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Musings on Accreditation: the Paradox of Change

I’ve just returned from the Association of Specialized and Professional Accreditors’ spring conference in Chicago.  The theme of the conference was consistency and fairness in accreditation.  It was inspiring — filled with collegial exchanges, shared best practices, and thought-provoking presentations.

I was welcomed to Chicago by a glorious spring day:  windy, sunny and 72 º.  The next morning the temperature dropped 40 º and it was snowing.  Classic spring in Chicago.  Predictable day-to-day variability that eventually heralds summer.   Spring is a great example of the constancy of unpredictability and change, in the context of predictable and desirable seasonal transition.  Spring is a season of growth.  Summer is the season of maturity.

What intrigues me is how training (and learning) is all about deliberately fostering change, while in accreditation a core characteristic is consistency in evaluation standards that measure change.  Postgraduate training hones the NPs’ professional skills with a laser focus on applying current best evidence and delivering best practices in patient care.  Simultaneously, seasoned nurse practitioners are changed by and contribute to the rapidly changing face of health care and healthy living.  NP postgraduate training is the nexus between change and consistency.

The science and practice of healthcare is constantly changing.  The pedagogy of adult learning evolves.  The practical aspects of implementing training programs change as resources and opportunities shift.  Scientific discoveries radically alter the diagnosis and treatment of disease and our understanding of health.  Nevertheless, the foundations for change are stable – focused consistently on core values such as ‘do no harm’, use best evidence, implement best practices and share knowledge.

The community of NP postgraduate training programs emphasizes collegial and collaborative inter-professional practice.  This results in a multi-faceted “learning community” of trainees, faculty, staff, patients and the public.  Change is a constant.  Training, assessment and evaluation become a ‘360’ activity.  Everyone has something to contribute. The NP postgraduate training environment becomes the transitional professional season between newly minted practitioner and experienced colleague.

In Spring, daily variability defines the season. However, the trajectory is towards summer.  In postgraduate training and accreditation, programmatic variability encourages diverse ‘flashes of brilliance’ that move the field forward.  The question becomes, how do we as a community create a programmatic postgraduate NP training environment that promotes proactive change and risk-taking while being anchored in stable accreditation standards that embody best practices and best evidence?

What do you think?  I’d love to hear from you.

Until next time,


NNPRFTC Executive Director