Committee on Dental Public Health Education
• ENDO RC
  — Review Committee on Endodontics Education
• OMP RC
  — Review Committee on Oral & Maxillofacial Pathology Education
• OMR RC
  — Review Committee on Oral & Maxillofacial Radiology
• OMS RC
  — Review Committee on Oral & Maxillofacial Surgery Education
• OM RC
  — Review Committee on Oral Medicine Education
• OFP RC
  — Review Committee on Orofacial Pain Education
• ORTHO RC
  — Review Committee on Orthodontics & Dentofacial Orthopedics Ed
• PED RC
  — Review Committee on Pediatric Dentistry Education
• PERIO RC
  — Review Committee on Periodontics Education
• PROS RC
  — Review Committee on Prosthodontics Education

Responsibilities of the Review Committees

These committees make recommendations related to: program accreditation status, procedures and policy, accreditation standards, and other related educational issues. Their recommendations are forwarded to the Commission for consideration and final action.

Commission members are frequently appointed to one of the above committees, or in the case of the chair and student commissioners, to serve as ex-officio members of all committees.

Review Committee Composition

Predoctoral Education Review Committee (9 members)

• 1 discipline-specific Commissioner appointed by American Dental Education Association
• 1 public member
• 3 dental educators who are involved with a predoctoral dental education program (two must be general dentists)
• 1 general dentist (One of whom is a practitioner
• 1 non-general* dentist dentist and the other an educator)
• 1 dental assistant, dental hygienist, dental therapist or dental laboratory technology professional educator
• 1 dental therapist educator

*a dentist who has completed an advanced dental education program in dental anesthesiology, dental public health, endodontics, oral and maxillofacial radiology, oral and maxillofacial pathology, oral and maxillofacial surgery, oral medicine, orofacial pain, orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics, or prosthodontics.

Six (6) Advanced Dental Education Review Committees (DENTANES, DPH, OFP, OMP, OMR, OM - 5 members each. At least one member must be a dental educator.)

• 1 discipline-specific Commissioner appointed by the discipline-specific sponsoring organization
• 1 public member
• 1 dentist nominated by the discipline-specific sponsoring organization
• 1 dentist nominated by the discipline-specific certifying board
• 1 general dentist

Six (6) Advanced Dental Education Review Committees (ENDO, OMS, ORTHO, PERIO, PED, PROS - 6 members each. At least one member must be a dental educator.)

• 1 discipline-specific Commissioner appointed by the discipline-specific sponsoring organization
• 1 public member
• 1 dentist nominated by the discipline-specific sponsoring organization
• 1 dentist nominated by the discipline-specific certifying board
• 1 dentist nominated by the discipline-specific certifying board and discipline-specific sponsoring organization
• 1 general dentist

Postdoctoral General Dentistry Review Committee (9 members)

• 1 discipline-specific Commissioner, jointly appointed by American Dental Education Association (ADEA) and the Special Care Dentistry Association (SCDA)
• 1 public member
• 2 current General Practice Residency (GPR) educators nominated by the SCDA
• 2 current Advanced Education in General Dentistry (AEGD) educators nominated by ADEA
• 1 general dentist graduate of a GPR or AEGD
• 1 non-general* dentist
• 1 higher education or hospital administrator with past or present experience in administration in a teaching institution

*a dentist who has completed an advanced dental education program in dental anesthesiology, dental public health, endodontics, oral and maxillofacial radiology, oral and maxillofacial pathology, oral and maxillofacial surgery, oral medicine, orofacial pain, orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics, or prosthodontics.

Dental Assisting Education Review Committee (10 members)

• 1 discipline-specific Commissioner appointed by American Dental Assistants Association
• 1 public member
• 2 general dentists (practitioner or educator)
• 5 dental assisting educators
• 1 dental assisting practitioner who is a graduate of a Commission accredited program

Dental Hygiene Education Review Committee (13 members)

• 1 discipline-specific Commissioner appointed by American Dental Hygienists’ Association
• 1 public member
• 5 dental hygienist educators
• 2 dental hygienist practitioners
• 2 dentist practitioners
• 1 dentist educator
• 1 higher education administrator

Dental Laboratory Technology Education Review Committee (5 members)

• 1 discipline-specific Commissioner appointed by National Association of Dental Laboratories
• 1 public member
• 1 general dentist
• 1 dental laboratory technology educator
• 1 Certified Dental Technician who manages and/or supervises dental laboratory technicians nominated by National Association of Dental Laboratories

Costs

Costs for convening the review committees are assumed by the Commission.