OSTEOPATHIC COUNCIL OF IRELAND:
REPORT INTO THE ACCREDITATION OF THE
NEW OSTEOPATHIC COMBINED PATHWAY PROGRAMME PROPOSED BY THE
IRISH COLLEGE OF OSTEOPATHIC MEDICINE,
This report presents the findings of the initial accreditation approval of the new osteopathic Combined Pathway (CP) programme proposed by the Irish College of Osteopathic Medicine (ICOM), to be delivered by the said College in the city of Cork, Ireland. The programme accredited consisted of the Diploma in Osteopathy (D.O) and the BSc (Hons) Osteopathy delivered part-time over five years. The review was undertaken by visitors appointed by the Osteopathic Council of Ireland (OCI) in accordance with the protocol set down by the Council’s Programme Accreditation Process (2017).
A prime focus of the review was the relationship of the CP to key professional, educational and practice standards. These include:-
– The OCI’s Code of Professional Conduct and Ethics
– The OCI’s Standards in Osteopathic Training and Education
– The European Framework for Standards of Osteopathic Practice
– The European Framework for Standards of Osteopathic Education and
– The European Framework for Codes of Osteopathic Practice
– The European Standard on Osteopathic Healthcare Provision
– The UK’s Framework for Higher Education Qualifications in England, Wales
and Northern Ireland
– The UK’s General Osteopathic Council’s Osteopathic Practice Standards.
The accreditation process was undertaken between March and May, 2019. The accreditation visit at ICOM took place in April 2019. The accreditation team were Mr Bob Davies (Team Lead, Osteopath), Mr Craig Toutt (Osteopath) and Dr Fionnuala Conway (Lay member, Creative Technology Consultant).
The CP is the first ever accredited osteopathy programme in Ireland. Its accreditation represents an important step forward in the OCI’s pursuit of government recognition of osteopathy as a statutory regulated health-care profession in the country.
- Formal recommendation
The recommendation given below is the recommendation of the accreditation team to the OCI. The OCI may choose not to follow this recommendation.
The recommendation of the team for the CP programme is:
Approval with Conditions
The conditions are that ICOM must:
- Review and update its website to ensure an unambiguous understanding that only those students who successfully complete the CP beginning in September 2019 are eligible for registration with the OCI (paragraph 10).
- Produce a single academic programme document that is comprehensive and self-contained and enables easy access to information by staff and students about the CP’s intended learning outcomes, its curriculum and assessments (paragraph 11).
- Incorporate business studies, nutrition and dietetics teaching into its curriculum (paragraph 21).
- Action the following self-identified tasks from its development plan by September 2019:
– Ensure plans and arrangements are in place to support the new College committees that will promote maximum input to curriculum design and optimal student learning (paragraph 27);
– Establish assessment strategies and review the role of the external examiner in relation to such strategies so as to promote a clear understanding of the College’s assessment processes and procedures for both staff and students (paragraph 28);
– Provide information to students that clearly details the College’s plans relating to student pastoral and academic support (paragraph 42);
– Ensure committees relating to quality assurance and academic integrity are in place and the role of Nescot and the independent advisors to such committees are clearly detailed (paragraph 54);
– Establish formal communication arrangements for staff and students to engage with the development and implementation of College policies and procedures (paragraph 57);
– Initiate a formal strategy that is able to identify all staff development needs including those of research. Documentation that details and records staff development must also be available (paragraph 60);
- Identify a moderator for the CP’s Final Clinical Competencies Assessment (FCCA) prior to the first FCCA of the new programme (paragraph 35).
- Set in place arrangements that ensure the learning and development of students on the new CP during their time in clinic will be osteopathic in principle and in practice (paragraph 45).
- Include in its website all admissions entry criteria for the new CP programme (paragraph 46).
- Set up a mechanism by September 2019 that ensures data relating to student progression and achievement can be easily captured and recorded (paragraph 47).
- Produce a five year business plan to incorporate an annual strategic document that includes financial projections and risk management considerations associated with student intake and attrition (paragraph 50).
- Review the protocols outlined by the Quantity and Qualifications Ireland to ensure the Protection of Enrolled Learners (PEL) arrangements are in place and adhered to (paragraph 51).
- Review its Service Level Agreement (SLA) with Nescot to ensure it is up to date (paragraph 56).
The following is a summary of the team’s main conclusions in relation to ICOM’s strengths:-
- The enthusiasm and commitment shown by ICOM’s Principal and Senior Management Team (SMT) to the development of the new CP;
- The College’s openness and diligence displayed towards its plans to ensure the CP’s future success;
- The supportive opinions strongly expressed by teaching staff and students, current and previous, towards the College’s overall operational practices and culture;
- The College’s clear acknowledgement, appreciation and understanding of the OCI’s requirements in relation to the need to deliver the CP as one that is thoroughly and robustly osteopathic in nature and content;
- The input of Nescot that ensures overall quality assurance to both academic and professional standards of the CP;
- The responsive commitment to supporting students through their course of study and ensuring their success on the pathway;
- The high quality of teaching that actively engages students in their theoretical and practical learning;
- The close working collegiate relationship amongst ICOM staff that ensures involvement in the communication process and exchange of information in supporting the students’ learning experience.
- Description of the review method
The following section gives a general description of the OCI review method. A broader detail of the review method is provided in the OCI’s Programme Accreditation Process (PAP) handbook.
The OCI review method combines off-site consideration of written evidence by the accreditation team with at least one visit of three days to the provider. For initial accreditation the review period is typically of six to eight weeks’ duration.
The team are selective in their lines of enquiry and focus on their need to arrive at findings and a recommendation against clearly stated criteria. The team refines emerging views on the provision against as wide a range of evidence as possible. For example, the perceptions expressed in meetings by students or by staff are tested against other sources of evidence. Documentary evidence typically used includes financial accounts, strategic plans, financial projections, insurance schedules, student work, clinic management records, internal reports from committees, boards and individual staff with relevant responsibilities and external reports from examiners, verifiers, employers and validating and accrediting bodies. A protocol exists for staff, students and patients to submit unsolicited information about the provision to the review team. Submissions can remain anonymous to the provider if preferred.
Meetings with students are strictly confidential between the students attending and the accreditation team; no comments are attributed to individuals.
The accreditation team respects the principle of proportionality in their enquiries and emerging conclusions.
Key features of an OCI review will include:
- An emphasis on the professional competencies expected of osteopaths and expressed in the OCI’s Practice Standards;
- Peer review: review teams include currently registered osteopaths and at least one lay visitor with higher education interests;
- A focus on the students’ learning experience, frequently to include the observation by visitors of clinical and non-clinical teaching;
- Flexibility of process to minimise disruption to the provider: there is negotiation between the accreditation Team Leader and the provider about the timings of the review and the nature of evidence to be shown;
- A process conducted in an atmosphere of mutual trust: the team do not normally expect to find areas for improvement that the provider has not identified in its own self-evaluation document (SED);
- An emphasis on governance and management, to include the maintenance and enhancement of standards and quality;
- Use of the SED as the key document: this should have a reflective and evaluative focus;
- An onus on the provider to supply all relevant information: any material identified in the SED should be readily available to visitors;
- A protocol for unsolicited information;
- Evidence-based judgements;
- Ensuring that the amount of time taken to conduct a review is the minimum necessary to enable team members to reach robust findings and recommendations;
- Providing transparency of process through the use of published OCI criteria;
- The role of the Institutional Contact, a member of the provider’s staff, to assist effective communication between the team and the provider;
- The facility to engage a further specialist adviser where necessary;
- Close monitoring by OCI representatives.
- Background and overall aims of the provider
- ICOM is a private osteopathic education institution located in modern premises in North Point Business Park, Cork, Ireland. The College’s premises (and its integrated, on-site, ‘Ashbrook’ osteopathic clinic) are rented on a ten year lease. Owned by Mr Kieran Corcoran, College Principal, ICOM was formed in 1996 and was previously known as the Irish College of Physical Therapy. It changed its name in 2018 due to the introduction of new government legislation in Ireland that made physiotherapy a regulated profession and protected the use of the title Physical Therapist (2, 68, 83, and 86).
- Prior to the introduction of the legislation relating to physiotherapy, ICOM delivered a number of diplomas, the most recent being the two-year Diploma in Orthopaedic Sports Therapy and Manipulative Therapy and the one-year Diploma in Spinal Manipulative Therapy. Both diplomas are currently undergoing a total (phased) withdrawal from the College’s syllabus and are being replaced by the new D.O (89). This D.O. was introduced in September 2018: its first year is currently being piloted in preparation for the D.O. beginning in September 2019 (2, 68, 83 and 89).
- Successful completion of the D.O. offers progression to the BSc (Hons) programme. This programme is validated by Kingston University in the UK and is delivered in conjunction with ICOM’s collaborative education partner, the North East Surrey College of Technology (Nescot) – an institution that has a Recognised Qualification (RQ) status awarded to it by the UK’s osteopathic regulatory body, the General Osteopathic Council (GOsC). The RQ permits the legitimate delivery of Nescot’s four year full-time honours degree in Osteopathic Medicine. However, the CP’s BSc (Hons) programme will primarily be delivered at ICOM’s premises on a part-time basis over a one-year period, although students will also need to spend six study weekends at Nescot’s campus in Ewell, Surrey, England (2, 68 and 83).
- ICOM is seeking accreditation of the CP that will begin in September 2019 (72, 85 and 86).Only those students who successfully complete the CP from that date will be eligible to directly apply for registration with the OCI(72, 85, 86, 87 and 89).Students and staff who, respectively, studied and taught on previous diplomas delivered by ICOM, students and staff who study and teach on the current diplomas delivered by the College and students and staff respectively studying and teaching on the first year of the new D.O introduced in September 2018 were interviewed during the accreditation visit in order to garner insight into those areas needing evaluation for the successful accreditation of the CP beginning in September 2019.
- ICOM acknowledges that students who are currently studying on diplomas that are being withdrawn would not be automatically eligible for registration with the OCI as these programmes have not been accredited (72, 85, 86, 87 and 89). Students who are studying these diplomas and took part in the accreditation process confirmed that they were aware of this arrangement and that they would need to apply for registration with the OCI through a different route (93). A separate process is to be considered by the OCI for these students should they successfully complete their appropriate studies and apply for registration.
- ICOM’s mission is “To provide osteopathic education that is built on professional clinical training and guided by current relevant research and excellent academic teaching” (42 and 53). To do this, it will provide clinical training for students that will be enhanced by a variety of patients and the fulfilment of 1000 clinical hours as required by the European Framework (EF) for Standards of Osteopathic Practice (2007), the EF for Standards of Osteopathic Education and Training(2008) and the OCI’s Standards in Osteopathic Training and Education(2017) (20, 42 and 53).
- In support of this mission, the College has three strategic aims. These are orientated to secure an academic and professional recognition for an osteopathic pathway to be delivered in Ireland and for that pathway to provide wider opportunities for individuals in that country to benefit from osteopathic education. ICOM’s values are focused on student and patient engagement and inclusivity, collegiality, openness and transparency and services that are delivered with environmental sustainability (42). This was reinforced to the accreditation team during the accreditation visit (86).
- At the time of the accreditation visit, the College had 55 part-time students, supported by three full-time and 14 part-time members of staff (77, 86 and 89). These figures include faculty and teaching staff employed by ICOM and faculty and teaching staff from Nescot. To date, sevenstudents have been offered a place on the CP starting in September 2019 (89). The College expects to admit approximately 15 students onto the new programme by the pathway’s starting date but has the capacity to enrol up to a maximum of 20 (89).
- ICOM has initiated and produced a Development Plan that has permitted the College to self-evaluate and reflect upon current management and operational practices (69). This has helped the College to identify particular areas that need developing in order to fully prepare itself for the management and delivery of the new CP. The accreditation team feels that this was a useful initiative in supporting the introduction of the programme. Some conditions made by the accreditation team refer to the Development Plan: these have been incorporated into this report within appropriate paragraphs.
- Commentary on the provision
An evaluation of the clinical and academic standards achieved
Course aims and outcomes
Programme aims and outcomes
- The College does not publish a hard copy prospectus but information relating to the CP’s aims and outcomes can be found on its website (83). However, the website contains material that is often different from documentation submitted for the accreditation process. Additionally, it does not specify that only those students who successfully complete both the D.O and the BSc (Hons) programme are eligible to apply for registration with the OCI. To enhance transparency and to ensure students’ understanding of what the CP will confer in relation to registration with the OCI, the College will need to update its website to ensure that this information is clearly outlined. This task would also support the fulfilment of an objective detailed in ICOM’s Development Plan (69).
- There is no overall single academic document that outlines the CP’s learning outcomes, curriculum and assessment schedules. These themes are outlined in various CP documents and are discussed in paragraphs 12 – 36 below. To enable easy access to information about these themes, the College will want to ensure that it produces a single CP programme document that is comprehensive, detailed and self-contained.
- The overall aims and intended learning outcomes of the CP are clearly detailed in respective programme specifications (47 and 49). They provide a benchmark for curricula and underpin learning and assessment strategies for both the D.O and the BSc (Hons) programme. (2, 6-17, 23, 50, 51, 52, 68, 78, 79 and 80).
- The programme outcomes of both the D.O and the BSs (Hons) programme match the aims of the indicative curricula and programme information described in various respective programme documentation (49 and 53). The intended learning outcomes for modules forming the D.O are clearly outlined in the diploma’s module descriptors and its programme handbook (6 – 17 and 53). Information relating to the D.O’s intended learning outcomes for its modules is also found in the College’s clinic handbook and programme specification document, although information in this latter document is incomplete and refers only to two modules delivered in the first year of the diploma (35 and 47).The intended learning outcomes for modules forming the BSc (Hons) programme are clearly outlined in the programme’s module descriptors(50, 51, 52, 78, 79 and 80).
- The College has comprehensively mapped and aligned the D.O to the EF for Standards of Osteopathic Practice(2007), the EF for Osteopathic Education and Training(2008) and the OCI’s Code of Professional Conduct and Ethics(2014) (2, 18, 20, 24, 53 and 68).The diploma is also mapped to the National Framework of Qualifications (Ireland), the OCI’s Standards in Osteopathic Training and Education (2017) and Forum for the Osteopathic Regulation in Ireland (18). The BSc (Hons) programme is aligned with the descriptor for level 6 on the UK’s FHEQ (49). Enhanced alignment of this programme is provided by reference to the UK’s Quality Assurance Agency’s Subject benchmark statement: Osteopathy(2007), although this benchmark statement is now obsolete and has been replaced by an updated version that has been available since 2015 (49). The accreditation team was informed that the BSc (Hons) programme had not been mapped to the GOsC’s Osteopathic Practice Standards(2012) as it was a programme that did not need validation by this body (89).
- Although the College has produced indicative curricula for its D.O and has comprehensive information relating to the BSc (Hons) programme, it does not have a single document that provides an overarching curriculum for the CP (89). All such information is contained in the CP’s BSc (Hons) specification and the D.O’s programme handbook (49 and 53). When producing its single CP document, the College will wish to ensure that this is addressed (see paragraph 11).
- ICOM informed the accreditation team that curricula design has been orientated to ensure a programme that has maximum osteopathic philosophy and content as opposed to curricula based on previous diplomas that were designed to deliver a skill set that was fundamentally musculoskeletal in content (89). The accreditation team support this. All of the CP’s curricula has been subject to robust self-reflection and review by the College’s SMT (2, 68 and 89). The curricula’s design has also benefitted from input from experienced members of faculty staff from Nescot (2, 68 and 89). The accreditation team believe that Nescot’s involvement is significant in ensuring the new programme’s appropriate academic development throughout its early years. Although there has been no specific input into the development of the CP’s curricula by ICOM’s lecturers not forming part of the College’s SMT, the College’s external examiner, students or service users, ICOM confirmed that all new committees operational from September 2019 will ensure future input into the curricula by such parties will take place from that date (89). The implementation of this task would support the fulfilment of an objective detailed in ICOM’s Development Plan (69).
- The curricula for the diploma is appropriately designed to enable students who successfully complete their studies to practice osteopathy in Ireland safely and to professional standards detailed by the OCI’s Standards of Osteopathic Training in Education(2017) and outlined by EF for Standards of Osteopathic Practice (2007) and by EF Code of Osteopathic Practice(2007) (2, 53 and 68). The diploma is orientated to ensure the development of diagnostic, palpatory, manual and personal and professional development skills commensurate with and in preparation for the successful graduation of an osteopathy student. The BSc (Hons) programme enhances these skills. Students who successfully complete this programme will have enhanced autonomy in relation to clinical and research skills, team work and on-going personal and professional development (49).
- The CP is spiral in nature and is delivered on a part-time basis over a period of five years. The first four years of the pathway are dedicated to the delivery of the D.O (2, 35, 47, 53 and 68).Each year of study on the diploma is delivered over 19 weekends with each weekend comprising eight hours of theoretical study and eight hours of practical study (2, 53 and 68). The fifth year of the pathway is dedicated to the delivery of the BSc (Hons) programme on a part-time basis over a period of one year (49).
- The D.O has a total European Credit Transfer and Accumulation System (ECTS) credit rating of 180 (2, 5, 53 and 68). Each year of the curriculum comprises three modules that are designed and align with levels 5, 6 and 7 of the European Qualifications Framework (EQF) (2, 5, 23 and 68). Each level has an ECTS of 45. The BSc (Hons) programme is a 120 credit programme at UK’s FHEQ level 6 (49).
- Each study year of the D.O comprises three distinct modules (6-17, 35 and 53): Year 1 delivers teaching in relation to the foundation sciences, osteopathic principles and technique and biomechanics (6, 7 and 8). These modules enable the acquisition of underpinning knowledge and skills. Year 2 delivers teaching relating to diagnostic and professional skills, human pathophysiology and osteopathic skills (9, 10 and 11). As well as consolidating knowledge, this year also contributes to students’ understanding of abnormal states of health. In year 3 there is a focus on students’ ability to integrate and synthesise knowledge and acquiring skills and to apply them in a clinical setting (12, 13 and 14). Year 4 delivers teaching on developing the scope of practice, study skills and the refinement of osteopathic techniques (15, 16 and 17). Emphasis is placed on students developing themselves as autonomous practitioners and for life as a professional osteopath.
- Although all modules that constitute the CP’s curriculum meet the OCI’s and the EF’s standards for osteopathic training and practice (see paragraph 17, above), there is an absence of teaching relating to the acquisition of business skills, nutrition and dietetics. The College recognises the absence of business studies from its curriculum (86 and 89). In order to provide students with the necessary knowledge and skills to be successful in practice, ICOM needs to incorporate business studies into the curriculum of the new CP. The College will also need to introduce teaching relating to the principles of nutrition and dietetics. The introduction of these subjects would ensure that the College offers an osteopathic programme with an academic content that fully matches all EF requirements.
- The BSc (Hons) programme consists of three modules that are designed to develop student personal and professional development and enhance autonomy (49, 50, 51, 52, 78, 79 and 80). Additionally, the programme expands student research skills: the Research module in particular requires a 5000 word research proposal on an osteopathy-related topic (50 and 78).
- The College’s curriculum enables over 1000 clinic learning hours and ensures each student will treat and manage at least 50 new patients prior to graduation(2, 35, 47, 68, 83 and 89). This fully meets the requirements of EF Standards of Osteopathic Education and Training (2008) and the OCI’sStandards in Osteopathic Training and Education (2017). Clinic hours are primarily accrued through pre-arranged timetables that form part of and organised with students’ theoretical studies (65). Students increase the amount of hours they spend in clinic as they progress through their studies and are able to ‘make- up’ clinical hours when necessary through prior arrangements with the College’s SMT (35).
- Students are introduced into the clinic from year one of the diploma. In that year students only observe clinical procedures and processes (6, 7, 8, 53 and 89). Students begin to assume patient responsibility from year 2 and continue to develop their clinical skills until year 4 (9 – 17 and 53). Students undertake their Final Clinical Competence Assessment (FCCA) in this year where they also complete the D.O. and all clinical components of the CP (16). Students must successfully complete the diploma, all clinical assessments and achieve their 1000 clinic hours before progressing to the BSc (Hons) component of the CP (71 and 89).
- ICOM’s Clinic Handbook contains detailed information relating to students’ academic and professional clinic expectations and requirements including those relating to the issues of patient consent and confidentiality (35). Students interviewed during the visit confirmed to the accreditation team that these subjects are regularly discussed as part of their clinic studies (93). The accreditation team acknowledges that the College has designed its clinic curriculum and referenced professional documentation to ensure comprehensive student understanding of matters relating to the issue of consent (13, 16, 31, 34 and 89).
- Curricula information will be available to all students beginning the CP in September 2019 through Weblearn: Nescot’s Virtual Learning Experience (VLE) (47, 53, 72 and 89). The accreditation team was provided with a 30 minute Weblearn presentation during the visit and can confirm that it provides an appropriate, informative and comprehensive student VLE.
- ICOM currently discusses and implements changes to curricula through regular monthly meetings (87 and 89). From September 2019, such meetings will feed into, develop and refine the CP’s curriculum on a regular, annual basis through a more structured and comprehensive system of committees the College is establishing to accommodate the new CP (2, 46, 68 and 87). The accreditation team was informed that faculty staff from both ICOM and Nescot as well as lecturers, students and the College’s CP external examiner will also have a greater input into the curricula’s development through these new committees (2, 68, 87 and 89). To promote maximum input to curriculum design and optimise student learning, ICOM will need to ensure plans and arrangements are in place to support the College’s new committees by September 2019. This would also support the fulfilment of an objective detailed in ICOM’s Development Plan (69).
- To accommodate the introduction of the CP, ICOM has developed a new assessment strategy that is aimed to enhance both student and staff transparency and to promote a clear understanding of assessment processes and procedures (2, 46 and 68). The strategy builds upon earlier assessment procedures used by the College, external academic research and input from Nescot (2, 26, 37, 68 and 89). Additionally, the College intends to utilise external examiner input to develop assessment strategy (2, 55, 68 and 69). This was verbally enforced to the accreditation team during the visit (89). However, ICOM recognises that all assessment strategy and the role of the external examiner in relation to this strategy needs to be reviewed and ready for use by September 2019 (69).
- Specific assessment policy, aims and procedures are set out in ICOM’s Quality Assurance Handbook, the diploma’s programme specification and handbook and the BSc (Hons) programme specification (46, 47, 49 and 53). They are not found within any one, easily to access document. When producing its single CP document, the College will wish to ensure that all information relating to student assessment is easily accessible by the time the new CP begins in September 2019 (see paragraph 11).
- The College will use a wide range of formative and summative assessment methods throughout the CP that are designed to test the achievement of the learning outcomes of all of the programme’s modules (2, 47, 53 and 68).Summative assessments includewritten exams, reflective essays and presentations: practical osteopathic skills are tested in the form of Objective Structured Physical Examinations (47 and 53). Formative assessments include, for example, short-answer tests and clinical competence assessments (47 and 53).All of the CP’s assessments methods meet the expectations of the OCI’s Standards of Osteopathic Training in Education(2017), the EF Standards of Osteopathic Education and Training(2008) and the UK’s Quality Assurance Agency’s Subject benchmark statement: Osteopathy(2015).
- Assessment guidelines provided by ICOM to students were scrutinised by the accreditation team. These included guidelines relating to essay writing and to the portfolio – both of which related to the D.O that was introduced in 2018 and is being piloted in preparation for the C.P starting in September 2019. The guidelines provided meaningful instructions relating to assessment requirements, marking criteria and contained clear information about how student work is graded (107). Assessments will be double or second marked: a moderation process will also be implemented. The external examiner will be provided with a sample of assessments to ensure consistency of marking standards (2, 46 and 68).
- Feedback on all of the CP’s assessments will be provided verbally and in writing: the maximum time for providing students with written feedback will be three weeks (26 and 46). Faculty staff and lecturers from both ICOM and Nescot confirmed that verbal feedback will be routinely given for all practical and clinical assessments (89 and 94). Students interviewed during the accreditation visit reported satisfaction with the helpfulness and timeliness of feedback following the submission of assessments to current and previous programmes (92 and 93).
- Clinic assessments begin in year 1 of the D.O. and are core in each module that constitute the diploma’s studies in years 3 and 4 (8, 9, 12-17 and 35). Clinical competence assessments are both formative and summative in nature. The Formative Clinical Assessment (FCA) is a continuous process with assessment by the students’ clinical tutor every six weeks (47). It will include evidence of and appropriately referenced research and reflective sheets that comment upon clinical feedback given by tutors to students informing them on areas of clinical practice that need improvement. Students also need to complete a clinic portfolio that is submitted at four pre-agreed dates throughout an academic year. To pass, students will need to present the portfolio at the end of the year with four successful ‘sign-offs’ (35, 47 and 107). The portfolio is summative in nature and will include students’ development plan, reflective accounts of practice relating to patients presenting with a variety of different symptoms, case study reports and evidence of competency relating to all stages of patient management (35, 47 and 107).
- The assessment of students’ clinical skills culminates with the FCCA. This forms part of the Professional Practice module that will be delivered in year four of the D.O.Its components include a case history, diagnosis and assessment, treatment and management (35, 47 and 53). The FCCA is worth 60% of the module’s total marks. Only those students who have successfully completed all clinical components of the D.O and have obtained the minimum requirement of 1000 clinical hours will be permitted to undertake the FCCA (35 and 53).
- The FCCA requires students to evaluate two patients – a new patient and a returning patient. They are assessed by two examiners from the College. Although there is currently no moderator for the FCCA, the accreditation team was informed that plans are in place to find a suitable experienced person from the College to undertake the role (89). To increase reliability of the assessment, ICOM should identify a moderator for the FCCA prior to the first FCCA associated with the new CP.
- Assessments for the three modules of the BSc (Hons) programme are designed to ensure appropriate student skill development associated with research skills through the production of a 5000 word research project and personal and professional development(50, 51, 52, 78, 79 and 80). Students must pass all modules on this programme to be awarded with their degree. This would also mark the completion of the CP and enable application for registration with the OCI.
- Examples of student achievement were not available as ICOM is yet to start the CP. However, except for those students who had their respective modes of study (primarily) for personal reasons, the accreditation team was informed by ICOM’s teachers and current students that they were unaware of students not graduating from any of the College’s previous diplomas (93 and 95). This information was reinforced by a previous ICOM student who was interviewed by the accreditation team (92). Past and present students also praised how well previous and current College training had prepared students for professional practice (92 and 93).
F. The quality of the learning opportunities provided
- All students beginning the CP in September 2019 will have unrestricted access to Weblearn: Nescot’s Virtual Learning Environment (VLE) (47, 53, 72 and 89). The accreditation team was provided with a 30 minute Weblearn presentation during the visit and can confirm that it provides an informative and comprehensive student VLE. Those College students who currently have access to Weblearn also confirm this (93).
- The College has a small library that is based in the clinic’s reception area and which was visited by the accreditation team. It is stocked with anatomical figures and charts as well as approximately 140 medical and osteopathic books appropriate for the osteopathic student. Currently, an informal process is used by the College to review library publications and student learning materials with purchases based upon informal staff and student requests. ICOM acknowledges that there is a need for a more formal process to be established for material acquisition in readiness for the new CP (2 and 68). This is also an objective that has been identified in its Development Plan (69). It should be noted however that Weblearn will facilitate student access to a comprehensive source of on-line material that will enhance the student learning experience (46).
- ICOM has three lecture rooms, two of which are equipped with hydraulic plinths. These are used for delivering practical skills teaching but can also be used to accommodate lectures that are more theoretical in nature (46). The College’s osteopathic clinic has a large practical area with couches and six treatment rooms each of which contain appropriate medical equipment that support the delivery of osteopathic treatment (46). The rooms can also accommodate a small number of students wishing to undertake informal technique practice. Suitable private break-out areas are in close proximity to the clinic which permit clinic tutor/student patient discussions. The tutor/student teaching ratio in clinic is 1:6 (2 and 68).
- ICOM has one small computer room that contains three PCs (46). This is available for students to use when they wish to do so. Internet access is available throughout ICOM’s premises and an independent contractor provides support for the College’s IT systems (46 and 87). The accreditation team was informed that the contractor is based off-site but can be contacted and utilised at short notice as and when necessary (87). Weblearn is comprehensively maintained by Nescot’s own IT support at its premises in Surrey (87).
- At present, ICOM does not have any formal procedures and arrangements that provide student pastoral and academic support: such support has been provided when necessary on an individual needs basis (2, 68, 89, 93 and 95). However, in line with standard Higher Educational Institutions, ICOM will be allocating a personal tutor to act as an academic adviser, to monitor student attendance and support students with their progression, assessments and personal development (61). In order to maximise student support for those students on the new CP, the College will need to ensure all students clearly understand the College’s plans relating to student pastoral and academic support. This task would fulfil an objective detailed in ICOM’s Development Plan (69).
Teaching and learning
- ICOM’s teaching team is represented by staff from varied medical and muscular-skeletal backgrounds including those who are manipulative therapists and those who are osteopaths (53, 64 and 95). Nescot’s teaching team are all osteopaths (64).All osteopaths who will teach on the CP have appropriate qualifications and experience to do so. Only osteopaths will coordinate and lead teaching on osteopathic modules associated with the new programme: the manipulative therapists who will have input into specific osteopathic modules are termed assistants and will support osteopaths with the delivery of osteopathic practical lectures (77, 87 and 89). Observations of clinic supervision and lecturers during the visit (that included osteopaths and manipulative therapists) provided insight into the current level of teaching quality. All clinic osteopaths and lecturers delivered high quality teaching and provided strong student support (94, 96 and 97).
- All teaching staff on the CP will use a wide range of methods to deliver the learning outcomes of the programme’s academic and clinical modules (2, 35, 46, 49, 53 and 68).Student learning is facilitated through lectures and tutorials that are didactic in nature but also through those that encourage maximum participation and discussion (2, 35, 46, 49, 53, 68 and 95). Past and current ICOM students informed the accreditation team that the College’s approach to student learning was highly supportive: all teaching staff at the College were open to students’ seeking academic clarity during lessons and displayed a strong commitment to student development (92 and 93).
- ICOM’s osteopathic clinic has successfully offered manual therapy treatment to its established patient base for a number of years (2, 68 and 98). Clinic observations during the accreditation visit provided insight into the current standard of treatment provided by manual therapy students. The accreditation team noted the knowledge and ability of such students (89, 94 and 97). However, should students from the new CP be paired or grouped with students enrolled on the (non-osteopathic) diplomas during their time in clinic, the College will need to set in place arrangements that ensure the clinical learning and development of the CP students will be osteopathic in principle and in practice.
- ICOM promotes the admission of students based on merit and ability and seeks to attract applications from individuals with excellent academic potential (46). It aims to recruit up to 20 students per year: a marketing plan has been identified to support this task and to maintain the longer-term viability of the College (69 and 87). ICOM’s admission’s criteria is clearly outlined in the Programme Specification document (47). However, the criteria is not outlined on ICOM’s website. The website needs to be updated to include such information. This task can be undertaken when addressing condition 1 of this report.
- The College is aware that all new committee structures need to be in place by the start of the new CP(see Governance and Management section, paragraph 54) (87). As a result, ICOM’s proposed new Student Recruitment and Progression team has yet to formally meet and discuss issues pertinent to its role. Although an admissions policy is in place for the new CP, the accreditation team recommends this needs to be developed by the Student Recruitment and Progression team so as to provide specific information about the structure of admissions interviews, the type of information that is to be recorded, where student data relating to admissions and progression is to be stored and the College’s commitment relating to recruitment through recognition of prior learning (46 and 72). In order to provide information about ICOM’s ability to deliver student leaning outcomes, appropriate progression and overall achievement of the award, the College needs to set up a mechanism by the start of the new CP that ensures such information can be easily captured and recorded.
- CP students will be inducted into the programme using a number of informative lectures throughout the first six weeks of their study (56). The induction process will provide students with all the necessary information for the taught sessions (including timetables and dates), an overview of the teaching and assessment methods, student support services, student representation, key contacts at ICOM, student handbooks and clinical placements (56). Induction processes are also in place for returning students. These are clearly detailed throughout all of the CP’s main programme documentation (35, 47, 49, 53 and 65).
- Students are required to achieve 40% to pass each module of the D.O and must pass all modules in any particular year before they progress to the next level (53). Clinical ability will be assessed continually on the CP and, in order to progress, students must achieve each of the clinical learning outcomes as detailed in those modules that have a clinical component (47). Students must successfully complete the D.O component of the CP before they are permitted to enrol onto the BSc (Hons) component of the CP (83). Students must successfully pass all three modules on the BSc (Hons) programme before they achieve their award and graduate.
Governance and Institutional Management (including financial and risk management and the maintenance and enhancement of standards and quality)
- ICOM is a registered company and is effectively financially managed as a sole trader entity (41, 68, 87, 88 and 91). However, to date, an established business planning process has not been maintained that would allow for an effective strategy and risk management. The College has identified the need for this process to be introduced and is currently being addressed in the form of a Development Plan, Risk Register and Business Plan (69, 76 and 98). The accreditation team recommends the College produces a five year business plan to incorporate an annual strategic document that includes financial projections and risk management considerations associated with student intake and attrition.
- The College also confirmed that it does not have a provision for the PEL (2 and 68). To safeguard students’ interests, the College needs to adhere with the protocols outlined by the Quantity and Qualifications Ireland and ensure PEL arrangements are in place.
- The Chief Operations Officer of ICOM is its Principal, Mr. Kieran Corcoran. He manages the strategic development and operational delivery of the College. Mr. Corcoran is supported by three personnel: the Programme Manager, Head of Finance and College Administrator. This group forms the College’s SMT (2, 68 and 74). The team works to formulate the development of the College and maintains the overall staff and student experience.
- To date, given the size of ICOM’s College community, there has not been the need for formal committee structures that deliberate on academic standards: management has been conducted in an informal manner (2,68and 87). However, governance and management development of the College in relation to the new CP has been supported by Nescot and through two independent education consultants, one of whom is a Nescot employee and one who was a Nescot SMT member (2, 68, 87, 89,102 – 106).
- The College has sole responsibility for all aspects of academic standards and quality assurance of the D.O although, as has been highlighted previously, Nescot will have continued input into the management of the CP. This will help to ensure parity of academic standards for the whole programme (2, 68 and 89).
- Rules and regulations relating to academic integrity and student fitness to practice are outlined in various programme documentation with the necessary information regarding timelines and processes also detailed in this documentation (35, 46, 53 and 71). Both Nescot and the consultants will continue to provide input to quality assurance processes subsequent to the introduction of the new CP(102, 103 and 104).Additionally,the accreditation team was informed that one of the independent consultants would chair the new committees for the first year in order to ensure the roles and responsibilities of such committees are fully implemented going forward (87). In order to ensure quality assurance and academic integrity, the College is aware that all new committee structures as well as Nescot’s role and the role of the independent advisors need to be in place by the start of the new CP and that flow documentation relating to the new committee structures and reporting lines needs to be available. In addressing this task, the College would support the fulfilment of an objective already detailed in its Development Plan (69).
- Nescot has undertaken a process of due diligence and has judged the finances of the College to be robust and that appropriate oversight is in place. A Service Level Agreement (SLA) is in place to ensure security for both parties (2, 54, 68 and 87). This should be reviewed to ensure it is up to date. ICOM does not have a progression agreement in place with another provider in the event of Nescot leaving the partnership. However, to mitigate this risk, the SLA has incorporated a ‘teach-out’ agreement of one year (54). This was verbally enforced to the accreditation team during the visit (87).
- The College has informal arrangements in place to provide opportunities for students and staff to engage with the development and implementation of policies and procedures and current staff, past and current students praised the College for its prompt response and open communication style (2, 68, 87, 92, 93 and 95). However, the SMT is aware that a more formal framework that would enable staff and student engagement must be in place by the time the new CP begins. The completion of this task would support the fulfilment of an objective already detailed in ICOM’s Development Plan (69). Additionally, both the SMT and College lecturers acknowledged that new policies and procedures had not been relayed to all College staff (87 and 95). The College will need this to be implemented when it constructs its more formal communication framework.Feedback relating to the new CP from students and student representative bodies will be collected from the VLE (87 and 89). The College is aware that it will need to be mindful of GDPR regulations.
- Processes based upon Nescot’s arrangements will provide an effective procedure to support the role of external examiner. Guidance for this role is provided in a comprehensive document that details duties and requirements (51). The accreditation team met the external examiner during the visit and she confirmed that she was aware of the duties associated with the role (89). As the new CP has not yet begun, there were no current external examiner reports to view.
- The College is committed to staff development and a budget for staff training is available: this has been utilised annually (45 and 46). To date, staff development has been undertaken when either a staff member or the College identifies a need that is particularly focused on developing professional skills related to osteopathy (2,41,68, 87 and 95).
- Since developing the new CP, lecturing staff at ICOM have attended a number of staff development events at the College that have been hosted and delivered by Nescot (2, 68, 87 and 95). However, although consideration has been given by the College to such development, this needs to be further enhanced to include research (46).The College informed the accreditation team that while it has plans to enrol some of its lecturers onto the BSc (Hons) programme in order to promote their research skills, it currently does not have a formal staff research strategy in place that would ensure this (86 and 87). It is important for ICOM to establish an appropriate annual staff development/mentorship plan that demonstrates how it will support staff development relating to all areas of the curriculum including that of staff research. ICOM will need to ensure that this is addressed by the start of the new CP. This would support the fulfilment of an objective identified by the College as needing action as detailed in its Development Plan (2,68, 69, 87 and 95).
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Accreditation meetings held at ICOM
- 9thMarch 2019: Pre-meeting with Accreditation Team Lead and ICOM SMT
- 12thApril 2019: Introduction and Overview with Accreditation Team and
- 12thApril 2019: Governance and Management with Accreditation Team, ICOM
SMT and Nescot Programme Leads
- 13thApril 2019: Curriculum, Teaching and Learning with Accreditation Team,
ICOM SMT and Nescot Programme Leads
- 13thApril 2019: Accreditation Team and current ICOM students
- 13thApril 2019: Accreditation Team Lead and Lay Team member and previous
ICOM student (telephone meeting)
- 13thApril 2019: Accreditation Team and ICOM and Nescot lecturers
- 14thApril 2019: Debrief meeting with Accreditation Team and ICOM Principal
Accreditation report reference list
- Application Form
- Self-Evaluation Document
- Development Plan
- Overriding Appendix
- Appendix 1 – Credits Hours Cork
- Appendix 2 – D.O 1.1 Foundation Sciences
- Appendix 3 – D.O 1.2 Osteopathic Principles and Technique
- Appendix 4 – D.O 1.3 Integrated Biomechanics
- Appendix 5 – D.O 2.1 Diagnostic & Professional Skills
- Appendix 6 – D.O 2.2 Human Pathophysiology
- Appendix 7 – D.O 2.3 Osteopathic Skills
- Appendix 8 – D.O 3.1 Applied Osteopathic Skills
- Appendix 9 – D.O 3.2 Professional and Clinical Practice
- Appendix 10 – D.O 3.3 Osteopathic Medicine
- Appendix 11 – D.O 4.1 Developing Specialist Practice
- Appendix 12 – D.O 4.2 Professional Practice
- Appendix 13 – D.O 4.3 Applied Osteopathic Skill 2
- Appendix 14 – Overriding Mapping Document
- Appendix 15 – Self Evaluation Document V1
- Appendix 16 – EFSOP (The European Framework for Standards of Osteopathic Practice )
- Appendix 17 – Irish Qualifications Frameworks
- Appendix 18 – European Framework Code Of Osteopathic Practice (EFCOP)
- Appendix 19 – Descriptors defining levels in the European Qualifications Framework
- Appendix 20 – OCI Codes of Professional Conduct and Ethics
- Appendix 21 – ICOM Cork Quality Handbook
- Appendix 22 – Assessment Strategy Accompanying Document
- Appendix 23 – ECTS Users Guide
- Appendix 24 – Qualifications Frameworks
- Appendix 25 – OISOET
- Appendix 26 – Annual Programme Review Form
- Appendix 27 – Consent Guide for Health and Social Care Professionals
- Appendix 28 – European Framework of Standards for Osteopathic Education and Training EFSOET
- Appendix 29 – Clinic Tutor Handbook
- Appendix 30 – Draft GOsC Obtaining Consent Supplementary Guidance
- Appendix 31 – Clinic Handbook
- Appendix 32 – SOPE
- Appendix 33 – The Student Assessment Workloads Review (Fielding 2008)
- Appendix 34 – Staff Student Consultative Committee Terms of Reference
- Appendix 35 – Quality and Resources Review Agenda
- Appendix 36 – Module Enhancement Plan
- Appendix 37 – Annual Programme Review Form
- Appendix 38 – Board of Study Template
- Appendix 39 – Code of Conduct for Students
- Appendix 40 – Extenuating Circumstances Claim Form
- Appendix 41 – Accounts
- Appendix 42 – ICOM Quality Handbook 18-19
- Appendix 43 – Programme Specifications V2
- Appendix 44 – Bridging Course Level 6 Handbook
- Appendix 45 – BSc Top Up Programme Specifications
- Appendix 46 – OS6708
- Appendix 47 – OS6709
- Appendix 48 – OS6710
- Appendix 49 – Cork Handbook Template
- Appendix 50 – Cork College SLA July 2018 V2
- Appendix 51 – External Examiners’ Role and Responsibilities
- Appendix 52 – Induction Programme
- Appendix 53 – Staff Code of Conduct
- Appendix 54 – Equality and Diversity Policy
- Appendix 55 – Principal Job Description
- Appendix 56 – Roles and Responsibilities of the Dean
- Appendix 57 – Personal Tutoring Policy
- Appendix 58 – ICOM Staff Recruitment and Selection Policy and Procedure
- Appendix 59 – SDF01 Application For Staff Development
- Appendix 60 – Staff CV
- Appendix 61 – Timetables
- Appendix 62 – Development Plan
- Appendix 63 – Tutor rota
- Appendix 64 – Self-Evaluation Document Draft Version 7
- Appendix 65 – Development Plan V2
- Appendix 66 – Personal Tutoring Policy
- Appendix 67 – Complaints Form
- Appendix 68 – ICOM – March 11th Request for further information
- Appendix 69 – Examination Board Terms and Structure
- Appendix 70 – ICOM Organisation Structure V2
- Appendix 71 – Modules Required for NESCOT Progression
- Appendix 72 – Risk Register
- Appendix 73 – Staff Duties
- Appendix 74 – NESCOT Module OS6708
- Appendix 75 – NESCOT Module OS6709
- Appendix 76 – NESCOT Module OS6710
- Appendix 77 – Old Content to ICOM Diploma Modules
- Appendix 78 – Assessment Table New Module
- ICOM Website/on-line prospectus
- Lectures during accreditation visit
- Kieran Corcoran – 10th April further information
- ICOM Introduction and Overview meeting notes
- ICOM Governance and Management meeting notes
- Kieran Corcoran Company Registration number/certificate
- ICOM Curriculum, Teaching and Learning meeting notes
- ICOM Teaching observations
- Public Liability Insurance document
- Past Student meeting notes – (phone call)
- ICOM Current students – meeting notes
- Bob Davies Clinic Observation
- Lecturer meeting – notes
- Craig Toutt Teaching observation 01 & 02
- Craig Toutt Clinic Observation
- Business plan & financial projections
- Northern Institute of Massage – letter of endorsement
- Appendix 87 – Lease Ashbrook Clinic
- Appendix 88 – Fire Service Certificate
- Appendix 89 – Schedule of Services OEC ICOM Cork April 2019
- Appendix 90 – Schedule of Service Mark Foster Consultancy 18-19
- Appendix 91 – Schedule of Services ICOM Cork April 2019 MF
- Appendix 92 – Schedule of Service OEC ICOM Cork 18-19
- Appendix 93 – Mark Foster CV 2019
- Examples of assignment guidelines and marking criteria
This report was written and compiled on behalf of the Osteopathic Council of Ireland by:
Bob Davies MA BSc (Hons) Osteopathy, Accreditation Team Lead
Craig Toutt MA ED, BSc OstMed, DO, DN, Accreditation Team Member
Dr Fionnuala Conway, Creative Technology Consultant, Accreditation Lay Team Member
© June 2019