~ Frequent Program Changes ~
ST Program Director (PD) Changes
ST Program Faculty (non-PD) Changes
Institutional Administrator Changes
(President/CEO and Dean)
ST Program Advisory Committee (PAC) Membership Change
ST Enrollment Capacity Changes
ST Facilities Changes
Findings Letter/Program Change Letter Submissions
ST On-Site Evaluation Documents
Program Director (PD) Changes
A change in Program Director (PD) should be reported to the ARC/STSA within 30 days of the change. The following documentation should be submitted in support of the appointment:
- Notification of the name of the new program director and date of the appointment. This notification should be submitted on institutional letterhead and signed by the President/CEO or their designee.
- An ARC/STSA Program Personnel Report Form. This form should include information for all program faculty, staff and administration directly related to the Surgical Technology program (President and Dean or comparable appointments).
- An ARC/STSA Program Faculty Curriculum Vitae Form
- An ARC/STSA Faculty Schedule of Responsibilities Form
- A current résumé indicating three years of recent scrub experience or three years recent experience as a ST program instructor. The résumé should also indicate employment at the current ST program.
- Proof of a current NCCA-approved credential in surgical technology (CST, CFA, or CST/CFA). Proof consists of submission of one of the following documents:
- A copy of the NBSTSA certification card
- A copy of the NBSTSA certification certificate
- A copy of the verification page from the NBSTSA website ( www.nbstsa.org ). [NOTE: If the Social Security number is used to access this verification, the Social Security number will appear on the document. Please black out the social security number on the document prior to submission. If the certification number is used to access this verification, the Social Security number will not appear on the document. ]
- In addition, effective January 1, 2009, all newly appointed program directors are required to submit proof of attendance at an Accreditation Fundamentals for Educators (AFE) Workshop during their first year of appointment. Please contact the ARC/STSA for dates and costs for this workshop.
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Program Faculty (non-PD) Changes
A change in program faculty (non-PD) who teach core surgical technology content should be reported to the ARC/STSA on the program's next ARC/STSA Annual Report. The following documentation should be attached to the Annual Report in support of the appointment:
- An ARC/STSA Program Personnel Report Form. This form should include information for all program faculty, staff and administration directly related to the Surgical Technology program (President and Dean or comparable appointments).
- An ARC/STSA Program Faculty Curriculum Vitae Form
- An ARC/STSA Faculty Schedule of Responsibilities Form
- A current résumé indicating qualification by education and experience to be effective in teaching the subjects assigned. The résumé should also indicate employment at the current ST program.
- Proof of a current NCCA-approved credential in surgical technology (CST, CFA, or CST/CFA). Proof consists of submission of one of the following documents:
- A copy of the NBSTSA certification card
- A copy of the NBSTSA certification certificate
- A copy of the verification page from the NBSTSA website ( www.nbstsa.org ). [NOTE: If the Social Security number is used to access this verification, the Social Security number will appear on the document. Please black out the social security number on the document prior to submission. If the certification number is used to access this verification, the Social Security number will not appear on the document. ]
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Institutional Administrator Changes
(President/CEO and Dean)
A change in an institutional administrator directly related to the Surgical Technology program (President/CEO or Dean - or comparable appointments) should be reported to the ARC/STSA within 30 days of the change. The following documentation should be submitted in support of the appointment:
- Name, credentials and official position/job title of the new administrator
- Date of appointment
- Institutional contact information, including:
- Mailing Address
- Telephone Number
- Fax Number
- E-mail Address
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Program Advisory Committee (PAC) Membership Change
Changes to the membership of the Program Advisory Committee (PAC) should be reported to the ARC/STSA on the program's next ARC/STSA Annual Report. The following documentation should be attached to the Annual Report in support of the appointment:
Program Advisory Committee (PAC) Form
Please note:
- The public member appointed to the Program Advisory Committee (PAC) holds a duty to represent the interests of the patient that may come under the care of the surgical technologist and therefore has a vested interest in the proper education of the surgical technologist for quality patient care. The public member must not be:
- A current or former employee of the sponsoring institution
- A current or former employee of any clinical affiliate associated with the program
- A current of former student of the surgical technology program
- A current or former healthcare provider
- Please include the current NBSTSA certification number for the committee member representing the Practicing CST on the ARC/STSA Program Advisory Committee (PAC) Form and submit proof of certification and currency. This proof can consist of one (1) of the following:
- A copy of the NBSTSA CST certification card
- A copy of the NBSTSA CST certification certificate
- A copy of the verification page from the NBSTSA website ( www.nbstsa.org ). [NOTE: If the Social Security number is used to access this verification, the Social Security number will appear on the document. Please black out the social security number on the document prior to submission. If the certification number is used to access this verification, the Social Security number will not appear on the document. ]
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ST Enrollment Capacity Changes
Proposed changes to the program's maximum enrollment capacity should be reported to the ARC/STSA for review and approval by the ARC/STSA Board of Directors. The following documentation should be submitted in support of approval of the maximum enrollment capacity change:
- Clarification regarding the exact maximum enrollment capacity of each enrollment cohort and number of cohorts per year. Also, please indicate the number of cohorts that overlap at any point in the program, if any.
- Documentation of a Needs Assessment supporting the change in maximum enrollment capacity, including Program Advisory Committee minutes reflecting discussion and support of this change
- Clarification regarding sufficiency of the program's resources, such as classroom equipment, laboratory instrumentation, supplies and equipment, computer resources, instructional aides, etc. to address any needs related to this change in enrollment capacity (Standard III.A.)
- Clarification and documentation of sufficient clinical affiliation sites and slots for this new enrollment capacity (ARC/STSA Clinical Affiliation Site Report form)
- Revised program publications reflecting this change in maximum enrollment capacity and enrollment opportunities
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ST Facilities Changes
Proposed changes to the program's facilities - classroom or laboratory facilities - should be reported to the ARC/STSA for review and approval by the ARC/STSA Board of Directors. The following documentation should be submitted in support of approval of the facilities change:
- A blueprint or floor plan showing the surgical technology classrooms, laboratory space, and faculty offices, including measurements, and photographs of these areas
- An updated list of laboratory furnishings, equipment, and supplies
- Verification of the program annual maximum enrollment capacity and actual (current) enrollment and start date(s) for the actual (current) cohort(s)
- Verification of faculty didactic and laboratory assignments, if program maximum enrollment capacity has changed
- Submission of an ARC/STSA Clinical Affiliation Site form, if program maximum enrollment capacity has changed. The ARC/STSA Clinical Affiliations form may be obtained online at: http://www.arcstsa.org/forms/ST/index.htm .
- Any changes in contact information - telephone number, fax number, address, etc.
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Findings Letter/Program Change Letter Submissions
When submitting a findings letter or program change to the ARC/STSA, please use the following guidelines when preparing your submission:
- A cover letter, on institutional letterhead, should include a reference to the purpose for the documentation submission (e.g.: response to a findings letter from the ARC/STSA dated October 11, 2008).
- A copy of ARC/STSA communication(s) related to the submission (findings letter, CAAHEP letter, etc.), if applicable.
- If the submission is related to a findings letter, for each Standard citation:
a. Section I - Narrative Response
- List the Standard, finding and request from the findings letter.
- Insert the program's narrative response
Note: If supporting documentation is included to demonstrate compliance or to clarify a change, please insert the supporting documentation in an appendix, labeled numerically, following the complete narrative response. Please reference the appendix number and page number in the narrative.)
b. Section II - Supporting Documentation - on the pages following the complete narrative response, insert any supporting documentation that provides evidence of compliance with the Standards.
Note: For a findings letter with more than two (2) citations, each citation/response should be listed on a table of contents that includes the Standard and the page of the narrative where the response is located. Citations with the same Standard number should be listed separately (e.g.: III.A. - Resources - Budget and III.A. - Resources - Computers).
- All pages of the submitted response, both hardcopy (paper) and electronic/digital form - including supporting documentation, should be numbered sequentially as one document, beginning with the first page of the narrative through the final page of the supporting documentation.
- All submissions should be submitted in BOTH a bound [3-ring binder, spiral, or other], hardcopy (paper) form and electronic/digital (CD-ROM, DVD, flash drive) form, using PDF (preferred) or Microsoft Word format. The electronic/digital copy should be a single, continuous "seamless" document - all files and folders combined into one, continuous document - and an exact duplicate of the hardcopy (paper) submission, preferably saved as a PDF document. NOTE: Please do not e-mail large documents (more than 20 pages) to the ARC/STSA.
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On-Site Evaluation Documents
When an On-Site Evaluation is scheduled, two common documents used to support the visit are:
- List of On-Site Visit Materials - ST specific - provided by the ARC/STSA and used by the program to prepare on-site documentation for the visitors to review
- On-Site Evaluation Schedule - Surgical Technology and Visit specific - completed and submitted to the ARC/STSA separate from any additional documentation (not bound into the Self-Study, etc).
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ST FORMS
*ARC/STSA 2006 Annual Report Data Sheet - ST
*ARC/STSA 2007 Annual Report Data Sheet - ST
*ARC/STSA 2008 Annual Report Data Sheet - ST
*ARC/STSA 2009 Annual Report Data Sheet - ST
*ARC/STSA 2010 Annual Report Data Sheet - ST
ARC/STSA 2010 Annual Report CST Outcomes Data Sheet - ST
Needs Assessment Form - ST
*List of On-Site Visit Materials - ST
*On-Site Evaluation Schedule - ST
Fair Practices Form - ST
Program Advisory Committee (PAC) Form - ST
Clinical Affiliation Site Report Form - ST
Program Personnel Report Form - ST
Program Faculty Curriculum Vitae Form - ST
Faculty Schedule of Responsibilities Form - ST
A-1 – ARC/STSA Budget Form
A-2 – Methods of Didactic and Laboratory Evaluation Form – ST
A-3 – Methods of Clinical Evaluation Form - ST
C-1 – Curriculum Sequencing Form - ST
C-2 – Didactic and Laboratory Courses – Summary Form - ST
C-3 – Clinical Courses – Summary Form - ST
* Please contact the ARC/STSA office at info@arcstsa.org or 303-694-9262 for forms marked with an asterisk above.
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Other ST Forms
The following forms are being piloted for use. They should only be used when directed to do so by the ARC/STSA office. Instructions for their use are embedded in the form. If needed, please contact the ARC/STSA office (303-694-9262) for further assistance in completing these forms.
ARC/STSA Curriculum Comparison Form - ST
ARC/STSA Clinical Affiliation Tracking Form - ST
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