Since I arrived at AUPHA in the mid-1990’s, there have been conversations about online programs offering degrees in healthcare management and what that meant for the field. In the early days, online programs were viewed as proprietary competitors taking market share from traditional, face-to-face programs in their local markets. There was a general sense among accreditors and the members of AUPHA that these programs were of lesser rigor and quality.
But in spite of this perception, the online programs have grown, flourished, and multiplied over the past decade, to the point where it is my sense (though we do not have accurate data) that in aggregate, more students graduate annually with a degree in healthcare management from an online program than graduate from AUPHA member programs offered only in a face-to-face format.
AUPHA staff have long been aware of the student demand for online education, as evidenced by the number of inquiries that we receive by phone, email, and in person at exhibits about what degrees are available in a format that does not require a student to leave their job or move from their current location. We happily offer up the AUPHA Directory that reflects the geographic distribution of programs, but these prospective students are not looking for a program in their back yard to which they have to commute several times per week to sit in a classroom. They are looking for a program they can complete from their home computer. But they want a good program, an accredited program.
As the number of online programs has grown at both proprietary institutions and more traditional not-for-profit universities, AUPHA’s board has evaluated and discussed the role of online programs in AUPHA. The conclusion of that discussion has been that, as an organization, our mission is to drive excellence and innovation in healthcare management education wherever it may be occurring, and we must be inclusive of all types of programs to fulfill that mission. So there is no barrier into entry in AUPHA membership based on delivery format. However, access to certain member benefits is limited by a program’s status vis-à-vis CAHME accreditation or AUPHA certification.
In the new 2013+ AUPHA Criteria for Undergraduate Certification, there are no restrictions on delivery format or method for the full curriculum in a certified undergraduate program. Therefore, any undergraduate program able to meet the rigorous criteria, regardless of delivery format, can potentially be certified. And any online program that commits to pursuing certification within a specified timeframe has access to Associate Candidate benefits. At the current time, however, a fully online program is not eligible for CAHME accreditation due to the CAHME eligibility criterion that requires that a program include at least 120 hours of in-person (face to face and belly to belly) instruction.
Pressure on CAHME has mounted in recent years to reassess the 120 face hour requirement with a view to potentially making it possible for fully online programs to become accredited. Program faculty of fully online programs have often shared with us their frustrations that their requests to CAHME to reassess this policy have (in their view) gone unheeded. They have therefore turned to AUPHA seeking our advocacy on their behalf. We have heard in repeated member satisfaction surveys that this is something the online programs would find of value in their membership.
In light of these pressures, the Board agreed at its June 2012 meeting that this topic warranted further examination, with a view to establishing a Board policy regarding online programs in healthcare management and their role in the future of our organization and the field, to include a position on accreditation of online programs. But that sort of a position cannot be developed in a vacuum, or lacking any unbiased understanding of how online programs compare to face-to-face programs on those metrics that really matter and on which CAHME and other accreditors are increasing their focus…educational and student outcomes. There are passionate and vocal members arguing that outcomes can be as good as or better in an online environment than those in a face-to-face environment. On the other side of the debate are those that argue that you simply cannot develop certain competencies (collaboration, team building, etc) in an online environment, that this requires a cohort to be face-to-face.
So given the various opinions, we decided to do what all good scholars do…turn to the evidence. We know that numerous studies have been conducted to demonstrate the efficacy of online education and the comparability of learning outcomes to those of face-to-face programs. We do not, however, have the staff resources nor the content expertise to effectively combine the results of that research into an informative report. We do, however, have Board designated funds in the AUPHA Foundation to support research to inform Board decision-making. So in early August we issued an RFP seeking authors interested in developing a white paper on the topic that will examine:
1. How do educational outcomes derived in an online or distance learning environment compare to those derived in a traditional (in person) environment?
2. How are educational outcomes assessed in an online learning environment that is focused primarily on competency attainment and demonstration?
3. How can the following types of educational objectives/competencies be achieved, demonstrated, and assessed in an online learning environment?
a. Professional socialization
b. Team building/Collaboration
c. Negotiation
d. Oral communication
e. Interpersonal Understanding
f. Talent Development
4. Are there AUPHA Undergraduate Certification Criteria or CAHME Accreditation Standards other than the 120 hour face-time requirement that exclude online programs from certification or accreditation?
5. What is the evidence of good practice in online education that an accreditor would wish to assess in order to determine the quality of an online program other than those already explicit in the AUPHA Undergraduate Certification Criteria & CAHME Accreditation Standards?
Armed with this information, I believe that the AUPHA Board will be able to reach agreement on a position vis-à-vis the accreditation of online programs. It is our hope that the evidence will allow the Board to come to such a position in an unbiased fashion. I will not speculate on the outcome of this process as I am not sufficiently informed as to what the evidence says. But I am very pleased that we have the resources to use this approach to information gathering to inform Board decision making.
The White Paper will be due at the end of the year, with a view to a Board discussion on the topic at the March 2013 meeting. Stay tuned for more news on this important issue.