Online Expansion Held Back

Yale U.'s hybrid physician assistant program hits an accreditation snag -- a win for critics who have wanted the program to be evaluated as a stand-alone offering.

April 14, 2015

Yale University has learned that a thorough review over a period of several years may be the fastest way for its hybrid master’s degree program in medical science to become accredited. The development -- while in no way killing the program -- is being seen as a victory for alumni and students who have expressed skepticism about online education.

The university’s School of Medicine had planned to treat the hybrid program, which combines online learning and in-person classes, as merely an increase in class size, which meant it would piggyback on the face-to-face program’s accreditation. But at the same March 2014 meeting of the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) where Yale received approval for its most recent change in class size, the accreditor also made it more difficult for programs to rapidly grow or shrink.

Programs that request a change in class size now have to wait and remain accredited in their current form for four years, meaning Yale’s new request could at the earliest be approved in 2018.

With the request to increase the class size, Yale argued that the hybrid option was the same as its face-to-face offering. The university’s announcement last month said it planned to “expand its impact and reach” and offer “a new pathway” for students to earn a degree.

Some students and alumni of the program, however, have expressed concerns that moving much of the curriculum online could damage the quality of the program. Chandra Goff, who graduated from the program in December, said applying for an increase in class size "implies that [the hybrid program] is equivalent to the on-site program, which it clearly can’t be, because so much of medical education is tactile experiences, learning motor skills, patient interaction, and professional and interpersonal skills." Most importantly, she said, "we’re worried that it will undercut the credibility of PAs everywhere -- not just from Yale, and not just from the online program."

Members of the classes of 2016, 2015, 2014 and 2013 reportedly issued a collective statement at a town hall meeting last month, saying the plan “has the potential to negatively impact our school, PA education, the PA profession and patient care in general,” according to the Yale Daily News.

Goff also criticized the administration for what she described as a lack of transparency. The school told students last year that it was considering creating an online degree option and would include them in the decision making process, she said, but "then we didn’t hear anything more about it until it was announced publicly."

The ARC-PA informed Yale of the policy and its decision in a letter to the program, executive director John E. McCarty said in an email. He declined to comment on whether the hybrid program would have been considered too different from the face-to-face offering had Yale not been approved for an increase in class size last year.

The university declined to share the letter, but both McCarty and James Van Rhee, program director at Yale, confirmed its content, saying it outlines the way the university should proceed.

“The ARC-PA letter also states that the most effective way for them to evaluate the proposed online program would be for Yale to apply for a new PA program separate from the currently accredited program using the provisional accreditation process,” Van Rhee, associate professor in the program, said. “We feel this is a reasonable response from the ARC-PA.”

Robert J. Alpern, dean of the School of Medicine, declined to comment for this article.

The decision is a setback for the hybrid degree program, announced last month in partnership with 2U, an online “enabler” company. In recent years 2U has had considerable success with graduate programs across the United States, taking competitive, in-person offerings and converting them into online degrees that can reach many more people.

The company's plans for the program at Yale included a combination of live online class sessions and asynchronous content, campus visits and clinical work at locations close to where students reside, meaning they would not have to move to New Haven, Conn. Since most of the education would not take place physically at Yale, 2U estimates the university could increase the number of cohorts it teaches from one to three a year. The class of 2015, as an example, enrolled 36 students.

A spokesman for 2U declined to comment, but referred to a press release that in the first paragraph pointed out the partnership was “pending approval of the online program by the [ARC-PA] and various state licensing agencies.”

While the ARC-PA’s decision does not jeopardize the partnership between 2U and Yale, it means a hybrid program option is farther away from launch than intended.

In order to be provisionally accredited, a program first has to submit a written request, pay an application fee, submit a feasibility study and host a site visit, among other requirements. That process takes at minimum one year to complete, and programs are able to obtain continued accreditation only after at least two years after the first students have graduated.

A request to change the class size, in comparison, only needs to be submitted six months in advance.

The setback was initially reported by the Yale Daily News, which wrote that Van Rhee told students the provisional accreditation process “will actually be quicker” than requesting a change in class size. Asked to confirm, Van Rhee said he “can’t really say,” adding that there are “too many factors to consider, such as [the ARC-PA] timeline and schedule and Yale timeline.”


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