NAACLS Self-Study Template

Standard III.C: Resources – Physical ResourcesContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationProvide a sample list of equipment andinstructional resources available to students andhow they are utilized in the curriculum.Files

Standard IV.A: Students – Publications and DisclosuresContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study (if not applicable write NA):Please label each attachment per item required.DocumentationURL/FileCollege CatalogProgram of Study identifying course sequenceand class scheduleApplication FormProgram BrochureStudent and/or Clinical Handbook

Accompanying Documentation for Self-Study (continued): Please indicate where the followinginformation can be found. Provide specific page numbers and paragraphs when referring to webpage or paper publications such as catalogs, handbooks, and brochures. Alternatively, scan andattach appropriate pages or include quoted, cited passages from the indentified publication.ItemsProgram Mission StatementProgram Goals and Graduate CompetenciesProgrammatic Accreditation/Approval Statusincluding NAACLS contact information.Results of external certification outcomes,graduation rates outcomes, placementrates outcomes of the last three activeyearsList of Clinical FacilitiesAdmission CriteriaA list of course descriptionsNames and academic rank or title of the programdirector and facultyTuition and fees with refund policiesService work policiesPolicies & procedures for 1) advising & guidingstudents through the program, 2) clinical assignment,3) student grievance & appeals, 4) criteria forprogram completion including probation, suspension,and dismissalAcademic Calendar AND rules & regulations governingacceptable personal and academic conduct, includingbehavior expectations for clinical experienceURL/File

Standard IV.B: Students – Student RecordsContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationInclude policies and procedures regarding theretention of records for enrolled students.Files

Standard IV.C: Students – Health and SafetyContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationInclude the policy and procedures used forsafeguarding the health and safety of students,faculty and patients.Include any forms or other documentation used toprovide evidence that students have receivedbiohazard and safety training.Files

Standard V: Operational Policies – Fair PracticesStandard V.A - Contents of Narrative for Self-Study (See Standards Compliance Guide forrequired/suggested contents):Standard V.A - Accompanying Documentation for Self-Study:Documentation (optional)FilesSubmit written and/or published documentationto support statements made in narrative:Standard V.B - Contents of Narrative for Self-Study (Optional):No narrative required.Standard V.B - Accompanying Documentation for Self-Study:DocumentationProvide location on website, or evidence ofdocuments with location, of non-discriminationpolicies for staff and faculty.Provide location on website, or evidence ofdocuments with location or non-discriminationpolicies for student recruitment and admission.Files

Standard V.C - Contents of Narrative for Self-Study (Optional):No narrative required.Standard V.C - Accompanying Documentation for Self-Study:DocumentationFilesProvide evidence that indicates that granting ofthe degree or certificate is not contingent uponpassing an external certification or licensureexam (For example: Student Handbook orCatalog statements.Standard V.D - Contents of Narrative for Self-Study (See Standards Compliance Guide forrequired/suggested contents):No narrative required.Standard V.D - Accompanying Documentation for Self-Study:DocumentationProvide a general plan for potential temporaryand permanent closures, addressing possiblestudent transition and completionopportunities.Files

Standard V.E - Contents of Narrative for Self-Study (See Standards Compliance Guide forrequired/suggested contents):Standard V.E - Accompanying Documentation for Self-Study:DocumentationFilesSubmit policy that explains under whatconditions students may be permitted toperform service work for institutionsStandard V.F - Contents of Narrative for Self-Study (See Standards Compliance Guide forrequired/suggested contents):Standard V.F - Accompanying Documentation for Self-Study:Documentation (Optional)Submit policies that demonstrate students arenot to be substituted for staff duringeducational scheduled times.Files

Standard VI: Administrative: MaintainingAccreditation/Approval – Program/SponsoringInstitution ResponsibilitiesThis Standard involves the administrative requirements for maintaining accreditation/approvalthroughout its award period, and therefore is not reviewed in the self-study or site visit process.

Standard VII.A: Program Administration – ProgramDirectorStandard VII.A.1 Qualifications- Contents of Narrative for Self-Study (See Standards Compliance Guidefor required/suggested contents):Standard VII.A.1 Qualifications - Accompanying Documentation for Self-Study:DocumentationProvide a curriculum vita for the program directorthat provides documentation of teachingexperience, knowledge of education methods andadministration, current NAACLS accreditationprocedures and certification procedures. Include afaculty position description for the programdirector, indicating responsibilities for the position.*For Phlebotomy Programs only: For certificationagencies recognized by NAACLS as meetingStandard requirements for PhlebotomyCertification Qualifications of a program director,see Standards Compliance Guide.Submit notification from NAACLS indicatingthat program director was approved (Approvalletter/previous award will satisfy allrequirements for this standard.Files

Standard VII.A.2 Responsibilities - Contents of Narrative for Self-Study (See Standards ComplianceGuide for required/suggested contents):Standard VII.A.2 Responsibilities - Accompanying Documentation for Self-Study:DocumentationSubmit a completed Faculty Fact Sheet for theprogram director, including requiredprofessional development.Submit a faculty position description for theProgram Director, indicating responsibilities forthe position.Files

Standard VII.A.3 Faculty Appointment - Contents of Narrative for Self-Study (See StandardsCompliance Guide for required/suggested contents):Standard VII.A.3 Faculty Appointment - Accompanying Documentation for Self-Study:DocumentationProvide documentation of faculty appointments(or equivalent) for the program director (letters ofappointment, college web pages, catalog listing,etc.). Language found in affiliation agreements isnot proof of appointment.Files

Standard VII.B: Program Administration – Site ProgramCoordinator (required for Multi-location only, assignedto each participating site)Standard VII.B.1 Qualifications- Contents of Narrative for Self-Study (See Standards Compliance Guidefor required/suggested contents):Standard VII.B.1 Qualifications - Accompanying Documentation for Self-Study:DocumentationProvide a curriculum vita for the site programcoordinator, providing documentation ofdiscipline-appropriate education experience.Files

Standard VII.B.2 Responsibilities - Contents of Narrative for Self-Study (See Standards ComplianceGuide for required/suggested contents):Standard VII.B.2 Responsibilities - Accompanying Documentation for Self-Study:DocumentationSubmit a completed Faculty Fact Sheet for the siteprogram coordinatorSubmit a completed Faculty Fact Sheet for the siteprogram coordinator, a faculty positiondescription indicating responsibilities, anddocumentation that site program coordinator isresponsible for required aspects of the program.Files

Standard VII.C: Program Administration – Faculty Members andClinical LiaisonContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationSubmit didactic faculty fact sheets for each majordidactic faculty memberInformation for a Clinical Liaison is to be includedon each Clinical Facility Fact Sheet that isattached to the table under Sponsorship.Include narrative on the relevancy of theprofessional development activities listed on theaccompanying didactic faculty fact sheets, asrelated to the program responsibilities of eachmajor faculty member.Document that the faculty teach effectively at theappropriate level. Supporting documentationshould include sample faculty and studentevaluation forms****Documentation submitted and made availablefor review that contains confidential information(i.e. Student/Faculty Names, Social SecurityNumbers, etc.) may have such content redacted toprotect privacy.Representative sample of communicationbetween the clinical liaison and the programdirector or designee.Files

Standard VII.D: Program Administration – AdvisoryCommitteeContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationSubmit evidence of regular, meaningful andrelevant input from Advisory Committeemembers (for example: minutes, emails, notesfrom phone conversations or individualmeetings, etc.).Files

Standard VII.E: Program Administration – EducationCoordinator (when required)Contents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationSubmit a completed Faculty Fact Sheet for theeducation coordinator.Submit a curriculum vita for the educationcoordinator, providing documentation ofknowledge of current NAACLS accreditationprocedures and certification procedures.Files

Standard VII.F: Program Administration – MedicalDirector (for PathA Programs only)Contents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationSubmit a completed Faculty Fact Sheet for themedical director.Include a signed facility position description for themedical director, indicating responsibilities for theposition.Files

Standard VIII.A for Accredited Programs: CurriculumRequirements – Instructional AreasContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationProvide a completed Standard VIII Matrix thatidentifies where items listed in Standard VIII.Aare addressed in the tricies-2015.aspxProvide a program schedule which includes thesequence of courses and student clinicalassignments.FOR MLS, MLT:Provide examples of how each course addressesthe pre-analytical, analytical, and post analyticalcomponents as listed in SCG. FOR HTL & HT:Provide examples of how each course addressesthe following: Histopathology applicationsSubmit a list of required prerequisite coursework.Files

Standard VIII.B for Accredited Programs: CurriculumRequirements – Learning ExperiencesContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationDocument program policies regarding studentsperforming procedures under qualified supervision(See Standards Compliance Guide for suggesteddocuments):Files

Standard VIII.C for Accredited Programs: CurriculumRequirements – EvaluationsContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationSubmit proof that evaluation systems relate tocourse content and support programcompetencies.Submit proof that evaluation systems areemployed frequently enough to provide studentsand faculty with timely indications of the students’academic standing and progress.Submit proof that evaluation systems serve as areliable indicator of the effectiveness of instructionand course design.Files

If outcomes measures listed in “II.B. ‘Accompanying Documentationfor Self-Study’” are below NAACLS approved benchmarks (or if thereis not three years' worth of accumulated data, in the case of initialprograms), provide all of the following items from one course inyour curriculum:DocumentationSyllabusCourse goalsMeasureable objectives in the cognitive,psychomotor, and affective domainsEvaluation systems that correlate with objectivesFiles

Standard VIII.A for Approved Programs: CurriculumRequirements – Instructional AreasContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationProvide a completed Standard VIII Matrix that identifies whereitems listed in Standard VIII.A are addressed in the tricies-2015.aspxFiles

DocumentationFOR PBT: A list of required prerequisite course work, ifapplicable Program goals Curriculum outline, including coursesequencing and a sample scheduledemonstrating how a student may progressthrough the program Course descriptions for each unit of instructionor course in the program, includingdocumentation of how each course addressesa variety of collection techniques, contact withvarious patients in a variety of settings, and aminimum of 100 hours of applied experiencesand 100 unaided collections Document where items in Standards VIII.A1-6are included within the program curriculumSuggested documentation may include:o course syllabi that include schedules andobjectiveso objectives for the didactic and clinicalaspects of the program that address thecognitive, psychomotor and affectivedomainso course examinationso program schedulesFiles

Documentation FOR CA:A list of required prerequisite course work, ifapplicableProgram goalsCurriculum outline, including coursesequencing and a sample scheduledemonstrating how a student may progressthrough the program, including sequencedcourse of study from basic content to higherlevel of learning in the modules offered. Notewhere and how the core competencies areobtained and the 100 hours of appliedexperiences are provided.Course descriptions for each unit of instructionor course in the programDocument where items in Standards VIII.A areincluded within the program curriculum.Suggested documentation may include:o course syllabi that include schedules andobjectiveso objectives for the didactic and clinicalaspects of the program that address thecognitive, psychomotor and affectivedomainso course examinationso program schedulesFiles

Standard VIII.B for Approved Programs: CurriculumRequirements – Learning ExperiencesContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationSubmit documentation that didactic and clinicalcurricula provide sequenced learning experiencesnecessary to achieve entry competencies.(See Standards Compliance Guide for suggesteddocuments):Files

Standard VIII.C for Approved Programs: CurriculumRequirements – EvaluationsContents of Narrative for Self-Study (See Standards Compliance Guide for required/suggestedcontents):Accompanying Documentation for Self-Study:DocumentationDescribe the evaluation system(s) utilized by theprogram to assess the effectiveness ofinstruction, frequency of use of the variousevaluation tools, and how the results ofevaluation are utilized in program evaluation andrevisionFiles

DocumentationSubmit policies and procedures for student andfaculty evaluation. (See Standards ComplianceGuide for suggested documents):Documentation of:- Utilization of feedback from evaluation indetermining program effectiveness (SeeStandards Compliance Guide for suggesteddocuments)- Programmatic curriculum improvements andchanges made as a result of systematicprogram review.Files

If outcomes measures listed in “II.B. ‘Accompanying Documentationfor Self-Study’” are below NAACLS approved benchmarks (or if thereis not three years worth of accumulated data, in the case of initialprograms), provide for one course in your curriculum the followingitems:DocumentationSyllabusCourse goalsMeasureable objectives in the cognitive,psychomotor, and affective domainsEvaluation systems that correlate with objectivesFiles

NAACLS Self-Study Template Introduction: Briefly describe the organization of your program to include: name of sponsor, brief history of program, certificate or degree awarded and specific information that will aid reviewers in understanding the program and institution. Program Sponsor: Sponsor Type: Program Type: Program Location: