July 15, 2004 - Accrediting Bureau of Health Education ...



ABHES EVALUATOR PACKET

Return completed and signed packet to the ABHES office (evaluator@), with a copy of your most recent resume evidencing areas of expertise, prior to evaluator training or service.

Name:      

Preferred Mailing Address:      

City:       State:       Zip:      

Cell Phone:       Work Phone:      

Preferred E-mail Address:      

Alternate E-mail Address:      

What is the best way to reach you? Cell phone Email Work phone

Optional Emergency Contact -- Name:       Cell Phone:      

Place of Employment:      

Title:      

Address:      

City:       State:       Zip:      

Work Phone:      

Work E-mail Address:      

On-site Visitation Availability

On-site visitations typically take place during two cycles each year: February through mid-May and August through mid-November. Are there any specific restrictions in your availability (days of the week, months, geographic locations) that we should note? If so, please list      .

NOTE: As an ABHES evaluator, you are not obligated to complete a minimum number of visits during the year. The number of visits available per specialty area depends upon what programs are offered by the institutions visited during the given travel cycle. Therefore, a volunteer may be asked to serve on several visit teams during the year, or none, depending upon the need for the area of expertise.

Employment – Educator (Academic or Administrator)

Are/were you employed by an ABHES-accredited school or program? Yes No

Are/were you employed as an academic* and/or administrator**? Academic Administrator

Retired or currently unemployed? Date of transition:      .

If so, list professional growth activities*** to evidence currency in field      .

*Academic is defined as an individual whose current responsibilities focus significantly on the curricular aspects of an educational institution or program. (Ex: dean, department head, instructor, professor)

**Administrator is defined as an individual whose current responsibilities focus significantly on the managerial aspects of an educational institution or program. (Ex: president, registrar, financial aid officer)

***Professional growth activities may include, but are not limited to, programs of continuing education, either for professional development or to maintain professional certification, membership and participation in professional organizations, participation in field-related workshops or seminars, and subscription to relevant periodicals or journals.

Employment – Practitioner

Are you currently an in-field practitioner*? Yes No

If yes, is your role as a practitioner Full-time Part-time/PRN

Retired, currently unemployed, or recently transitioned into education? Date of transition:      .

If so, list professional growth activities** to evidence currency in field      .

*Practitioner is defined as an individual who is currently or recently directly engaged in a significant manner as a health-care related specialist. Depending on the nature of the practice, this definition may encompass designations such as medical assistant, medical laboratory technician, and surgical technologist. (Ex: medical assistant working in a clinic)

**Professional growth activities may include, but are not limited to, programs of continuing education, either for professional development or to maintain professional certification, membership and participation in professional organizations, participation in field-related workshops or seminars, and subscription to relevant periodicals or journals.

Education and Professional Credentials

At what level are you credentialed?

Diploma/Certificate Baccalaureate Degree

Occupational Associate Degree Master’s Degree

Academic Associate Degree Earned Doctorate Degree

Please list current professional credentials (registration, licensure, certification) and expiration date:      

Specialty Experience

Bilingual or fluent in languages other than English? Yes No If yes, please list languages      

Specialty Experience

Program Specialists must document at least two years of related experience in any area checked below.

Please check your specialty area(s) and list the corresponding number of years of expertise in the field(s) identified below. Note areas in which you have practical or teaching experience and are properly credentialed, as evidenced and described in your resume. If retired, you must evidence currency in field.

Specialty Area # of Years

| | | |

| |      |Billing/Insurance (Insurance/Medical Coding, Claims, Patient Accounts) |

| |      |Cardiovascular Technology; Invasive/ Non-invasive |

| |      |Computer Technology (Microsoft Certified System Engineering, Network & Database Engineering Software |

| | |Engineering, Internet Webmaster) |

| |      |Diagnostic Medical Sonography / Ultrasound Technician |

| |       |Dialysis Technician |

| |      |Dietetic Technician |

| |      |Dental Assisting |

| |      |Dental Assisting w/Expanded Functions |

| |      |Dental Hygiene |

| |      |Dental Laboratory Technician |

| |      |EKG / Electrocardiogram Technology |

| |      |Emergency Medical Technician |

| |      |General Office |

| |      |Healthcare Management |

| |      |Health Information Technology, Health Information Management |

| |       |Home Health Aide |

| |      |Massage Therapy/Therapeutic Massage Therapy |

| |      |Medical Assisting |

| |      |Medical Laboratory Technology/Assisting |

| |      |Medical Office (Medical Secretary, Transcriptionist, Medical Records Specialist) |

| |      |Magnetic Resonance Imaging (MRI) |

| |      |Nuclear Medicine |

| |      |Nursing (RN, LPN, PN, VN, CNA, NA) |

| |      |Occupational Therapy |

| |      |Optical/Ophthalmic |

| |      |Paramedic |

| |      |Paralegal |

| |      |Patient Care Technician |

| |      |Personal Trainer / Fitness |

| |      |Pharmacy Technology |

| |      |Phlebotomy |

| |      |Physical Therapy (Physical Therapy Technician or Aide) |

| |      |Psychiatric Technician |

| |      |Radiation Therapy |

| |      |Radiologic Technology/Radiography |

| |      |Rehabilitation Services |

| |      |Respiratory Therapy |

| |      |Surgical Assisting |

| |      |Surgical Technology |

| |      |Sterile Processing Technology |

| |      |Veterinary Assisting/Technology |

| |      |Other, please specify       |

| | | |

| | | |

| | | |

Distance Education Experience

Distance Education Specialists must document at least two years of related experience in any area checked below.

Please check your specialty area(s) and list the corresponding number of year(s) of expertise in each area. Note areas in which you have practical or teaching experience, as evidenced and described in your resume. If retired, you must evidence currency in field.

Specialty Area # of Years

| | | |

| |      |Instructional Experience (specific to distance education environment) |

| |      |Curriculum Development/Instructional Design of Distance Education |

| |      |Evaluation of Distance Education Design and Delivery |

| |      |Online Learning |

| |      |Teleconferencing A/V |

| |      |Other, please specify       |

Administrative Team Leader Experience

Team Leaders must document at least two years of administrative experience in the areas listed below. Previous service on site visits with ABHES or other recognized accrediting agencies is suggested.

Please check your specialty area(s) and list the corresponding number of years of expertise in each area. Note areas in which you have practical experience, as evidenced and described in your resume. If retired, you must evidence currency in field.

Specialty Area # of Years

| |      |Department of Education Regulations (compliance with government requirements) |

| |      |Student Finance (review of tuition and fees, collection practices and procedures, cancellation and refund|

| | |policies and calculation of Title IV refunds) |

| |      |Satisfactory Academic Progress (knowledge and understanding of Appendix B, Standard of Satisfactory |

| | |Academic Progress) |

| |      |Clock/Credit Hour Conversion & Allocation (assessment of appropriate outside coursework) |

| |      |Student Admissions/Recruitment (review of program advertising and program representations) |

| |      |Student Satisfaction |

| |      |Program Effectiveness Plan (development and review) |

| |      |Student Outcomes (retention, placement and credentialing) |

| |      |Student Record Maintenance (review for compliance of Appendix E, Records Maintenance) |

| |      |Degree Program Standards (evaluate standards of degree programs as applicable) |

| |      |General Office (e.g. Receptionist, Office Administration, Computerized Office Assistant) |

| |      |Service on visitation teams with ABHES or other recognized accrediting body |

| |      |Other, please specify       |

Baccalaureate Degree Specialist Education and Experience

A master’s degree (minimum) or earned doctorate degree is required, please specify highest degree and awarding institution       (Note: Earned degrees must be held from an institution/program accredited by an agency recognized by the United States Department of Education or the Council for Higher Education Accreditation.)

Baccalaureate Degree Specialists must document at least five years of experience specific to the bachelor’s degree level. Please check your specialty areas and list the corresponding number of years of expertise in each area. Note areas in which you have practical experience, as evidenced and described in your resume. If retired, you must evidence currency in field.

Specialty Area # of Years

| |      |Instructional Experience (educational methods and student evaluation specific to the bachelor’s degree |

| | |level) |

| |      |Curriculum Review (development, review and assessment of baccalaureate degree programs) |

| |      |Faculty Administration and Oversight (supervision of academic personnel specific to the bachelor’s degree|

| | |level) |

| |      |Student Services (academic advising, tutoring, placement services to support baccalaureate programs) |

| |      |Educational Resources (assessment and/or selection of digital and hard copy resources to support |

| | |baccalaureate programs) |

| | | |

|EVALUATOR DISCLOSURE AND RECUSAL CONCERNING ACTIONS INVOLVING POTENTIAL CONFLICTS OF INTEREST |

The Accrediting Bureau of Health Education Schools (ABHES) conducts its evaluation of institutions and programs in an objective and confidential manner. In order to ensure objectivity, impartiality, and integrity in the accreditation process, an evaluator should not be involved in evaluations of institutions or programs that constitute a conflict of interest, or may be perceived as such, should not accept any gratuity from a reviewed institution, and should not disclose any information received as the result of the evaluator's involvement in the accreditation process.

Recusal from Activities Involving Conflicts of Interest

It is the responsibility of each evaluator to identify to the Executive Director actual or potential conflicts of interest. It will then be determined whether the evaluator should be recused from review of the institution or program.

Examples of possible conflicts of interest between an evaluator and the institution or program under review include:

• ownership of stock in the company or parent organization controlling the institution or program;

• current or prior service as an employee, officer or director of, consultant to, or in a business or financial relationship with the institution or program;

• competition in the same service area as the institution or program (normally defined as within a 50-mile radius);

• personal friendship other than casual business relationship with owners, operators, or senior employees of the institution or program; and,

• any other interest which affects or may affect the objective judgment of the evaluator in the performance of his or her responsibilities.

Duty Not to Accept Gifts or Other Consideration

Evaluators shall not solicit or accept, for themselves or any other person, gifts, gratuities, entertainment, loans or other consideration from individuals that are associated with an institution or program subject to accreditation by ABHES where the circumstances indicate that the consideration may be motivated by the donor's interest in the evaluator's findings or recommendations or the final accreditation determination.

Before, during and after an accreditation visit, evaluators may not engage in any behavior that might suggest they would consider or seek, either at present or in the future, any employment, consultation or other relationship of any type with the institution or program evaluated. Accordingly, without regard to whether the evaluator receives compensation, evaluators may not provide any institution or program with assistance or advice in any way related to ABHES accreditation following a visit.

Duty of Confidentiality

Evaluators will treat all information obtained through the evaluation process as confidential. Once the visit has concluded, evaluators shall have no contact with the host institution regarding the visit. Evaluators shall release no specific information about the reason for the visit, violations, or possible actions to students or employees of the institution. Inquiries about the findings, recommendations or actions of the Commission shall be referred to the Executive Director.

I agree that, as a condition of my services as an ABHES evaluator, I will abide by the ABHES Conflicts of Interest and Confidentiality policy described above.

I agree that the information I have provided above regarding my qualifications to serve as an ABHES evaluator accurately represents my academic and professional experiences to date.

Name: [pic]

Signature: [pic] Date: [pic]

Return completed and signed evaluator packet,

with a copy of your most current resume evidencing areas of expertise,

to the ABHES office (evaluator@)

prior to evaluator training and service.

January 2014

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