MAERB Statement Focused on COVID-19 Adjustments

The Medical Assisting Education Review Board has issued several statements focused on the adjustments of the CAAHEP-accredited medical assisting programs due to temporary institutional closures or restricted access to institutional resources, conversions of course material to online education, and the delay and disruption of practicum sites and clinical experiences. 

This current statement addresses and amends the original statements, in considering the extended timeframe anticipated to fully address the nationwide COVID-19 coronavirus pandemic.  The CAAHEP Standards and Guidelines for Medical Assisting Education Programs are designed to produce quality entry-level medical assisting students. In addition, the central goal of the Standards is to preserve patient safety by providing a strong educational foundation with supervised practice and guidance.  The MAERB is issuing this revised statement to ensure that the outcomes of producing quality entry-level medical assistants and ensuring patient safety continue to be met.

The exceptions that are outlined below are effective immediately and will be in effect until October 31, 2020.  Before making any plans, programs should ensure that they are working effectively with the guidelines of their sponsoring institution, their institutional accreditors, Title IV funding, and state regulations. In addition, programs need to align with local, state, or federal directives, along with the requirements of their affiliated practicum sites, during this public health emergency.  See below for a checklist of items to be aware of.  In addition, there are answers to some specific questions that have been asked that are consistent with this revised statement. 

Fulfillment of the Practicum Component

Effective immediately, the MAERB is amending its previous statements to allow for a broader range of approaches to the practicum, including simulation, so that students can achieve the goals of Standard III.C.3 in participating in at least 160 contact hours in an ambulatory healthcare setting, demonstrating the knowledge, skills, and behaviors of the MAERB Core Curriculum in performing clinical and administrative duties. 

The MAERB recognizes there are some programs that anticipate being able to have students complete a practicum experience within an ambulatory healthcare setting, but circumstances are decidedly varied across the country.  The goal would be to have students participate fully in the practicum experience, even if there were a slight delay in graduation. 

Due to varying degrees of clinical access across the country in fulfilling practicum requirements and in order to ensure that the students still fulfill this requirement, the program may provide an equivalent experience. The equivalent experience may include the following: 

  • Simulation, utilizing digital options with interactive components;
  • Simulation, utilizing a simulation lab or other setting;
  • interactive case studies or scenarios, utilizing an online platform or other virtual options (i.e., Zoom, Skype, GoToMeeting, among others)

All these environments need to ensure student and patient safety.  While delays may still exist even with these alternatives, potentially the progression toward student completion can occur more efficiently. 

As CAAHEP-accredited programs must ensure that the students are able to achieve competency and serve the community, you will need to consult with your advisory board, affiliated practicum sites, local employers, and sponsoring institutions to supply an equivalent experience that is acceptable to your broad range of communities of interest. You will also be documenting those changes in a Program Status Report. The number of hours is not as important as the quality of experience.   Programs may find that they are able to divide the practicum experience into two parts with the goal of providing simulated practice and then moving students into a practicum setting.  Other programs have students who have partially accomplished the practicum and are able to reinforce the education that they have received through observation or in another setting.  For all students who may be participating in an alternative version of the practicum, a Student Status Form must be filled out and retained by the program. 

Achievement of the Psychomotor and Affective Competencies

The students will still need to achieve all the psychomotor and affective competencies in the MAERB Core Curriculum as well as be taught and assessed on all the cognitive objectives prior to or in conjunction with those psychomotor and affective competencies.  In establishing that the student has achieved those psychomotor and affective competencies, the program can use simulation or online education with the proviso that the students are not handling specialized equipment—such as needles—in an environment in which they cannot take the proper precautions.  Supervision is still a necessary component of that achievement.  The program also may be giving incompletes in order to bundle the achievement of the competencies later. Standard V.C requires that the health and safety of patients, students, faculty, and other participants be adequately safeguarded.  Again, for all students who participate in these alternate methods of achieving the psychomotor and affective competencies or whose education has been interrupted, a Student Status Form must be filled out and retained by the program. 

Necessary Documentation

Any changes that are made must be made with the full support of the sponsoring institution, in conjunction with federal and state regulatory compliance, to ensure that the students receive the educational experience the institution is responsible for fulfilling. Because of the inclusive nature of these changes, between now and October 31, 2020, the MAERB will not require that programs submit a Teaching Invasive or Protective Competencies Via Distance Education (TIPCDE) workbook for permission to teach the invasive or protective competencies online. 

Your careful documentation, however, is vitally important, and the MAERB is requiring every participating medical assisting program to keep the following documentation for the program and the student:

Program Status Report: All programs will be required to submit an action plan to indicate what alternative mechanisms they have set into place to fulfill the outcomes of the CAAHEP-accredited program.  Programs will be required to submit this information by September 1, 2020.   Programs will receive the template for this report by April 20, 2020. 

Student Status Form: If the program takes an alternative path to either the practicum fulfillment or the achievement of the student’s psychomotor or affective competencies, it will need to fill out this form for every participating student and keep it in the program’s permanent records for reference so that the program can illustrate that entry-level competence has been achieved.   Programs will need to retain these records permanently.  You will find a this form on the Document Tab under the section “Personnel and Program Changes.” 

Purpose and Rationale of this Amendment

While there is a necessity to respond to the national crisis, MAERB wants to reiterate the value of the current educational practices that are embedded in CAAHEP’s Standards and Guidelines for Medical Assisting Education Programs.  The students’ experience of a practicum in an ambulatory healthcare environment is invaluable.  There they can put into practice the clinical and administrative competencies that were so carefully taught and then achieved in a classroom and laboratory setting. The practicum experience, along with the intensive educational component, prepares graduates of CAAHEP-accredited programs to succeed in the marketplace.  The expectation, even in this current environment, is that medical assisting students should be able to achieve the psychomotor and affective competencies in a lab and classroom and participate in a practicum if possible.

 In making these changes, the MAERB is responding to the concerns and questions that have been voiced by the program directors during this public health crisis.  The short-term and temporary exceptions outlined above are necessary, as more is learned nation-wide about the nature of a pandemic and the need to respond to that crisis. It became evident to the MAERB board that temporary adjustments needed to be made, innovations created, and flexibility tested.  What has not changed, however, is the need for the programs to stay in compliance with the CAAHEP Standards, producing quality entry-level medical assistants and preserving patient and student safety. 

Community Resilience, Flexibility, and Strength

We are all participating in an unprecedented global health crisis, and the MAERB sends its best wishes to the community which it is privileged to serve.  You all have demonstrated great resilience during the many changes that we have encountered.  Your willingness to share information with us has helped us to define this temporary pathway; your commitment to quality medical assisting education ensures that this temporary exception will not diminish student achievement. 

Please stay safe and healthy.

Checklist Items

  1. Does the adaptation successfully achieve the outcomes of the CAAHEP Standards and Guidelines? 
  2. Is the adaptation acceptable for the institutional accreditor?
  3. Is the adaptation acceptable for the state higher education authority?
  4. Does the adaptation comply with state requirements, if applicable, for medical assisting education? 
  5. Does the adaptation comply with the specific credentialing exam pathway that the program relies upon, if applicable? 
  6. Does the adaptation meet the current state directives regarding the pandemic? 
  7. Does the adaptation fit the needs of your local community, based upon your communication with the advisory board and practicum affiliation sites? 

The following information listed below has been revised to be consistent with the April 13, MAERB COVID Statement listed above.  You will find specifics about possible changes for your reference.  

Online Didactic Material

Many of you are being asked to put more of your didactic material online so that students do not need to come to class meetings. This would not require MAERB approval. 

Practicum Options 

Some programs are finding that the practicum time frame needs to be extended due to clinics limiting the participation of students during this period.  Other programs have shifted the timeframe of when the students are doing the practicum, extending the overall time that the student spends in the program.  This would not require MAERB approval as it is an institutional decision, and the accreditation requirements are being fulfilled.  We have been notified that some institutions are changing their program requirements to ensure that students are able to complete the practicum.  For example, programs that require a 240-hour practicum are shifting the requirement to 160 hours.  As long as the students achieve a 160-hour practicum, they fulfilling the requirements of a CAAHEP-accredited program, so it is up to your institutional processes and practices if there is the need to make a shift. There are programs that are able to use simulation, alternative activities that enable students to use their clinical and administrative skills, alternative locations, and so on, as described above.  

Achievement of Psychomotor and Affective Competencies

Depending on the locale, some programs are teaching the didactic material online, and they are bringing small groups of students or individuals on campus for the lab-based competencies, so that they are still complying with social distancing requirements but the students are able to complete the labs.  At the same time, that is an option that is available only to certain places, as every state, county, city, and institution has different regulations and restrictions set up. 

It is also acceptable to bring students into a simulation lab or have simulation access online as the most recent statement outlines.  

Some programs are extending the academic term so that students can complete the necessary in-person affective and psychomotor competencies for their coursework. Program Directors have told us that they are putting into place a variety of options: 1. Giving students incompletes and planning for educational sessions after the term ends so that the students can achieve the competencies; 2. Holding individual sessions for students to limit mingling so that students can achieve the competencies; 3. Altering schedules so that the competencies are taught later in either the term or the program with the goal of making sure the competencies are covered. 

Pass/Fail or Credit/No Credit Options

We are receiving questions if it is possible to make the medical assisting courses “pass/fail” or “no credit,” as institutions are trying to ensure that students are protected in the midst of all these changes.  Obviously, you did not list on your medical assisting syllabi that the course would have a pass/fail option, but a lot of institutions are making that shift because they have shifted to online courses mid-way through the spring 2020 term. 

There would be no concerns on the part of CAAHEP if you were to make the course “pass/fail.” However, the requirement for teaching and assessing the entire MAERB Core Curriculum needs to be maintained.  In addition, students need to achieve the psychomotor and affective competencies.  Obviously, if the students were not able to achieve the psychomotor or affective competencies, the students would need to get an “incomplete” grade, as I have outlined in other messages.  We have a lot of schools, due to shifting courses online, who are shifting to “credit/non-credit” or “pass/fail,” even though it is not on the syllabus. 

Advisory Meetings

We have received questions about spring advisory meetings, as many of you schedule your advisory meeting during the spring.  First, there is no problem if you defer it until fall, as you would still be conforming to the annual requirement.  Second, there is no problem with setting up a virtual meeting or a correspondence meeting with materials sent through email and people provided with the opportunity to present feedback and questions through mail or phone.  The goal is to make sure that there is a concerted and organized method for getting your communities of interest information about the program and getting materials back to them. When you are writing the minutes of the meeting, make it clear what method you used so that you can document the exception to your usual practice.