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RWANDA ALLIED COUNCIL

STANDARDS FOR ACCREDITATION/RECOGNITION OF ANAESTHESIA TRAINING INSTITUTIONS/ PROGRAMMES

July 2016

Office of the Registrar

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TABLE OF CONTENTS

Introduction ...... 3 List of abbreviations ...... 4 SECTION ONE: MANDATE OF THE COUNCIL...... 5 SECTION TWO: STANDARDS OF TRAINING & ...... 6 STANDARD 1: Governance and ...... 6 STANDARD 2: Academic Programme ...... 8 STANDARD 3: Physical Infrastructure ...... 11 STANDARD 4: Academic Faculty ...... 12 STANDARD 5: Student Affairs ...... 13 STANDARD 6: Programme Monitoring & Evaluation ...... 14 STANDARD 7: Research and Innovation...... 14 SECTION THREE: NEW ANAESTHESIA SCHOOLS ...... 15 SECTION FOUR: GUIDELINES FOR TEACHING HEALTH FACILITIES ...... 17 1. Facilities ...... 17 3. Minimum Requirements for a Teaching for anaesthesia ...... 17 4. Supervision and Clinical portfolio ...... 18 SECTION FIVE: THE PROCESS OF RECOGNITION/ ACCREDITATION ...... 19 1.1 The Process of application ...... 19 SECTION SIX: APPEAL PROCESS ...... 20 Glossary ...... 21 REFERENCES ...... 25 Technical Team ...... 27

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Introduction

The Allied Health Professions Council (referred to as “The Council’) is the professional body for allied medical professions including non- anaesthesia practitioners and has the mandate to accredit anaesthesia programmes among others in partnership with the Higher Education Council (HEC).

The legal mandate gives the Council the responsibility of ensuring that learners undertaking anaesthesia training acquire the appropriate knowledge and skills that are necessary for the delivery of anaesthesia services.

The rising of HLIs offering health professions programmes in Rwanda has resulted in a need for standardized guidelines for inspection and accreditation of health related programs and teaching health facilities in order to ensure these training institutions meet the minimum requirements needed to successfully train competent physical health professionals which will ultimately ensure the provision of quality healthcare services.

These guidelines were developed as a yardstick to ensure Anaesthesia Schools and teaching health facilities meet the set requirements. It is also aimed at standardizing the competencies and standards of proficiency of students who undergo training in the accredited institutions.

It is anticipated that compliance with the standards will enable the anaesthesia training institutions to run and sustain their training programs thereby equipping the anaesthesia professionals with the necessary skills and knowledge.

Office of the Registrar Rwanda Allied Health Professions Council

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List of abbreviations

CPD: Continuous Professional Development

RAHPC: Rwanda Allied Health Professions Council

ICT: Information Communication Technology

M&E: Monitoring and Evaluation

WHO: World Health Organization

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SECTION ONE: MANDATE OF THE COUNCIL

The mandate of the Council is stated in its respective statutes. In exercise of its mandate and in partnership with the Higher Education Council, the Council shall: a. Approve of all Non-physician anaesthesia programmes and any modifications of the same for purposes of accreditation. b. Monitor the implementation of accredited programmes continuously. c. Evaluate continuing programmes. d. Register students and graduates from the training for purpose of being allowed to carry out professional practice.

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SECTION TWO: STANDARDS OF TRAINING & EDUCATION (Refer to guidelines for subject benchmarks for Anaesthesia see Annex)

STANDARD 1: Governance and Management

1.1 Justification An introductory statement about the anaesthesia training institution and its ties to its mother institution if it is a department or faculty/school. The justification should be evidence-based and involve a needs assessment/situation analysis.

1.2 Mission, Vision, Philosophy/Core Values 1.2.1 Vision: Should be relevant to the training of anaesthesia professionals in line with the values of the degree awarding institution. 1.2.2 Mission: Should address quality of education with respect to acquisition of professional competence. 1.2.3 Philosophy/ Core Values The values guiding the school towards achieving its goals. The training institution should have values and provide an environment that promotes professional and ethical behaviour. It should encourage harmonious and productive relationships among administrators, staff, and students. The training institution should be committed to being socially accountable in its activities Should be consistent with the philosophy of the mother institution 1.2 Legislation/Regulation 1.2.2 The awarding institution must be registered and duly recognized by the Competent Authority (Higher Education Council). 1.2.3 The non-physician anaesthesia training programme shall have the approval of the Council 1.3 Governance Structure This shall be regulated by defined statutes, rules and regulations. 1.3.1 Organizational Structure: The School shall have a well-defined leadership and management structure. This shall include an organogram. 1.3.2 Management Team (a) Degree awarding institutions

i. Head of Department who shall fulfill the following criteria: a. Be a holder of Master degree in Anaesthesia or its equivalent b. Be at least a Senior Lecturer, as stipulated by Commission/Council responsible for Higher Education

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1.3.3 Core thematic Areas Shall include but not limited to the following:  Applied &  Fundamentals of anaesthesia  Essentials of Practice Critical Care  Regional Anesthesia and  Trauma, Burns and Musculoskeletal  Airway, ENT and  Equipment, Pharmacology and Techniques  Pre-operative Assessment  Anesthesia Outcomes 1.3.4 Standing committees. Shall include but not limited to the following:-  Curriculum committee  Examination committee  Quality Assurance Committee 1.3.5 Membership of School Board. Shall comprise of Faculty and Students

1.3.6 Administration a. The appropriate administrative staff to support the implementation of the school’s educational programmes and ensure good management of its resources.

1.3.7 Academic Autonomy The school should have the autonomy to design the curriculum and allocate resources in collaboration with the University Administration using benchmarks recommended by the Council’s Anaesthesia Boards and competent authority responsible for Higher Education.

1.4 Financial Resources and Management: The School shall demonstrate evidence of: a. Financial resources to support program b. Financial management systems with clear policies and procedures

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STANDARD 2: Academic Programme

2.1. Naming of Programme Shall be Bachelor with honours in Anaesthesia 2.2. Professional Titles Three titles will be recognized: i. Specialist Anesthetist ii. Clinical Officer Anesthetist iii. Assistant Clinical Officer Anesthetist iv. Certified Registered Nurse Anesthetist v. Registered Nurse Anesthetist vi. Nurse Anesthetist

2.3. Curriculum The curriculum shall be in line with the requirements set by the Council’s Board (refer Subject benchmarks for Anesthesia).

2.3 Admission Policy and Selection a. Policy on student selection, b. Admission criteria stating minimum entry requirement for the University/institution, in line with the Authority responsible for Higher Education, Council’s minimum requirements. c. Student number in relation to physical facilities /infrastructure, human and financial resources. d. The school shall ensure that students admitted are supported by the teaching health facility capacity. 2.4 Student Indexing The school/institution shall show evidence of being up to date with annual submission of students’ name for indexing (student Registration).

2.5 Duration The minimum duration of the programme for Bachelor’s programme shall be four (04) years for full-time student and five & half (5.5) years for part-time student. No student shall exceed the number of years stipulated in the relevant University prospectus as stipulated in the General regulations set by HEC.

2.6 Curriculum Linkage with anaesthesia practice and the systems. Students shall be exposed to areas they will be expected to work in tertiary and facilities upon completion.

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2.7 Programme Management There shall be a curriculum committee to support, plan and monitor programme implementation. 2.7.1 Programme Outcomes (refer to subject benchmarks for details) i. Professional values, attitudes, behavior and ethics, ii. Scientific foundation of anaesthesia, iii. Clinical anaesthesia skills, iv. Communication skills including Information communication technology (ICT), v. Critical thinking and research, vi. Health systems management, vii. Leadership, Management and Entrepreneurship.

2.7.2 Model, structure and instructional methods a. Schools should state the model and structure of their curriculum as well as their methods of instruction. They are encouraged to adopt methods that support innovation, student-centered learning, and use of evidence-based training methodologies. b. Assessment of students  Establish assessment systems compatible with the learning/teaching methods.  schools should publish their examination regulations and make them known to students, c. The module title shall be reflected in the purpose of the module and the module’s expected learning outcomes; and

d. The expected learning outcomes shall be reflected in the module/course content, which shall be linked to the mode of delivery, instructional materials and/or equipment, assessment and reference materials.

2.7.3 Module/Course description The curriculum content should provide students with the necessary foundation in the basic/biological sciences, behavioural and social, management and clinical sciences to achieve the desired graduate competencies. The science foundation courses should be appropriately sequenced, integrated and the desired knowledge reinforced, and advanced progressively throughout the curriculum.

All modules/courses shall have a module/course title, prescribed units, purpose/aim, outcomes and content. Compulsory module areas indicated below are described in subject benchmarks for anaesthesia.

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i. Professional values, attitudes, behavior and ethics, ii. Scientific foundation of anaesthesia , iii. Clinical skills, iv. Communication skills, v. Information communication technology (ICT), vi. Critical thinking and research, vii. Health systems management, viii. Leadership and Management, Entrepreneurship. 2.8 Other resources a) Educational exchange programmes for staff and students b) Partnership and collaboration with other Higher Leaning Institutions

2.9. Academic Support The school shall, beyond the primary obligations, make provision for the following: a. Needy and disadvantaged students b. Students with disabilities c. Students with medical/ social challenges

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STANDARD 3: Physical Infrastructure

Anaesthesia schools shall have appropriate physical teaching facilities for the number of staff, students and programme, as stipulated by the commissions responsible for Higher Education. 3.1 Physical resources a. Administrative Block b. Staff offices c. Lecture rooms and tutorial rooms d. Appropriately equipped Technical and Skills Laboratories e. Library & Information technology services The institution shall have a schedule for maintenance and repair. Adequate sanitary facilities must be provided for staff, students and others.

The minimum physical, teaching and learning facilities shall include:

3.2 Teaching/tutorial facilities a) Minimum space of 2 square meter per student b) Audio visual facilities per teaching room c) Appropriate and adequate chairs and tables d) Adequate lighting and ventilation. e) Facilities for disabled students f) Laboratory space 1 - 2.5square meters per student g) Class room space 1 - 2 square meters per student 3.3 Teaching Skills Laboratory (i) Each major discipline in anaesthesia should have its own teaching equipment (ii) Each of the laboratories should have a store, wash up, preparation room/office. (iii) The fittings that include Windows, Doors, ceiling, power supply, water supply, desks and benches, firefighting devices and emergency exit should be appropriate and based on WHO guidelines. (iv) Essential Laboratory apparatus/equipment as per prescribed list by the board

3.4 The school should have Skills Laboratory equipment in right ratios (see attachment) but tailored to the minimum curriculum for the level.

3.5 Clinical resources for training- There must be a /health facilities within 5km-

a) Identification and development of satellite teaching approved by the board defining the following among others: Total number of staff required for both service and teaching functions, Distribution of staff between university and hospital, The role of staff in the anaesthesia school/hospital in areas of teaching and patient care, Student- equipment ratio, Resources sharing, Quality assurance of services rendered and relationship between the departments of the hospital and the university. b) Sustainable provision of clinical consumables to students c) Provision of tutorial rooms within the clinical area for teaching

3.6 Suitable accommodation facilities for students.

3.7 Adequate financial resources.

3.8 Library and information technology services to commensurate with student numbers  Student book ratio of 1:40

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 Student computer ratio 1:5  Library space 1 - 2 square meters per student  Access to internet 3.9 Adequate research facilities

3.10 Educational exchange programmes for staff and students

3.11 Staff offices shall be located within the school and shall be accessible to all stakeholders. Head of Programme’s office (a minimum area of 18 M2).

The departmental offices shall comprise of the following minimum number of offices:  One head of department office (a minimum area of 18 M2)  One secretary’s office (a minimum area of 7 M2)  Each faculty shall have a minimum area of 7 M2  Non-academic members’ staff offices shall have the following minimum floor areas (a minimum area of 7 M2).

STANDARD 4: Academic Faculty

 The number and qualifications of faculty are sufficient to meet the program’s mission and goals through educational administration, curriculum development, instructional design and delivery, research, and evaluation of outcomes.  The HLI and program encourage and support appropriate professional and career development of faculty relevant to their roles in the program, including support for new/junior faculty.  Faculty members are evaluated in accordance with University policies and with reference to clearly outlined criteria using multiple sources of information.  The rights and privileges of faculty are commensurate with other faculty in the university having comparable roles and responsibilities.  The program faculty have responsibility and authority for curriculum development, implementation, and evaluation.  The university and program support research and other scholarly activity conducted by faculty.

The following areas relating to academic, technical and administrative staff shall be stated clearly: a. A policy on recruitment addressing qualifications, specialization and career progression b. Academic Staff numbers; (i) A Lecturer/Student ratio of 1:20 is recommended for class room teaching (Lectures).There should be at least 1 Lecturer with specialization in that discipline and 1 non-physician anaesthetist per anaesthesia discipline. (ii) A Lecturer / students ratio of 1:10 is recommended for practical demonstrations. (iii) A clinical instructor/student ratio of 1:10 is recommended for class practical (iv) Basic sciences staff/student ratio of 1:12. (v) Clinical Placement areas staff/student ratio of 1:3. c. Full time academic Staff qualification

i. Basic sciences and non-clinical anaesthesia staffing should have 50% being holders of PhD or Master’s degree in the respective area/s of teaching with appropriate mix of medical and non-medical staff.

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ii. Clinical anaesthesia department/s lecturers should at least be 90% of total staff and should be holders of Master’s degree in Clinical Anaesthesia or its equivalent. d. Part-timers should be not more than 20% of clinical anaesthesia and 40% for preclinical/basic sciences teaching staff. e. A clear policy on staff development, and career progression f. Staff welfare: Support and counseling

STANDARD 5: Student Affairs

The program must support and prepare students with the competencies relevant to anaesthesia practice and regularly assesses their competencies and achievements:  The program shall ensure student participation in program planning, development, and evaluation.  Methods of teaching and learning must be aligned with program and curricular goals  The program must have a required mix of clinical education experience that is designed to encompass essential areas of practice and settings across the lifespan, and that enables students to achieve the required competencies.  There must be a framework for evaluation of student achievements with clearly defined evaluative criteria and outcomes: o A variety of appropriate methods and tools should be used to measure student performance o The program must provide appropriate and timely feedback to students about their strengths and opportunities for improvement and remediation.  The program shall provide mechanisms for students to address their individual or programmatic academic and clinical placement concerns.  The program shall ensure students have timely and confidential access to academic support and academic or psychosocial counselling services.

There should be a policy on student welfare which should address the following among others: a. Support and counseling b. Mentoring c. Academic support d. Career guidance e. Healthcare f. Financial matters g. Student organizations h. Rules of conduct should be published. i. Suitable accommodation facilities should be availed particularly during clinical period j. Dress code k. Recreational, cultural and spiritual support

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Recreational facilities: The institution shall provide accessible recreational facilities including outdoor and indoor facilities.

STANDARD 6: Programme Monitoring & Evaluation

a) The school/HLI shall have a policy on quality assurance and quality control, which should address monitoring and evaluation systems that provide for internal and external mechanisms to addressing the following: 1. Staff performance and appraisal 2. Student performance 3. Course content 4. Facilities 5. Organization 6. Programme evaluation b) The Council shall review the annual Monitoring and Evaluation (M&E) reports submitted by the schools. Where there is need, the Council shall advise the School/program on necessary measures that shall be instituted to maintain standards. There shall be formal reviews at the end of every programme cycle. c) The Council shall inspect the School/program at least once every cycle, with renewal of the accreditation certificate if the inspection is satisfactory.

STANDARD 7: Research and Innovation

A university shows evidence of promoting quality research and innovation. a. A university shall have thematic research areas in line with its institutional research policy and aligned to the national research policy. b. A university shall endeavor to have adequate funds for research by allocating a minimum of 2% of its operational budget to research. c. A university shall facilitate its staff to carry out research. d. A university shall have mechanism of providing incentives to members of staff who undertake research, attract research funds, innovate and/ or patent. e. A university shall document and disseminate its research outputs.

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SECTION THREE: NEW ANAESTHESIA SCHOOLS

The standards set out in section Two shall apply to new schools with modifications outlined in this section. Recognition of New Schools shall be upon fulfillment of the following requirements: 1. All legal requirements set out in Standard 1(1.3). At institutional level the following should be in place before intake of the first group of students: a. Approval (provisional accreditation) by the Council b. Institutions must enroll trainees who meet the minimum academic qualifications as required by HEC. c. Institution must conduct training using the HEC/ RAHPC approved curricula. d. Core Anaesthesia Module lecturers/Tutors must be registered and licensed by the RAHPC e. Institutions will ONLY admit the number of trainees recommended by the HEC/RAHPC based on available resources. f. Institutions MUST ensure availability of clinical attachment for trainees in RAHPC approved clinical laboratories. g. A definition of the governance structure of the anaesthesia school h. Appointment of the founding Head of the programme in accordance to the requirements in Section Two above. i. Appointment of Heads of thematic areas j. Appointment of administrative leadership. k. Establishment of the standing committees of the anaesthesia school.

2. Programme requirements

Before admission of the students the following should be in place: a. A curriculum approved by competent authority in charge of Higher Education in collaboration with the Council b. A comprehensive plan covering areas of financial resources, staff, curriculum implementation and students management for the first programme cycle i. Working plan for the curriculum as a whole, consistent with the educational objectives, ii. A detailed layout of the academic programmes for the first half of the programme cycle

iii. Written standards and procedures for the admission, evaluation, advancement, and graduation of students and for disciplinary action, including appeal mechanisms to ensure due process is followed,

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iv. Specification of the teaching and student evaluation methods suitable for the achievement of stated educational objectives, v. Design of a system for curriculum implementation and review, vi. Design of a system for educational programme evaluation, including the designation of outcome measures to indicate the achievement of overall educational objectives. vii. Six (6) months prior to commencement of the clinical phase of training, the following requirements shall be in place: a. The School shall have appointed appropriate staff as liaison officer to support clinical teaching. b. The school shall have set up appropriate physical infrastructure to facilitate clinical teaching as stipulated in section Two above,

3. Monitoring and evaluation a. The school shall submit annual reports to the Council on the implementation process on a format provided by the Council b. The Council shall carry out an inspection on the school prior to commencement of the clinical phase of training after one year from the commencement, after the School submits the necessary reports as provided in section 3 (a) above. c. The school shall conduct a full review of the first programme cycle, and this review shall incorporate the stakeholders. This report shall be submitted to the Council, following which, the Council shall re-inspect the School and if satisfactory, grant full accreditation in collaboration with the competent authority responsible for Higher Education d. Once fully recognized, the school shall then be inspected for renewal of the recognition certificate as stipulated in section two above. e. If not satisfactory, the School and the Council shall agree on an appropriate time limit within which the School should have made appropriate corrections. Once satisfactory, full recognition shall be granted. In the event of non-compliance, disciplinary action shall be taken as laid out in section 6. f. Thereafter these reviews shall be conducted with every cycle in accordance to the stipulation above for pre-existing schools.

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SECTION FOUR: GUIDELINES FOR TEACHING HEALTH FACILITIES

Teaching health facilities are key components in the training of anaesthesia professionals. The hospital facilities must attain and maintain minimum requirements. The hospital facilities and hospital must be in compliance with all relevant acts that govern the running of health facilities. The Council in consultations with the relevant government authorities shall accredit all anaesthesia training facilities.

1. Facilities Teaching health facilities for anaesthesia shall have the following functional components: (i) Pre anaesthesia assessment (ii) Operating Theatres with essential anaesthesia staff and equipment (iii) An operating theatre with post anaesthetic care Unit (iv) Resuscitation and emergency equipment

2. Relationship between Non-physician Anaesthesia Institution and Health Facilities ( Hospital, etc)

Every Institution running non-physician anaesthesia curriculum shall have a primary teaching hospital facility. The Institution with a non-physician anaesthesia program may use more than one teaching hospital facilities, as long as these hospitals are approved by the board/council. Memoranda of Understanding must be signed for the collaboration of the training institution and the hospital. All teaching Hospitals must have the following: a. Adequate cases for its level in healthcare b. Appropriate equipment for its level in health care. c. Distribution of staff between university and hospital and their role in the areas of teaching, research and patient care should be stated clearly. d. Student/supervisor ratio of 1:4 e. Supervisors who are a level above the students to be supervised or same level but with an experience of at least 3years

In case the anaesthesia institution does not own the hospital facility, there must be a clearly stipulated agreement addressing the above.

3. Minimum Requirements for a Teaching Hospital for anaesthesia a. Functional Units and ratios as stipulated in 1 and 2 above above. b. Tutorial rooms and side labs in the units for the students (tertiary only), c. Adherence to policy on prevention and control, 17 | P a g e

d. Adherence to policy on Occupational Health and Safety, e. Adherence to policy on staffing norms, f. Teaching hospitals shall be accredited as CPD Providers by the Councils, g. Provide resource centers including use of ICT 4. Supervision and Clinical portfolio

i. Completion of the training portfolio (Clinical Portfolio) must take place in approved training facilities (evidence of compliance with lab training approval standards may be requested).

ii. Learning, teaching and supervision must be designed to encourage safe and effective practice, independent learning and professional behavior.

iii. Students and practice placement trainers must be fully prepared for placement which will include information about and understanding of the following:  The learning outcomes to be achieved  Evidence required for the Clinical training portfolio to demonstrate the RAHPC standards of proficiency  Procedures for verifying if the portfolio has been completed and standards met is the role of the placement facilitator if appointed

iv. Unless other arrangements are agreed, practice placement trainers:

 Are registered on the appropriate part of the RAHPC register  Have relevant post-registration experience  Undertake appropriate training in teaching and learning techniques or CPD

v. There must be clear evidence of the collaboration and partnership arrangements between the HLI and practice placement providers, including audit of training standards, monitoring of students and feedback arrangements.

vi. The HLI must ensure necessary documentation and information is supplied to practice placement providers.

vii. Practice placement providers must ensure necessary information is available at the appropriate time for both the HLI and students.

viii. Throughout the placement a range of learning and teaching methods are employed that respect the needs of patients/clients and colleagues.

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SECTION FIVE: THE PROCESS OF RECOGNITION/ ACCREDITATION

The Council shall offer two forms of accreditation based on whether the institution seeking accreditation is a new or continuing school/programme namely: 1. Provisional Accreditation 2. Full Accreditation

1. Provisional Accreditation Provisional Accreditation is granted to a non-physician anaesthesia school, which is in the developmental stages of program implementation in a program that is partially operational.

This Accreditation provides evidence to educational institutions, licensing bodies, government or other granting agencies that, at the time of initial evaluation(s), the developing non-physician anaesthesia program has the potential of meeting the standards set forth in the requirements for a recognized non- physician anaesthesia program. Provisional Accreditation is granted based upon one or more site evaluation visit(s).

1.1 The Process of application 1. The parent institution shall apply to the Council for Accreditation

2. The Council shall thereafter provide the Accreditation standards to the applicant.

3. The applicant shall provide a preliminary status report addressing the requirements highlighted in the standards.

4. The Council and the applicant shall schedule a preliminary visit within a period of 3 weeks.

5. The Council shall ensure that the standards outlined have been met before granting the provisional Accreditation. The Council shall within 1 month issue provisional Accreditation where all the standards have been met. Where the standards have not been met, the Council shall issue a report indicating areas for improvement within a prescribed period.

6. Provisional Accreditation shall be revoked where the school fails to meet the set standards within the prescribed period. The school is subject to the rules of section 3 section 4 above.

7. The Validity of provisional Accreditation is maximum two (2) years

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2. Full Accreditation

Full Accreditation shall be granted to the institution that has met all the stipulated standards by the Council after the first programme cycle. 2.1 Student’s feedback.  The Council shall have a mechanism in place such an assessment tool for student feedback.  The tool shall provide information on strengths and weakness of the programs offered  The information shall be analyzed and the feedback shall be sent to the school within a period of 3 months. 2.2 The Process of full Accreditation

1. The parent institution shall apply to the Council for full Accreditation

2. The Council shall thereafter provide the Accreditation standards. The applicant shall provide a preliminary status report addressing the requirements highlighted standards.

3. The Council and the applicant shall schedule a visit within a period of 3 months.

The Council shall ensure that the standards outlined have been met before granting the full Accreditation.

The Council shall within 1 month issue full accreditation where all the standards have been met. Where the standards have not been met, the Councils shall issue a report indicating areas for improvement within a prescribed period.

The Validity of full recognition is equivalent to one programme cycle

3. Constitution and Role of the Inspection team for Accreditation The Council shall constitute a joint team that shall carry out inspection for the purpose of recognition. At least a three (03) weeks’ notice shall be communicated to the school for the scheduled inspection visit. 4. The cost of Inspection The cost of joint inspection shall be covered by the Council and the individual Institution. 5. The Inspection report The report shall be prepared and availed at the end of the inspection. The training institution shall respond to the report within Sixty (60) days after receiving it.

SECTION SIX: APPEAL PROCESS Programs denied recognition status or whose recognition status has been withdrawn, have the opportunity to appeal the decision. A request for an appeal must be received by the Council. The Council shall constitute a team to conduct a re-inspection within thirty (30) days.

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Glossary

Academic quality- is a way of describing how well the learning opportunities available to students help them to achieve their award. It is making sure that appropriate and effective teaching, support, assessment and learning opportunities are provided for all students.

Accreditation- is a type of quality assurance process which utilizes all aspects of review and assessment according to pre-defined standards. Accreditation may be applied to education programmes or a programme of health related delivery.

Academic faculty- members of staff involved in the delivery of the entry level programme. The term “Teaching Faculty” is also used.

Anaesthesia- A way to control pain during a or procedure by using called anesthetics. It can help control your breathing, blood pressure, blood flow, and heart rate and rhythm

Anaesthetist/Anaesthesiologist- for the purpose of this document the word anaesthesiologist refers to all professional individuals who specialized in anaesthesia after undergoing undergraduate .

Non-physician Anaesthetist’ (NPA) - This refers to all health professionals who provide anaesthesia without undergoing medical education (no prior undergraduate qualification in medicine).

Specialist clinical officer Anaesthetist – is a skilled person qualified by academic and clinical education in anaesthesia who have acquired a Master’s Degree or its equivalent in anaesthesia from a recognized higher learning institution.

Clinical Officer Anaesthetist- A skilled person qualified by academic and clinical education in anaesthesia who have acquired a Bachelors’ Degree or its equivalent in anaesthesia from a recognized higher learning institution.

Assistant Clinical Officer Anaesthetist- refers to a skilled person qualified by academic and clinical education in anaesthesia who have acquired advanced or its equivalent in anaesthesia from a recognized higher learning institution.

Certified Registered Nurse Anaesthetist- A registered nurse who has qualified by academic and clinical education in anesthesia who have acquired a Master’s Degree or its equivalent in anaesthesia from a recognized higher learning institution.

Registered Nurse Anaesthetist- A registered nurse who has qualified by academic and clinical education in anesthesia who have acquired a bachelors’ Degree or its equivalent in anaesthesia from a recognized higher learning institution.

Nurse Anaesthetist- An enrolled nurse who has qualified by academic and clinical education in anesthesia who have acquired an advanced Diploma or its equivalent in anaesthesia from a recognized higher learning institution. Approval refers to the formal processes by which a diploma or degree-awarding body agrees that a programme may be offered for study by students.

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Associate faculty — the people whose employing faculty is not the anaesthesia faculty and who teach their subject in anaesthesia professional programmes. Examples of associate faculty are , biologists and nutritionists. See also faculty.

Bachelor’s degree — is an academic degree granted to individuals who have undergone: study demonstrating acquisition of a systematic and coherent body of knowledge, the underlying principles and concepts, and the associated communication and problem-solving skills; development of the academic skills and attributes necessary, comprehend and evaluate new information, concepts and evidence from a range of sources; development of the ability to review, consolidate, extend and apply the knowledge and techniques learned, including in a professional context; development of a foundation for self-directed and lifelong learning; and development of interpersonal and teamwork skills appropriate to employment and/or further study. A programme leading to this qualification also usually involves major studies in which significant literature is available. Programme content is taken to a significant depth and progressively developed to a high level which provides a basis for postgraduate study and professional careers.

Clinical education — is the delivery, monitoring and evaluation of learning experiences in clinical settings. Clinical education sites may include institutional, industrial, occupational, , and community settings providing all aspects of the patient/client management model (examination, evaluation, intervention, diagnosis, prognosis/plan of care, and interventions including prevention, , and wellness programmes).

Clinical education director/coordinator — is a professional and an academic faculty member, who is responsible for the clinical education component of the professional entry level programme that is normally delivered by dully qualified professionals in the clinical environment.

Clinical education site instructors — Health Professionals practising in clinical placement sites who supervise and evaluate the clinical skills of the student while on placement and report to the higher education institution. (May also be known as clinical supervisor/clinical educator).

Competency- The ability to perform the activities within an occupation or function to the standard expected in employment. It refers also to the ability of a professional to practise safely and effectively in a range of contexts and situations of varying levels of complexity. The level of an individual’s competence in any situation will be influenced by many factors. These factors include, but are not limited to, the professional’s qualifications, clinical experience, professional development and their ability to integrate knowledge, skills, attitudes, values and judgments.

Continuing professional development (CPD) — is the process through which individuals undertake learning, through a broad range of activities that maintains, develops, and enhances skills and knowledge in order to improve performance in practice

Core academic faculty — the people who are employed in the anaesthesia school/ faculty/department to teach professional education programmes. See also faculty.

Curriculum development — “describes all the ways in which a training or teaching organization plans and guides learning. This learning can take place in groups or with individual learners. It can take place inside or outside a classroom. It can take place in an institutional setting like a school, or training centre...”

Degree - an academic rank conferred by a university after examination or completion of a course

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Faculty - a department or group of related departments in a college or university’ and ‘all the teachers in a faculty of a college or university.

Fundamental legal responsibilities- Obligations arising from legal and regulatory frameworks including but not limited to frameworks that apply to health records, work health and safety, privacy, and the professional’s registration.

Graduate degree - a degree subsequent to a first academic degree; Master’s and Doctoral degrees are examples of graduate degrees. The term Postgraduate degree is also used.

Health- A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. (World Health Organisation, 1946).

Health literacy- A client’s knowledge, motivation and competence to access, understand, appraise and apply health information to make effective decisions and take appropriate action for their health and health care. (Sørensen et al, 2012).

Health worker - Refers to all individuals engaged in actions with the primary intent being to enhance health. This includes those who promote and preserve health, those who diagnose and treat disease, health management and support workers, professionals with discrete/unique areas of competence, whether regulated or non-regulated, conventional or complementary. (World Health Organisation, 2006)

Interprofessional practice- Two or more professions working together as a team with a common purpose, commitment and mutual respect (Dunston et al, 2009).

Key competency - Practice that is necessary for a professional to safely and effectively perform the relevant professional role in a range of contexts and situations of varying levels of complexity. The language used in the key competencies reflects the complex integration of knowledge, skills, attitudes, values, and judgments.

Master’s degree - is an academic degree granted to individuals who have undergone study demonstrating a mastery or high-order overview of a specific field of study or area of professional practice. Within the area studied, graduates possess: advanced knowledge of a specialised body of theoretical and applied topics; high order skills in analysis, critical evaluation and/or professional application; and the ability to solve complex problems and think rigorously and independent.

Programme- is used to describe any stand-alone, approved curriculum by the Council followed by student, which contribute to a qualification of a diploma or degree-awarding body or otherwise carries credit where is used. The provision may be of any length, volume or credit value, and includes pre- defined programmes leading to a specific qualification, multidisciplinary programmes, pathways through a modular scheme, short periods of study leading to the award academic credit, as well as programmes where the specific content is negotiated between the HIL and individual student.

Programme design- is a creative activity, which may result in innovative ideas for higher education provision. It is followed by a process of “development” which leads to the creation of a programme. Through this process, the content, modes of delivery, structure and components of the programme, including assessment methods and the means by which students will be engaged with the curriculum are considered.

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The development process may also be used to enhance an existing programme, for example in response to the outcomes of programme monitoring and review.

Programme monitoring- refers to a regular, systematic process. It may take place annually or at shorter or longer intervals and provides a check on ongoing learning and teaching provision at an operational level.

Programme review - refers to a less frequently, but periodically and to an agreed cycle. It has a broader remit and is informed by a view of trends over time. The review of a programme may be related to its re-approval, if the original approval was time limited; if the approval was open ended, review is designed in a way that fulfills the function of re-approval.

Professional entry level education programmes — are those that equip professionals to practise as independent professionals. RAHPC recommends that education for entry level professionals should be based on university or university-level studies of a minimum of three for advanced diploma and four years for Bachelor’s degree, independently validated and accredited as being at a standard that affords graduates full statutory and professional recognition.

Qualification- formal certification, issued by a relevant approved body, in recognition that a person has achieved learning outcomes or competencies relevant to identified individual, professional, industry or community needs. The term credential is also used.

Recognition- is formal acceptance of a learner’s knowledge, skills, or former academic studies and the granting of advanced standing or credit. The term may also apply to formal acceptance of an educational institution by another institution or public authority. Recognition relates more to acceptance and equivalency, ie determining a relationship of parity between one system, jurisdiction, or institution and another with respect to the value and significance of courses, , certificates, licenses, and/or degrees.

Regulation of the profession - cluster of laws, regulations, directives or rules set by the RAHPC to Non-physician anaesthesia profession. The regulation can also be in form of self-regulation set by the non-physician anaesthesia profession.

Standards of practice - are a collection of documents describing the professional consensus on the practise of Anaesthesia for anaesthesia professionals working in any occupational setting. Standards reflect the collective judgement of the profession at a given point in time.

Threshold- Is the point on the continuum of competence at which an individual’s ability across the specified key competencies is sufficient to practise as a registered in Rwanda.

Threshold competence- Is the level of competence across the specified key competencies required to practise as a registered health professional in Rwanda.

Well-being- A state in which an individual has the physical capacity, mental health and social resources they need to successfully manage a particular psychological, social and/or physical challenge. (Dodge et al 2012)

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REFERENCES

1. Australian Qualifications Framework (AQF) Advisory Board. Australian Quality Framework Implementation Handbook Fourth Edition. Carlton, : AQF Advisory Board; 2007. http://www.aqf.edu.au/Portals/0/Documents/Handbook/AQF_Handbook_07.pdf (Access date 9th September 2015) 2. Canadian Information Centre for International Credentials. Guide to terminology usage. Toronto, : CICIC; 2003. http://www.cicic.ca/docs/guide/guide2003.en.pdf (Access date 30th June 2015) 3. World Federation for Medical Education: WFME Global Standards for Quality Improvement, 2003. 4. . Tomorrows’ Doctors Recommendation on undergraduate Medical Education. The Education Committee of the General Medical Council, London 1993. 5. Global Minimum essential requirement in Medical Education. Core Committee, Institute for International Medical Education. Copy 1999 – 2006. 6. Recognition guidelines for New and Developing Medical Schools. Caribbean Recognition Authority for Education in Medicine and other Health Professions CAAM – HP – 2.1 – 2004. 7. Core curriculum in for Medical Students. World Psychiatric Association. World Federation for Medical Education. WHO 2005. 8. Dodge R, Daly A, Huyton J & Sanders L 2012, ‘The challenge of defining wellbeing’, International Journal of Wellbeing 2(3):222-235.

9. European Region World Confederation for Anaesthesia. European Region World Confederation for Anaesthesia Glossary of Terms. Brussels, Belgium: ER-WCPT; 2010. 10. Lester S 2014, ‘Professional standards and competence frameworks in the ’, Assessment and Evaluation in Higher Education, 39 (1):38-52.

11. Lewis SR, et al. Physician Anaesthetists versus non-physician providers of anaesthesia for surgical patients. Cochrane Database Syst Rev 2014;7;CD010357.

12. Oxford University Press. Oxford Advanced Learner's Dictionary. Oxford, UK: Oxford University Press; 2011.

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http://www.oxfordadvancedlearnersdictionary.com/dictionary/faculty (Access date 9th September 2015) 13. Recognition of medical education institutions. Report of a technical meeting Schaeffergarden, Copenhagen, Denmark, 4 – 6 October 2004. 14. Technical discussions. Accreditation of hospital and Medical educational institutions–challenges and future directions. B. Medical education institutions. ME/RC50/Tech.Disc.11 15. Iraqi National Guideline On Standards for Establishing and Accrediting Medical Schools Prepared by Deans of of , Faculty and MOH Technical Staff Endorsed by Ministry of Higher Education in collaboration with Ministry of Health and World Health Organization, January2010. 16. Commission of University Education (CUE): Universities standards and guidelines June 2014 17. Morgan, G.E., Mikhail, M.S., Murray, M.J., Kleinman, W., Nitti, G.J., Nitti, J.T., Raya, J., Bedford, R.F., Bion, J.F., Butterworth, J. and Cohen, N.H., 2002. Clinical (Vol. 1). New York: McGraw-hill. 18. Smith, A.F. and Carlisle, J., 2015. Reviews, systematic reviews and Anaesthesia. Anaesthesia, 70(6), pp.644-650 19. World Confederation for Anaesthesia. WCPT guideline for the clinical education component of the physical therapist professional entry level programme. London, UK: WCPT; 2011. www.wcpt.org/guidelines/clinical-education (Access date 22nd September 2015) 20. World Health Organization 1946, Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

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Technical Team 1. Alexis MUTANGA- Registered Anaesthetist 2. Emmanuel RUSATSI- Registered Clinical Perfusionist and Nurse Anaesthetist 3. Paulin RUHATO BANGUTI, MD- Senior Lecturer and Anaesthesiologist 4. Jean Marie UWITONZE- Registered Anaesthetist 5. J. Baptiste NDAHIRIWE- Registrar, Rwanda Allied Health Professions Council (RAHPC)

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Office of the Registrar P. O. Box 6600 Kigali-Rwanda Tel: +250 727-795-209 Email : [email protected] Website: www.rahpc.org.rw

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