NCCSA » Request for Program Review

Program Name*

Address*

Street Address City State ZIP Code

Contact Person / Title*

First Last

Phone*

Email*

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1. Please Indicate the type(s) of academic institutions.*

An accredited post-secondary academic institution recognized by the U.S. Department of Education.
A foreign post-secondary academic institution listed in the International Medical Education Directory (IMED).
A hospital based or privately operated program affiliated with a medical center.
An educational program of the United States Armed Forces applicable to surgical assisting.
CAAHEP accredited program
ABHES accredited program

Item 1 Reference*

2. Which is awarded upon successful completion?*

Academic Degree
Certificate

Item 2 Reference*

3. Please provide a written statement of your program’s goals supporting the required knowledge and skills for entry into the surgical assisting profession, as defined by the American College of Surgeons (ACS).*

Item 3 Reference*

4. Does your educational program offer students an opportunity to prepare and subsequently sit for the NCCSA Certified Surgical Assistant (CSA) Examination without bias, and as an indicator of academic program outcomes?*

Yes
No

Item 4 Reference*

5. Does your program operate a physical laboratory for student education?*

Yes
No

If yes, is the student to instructor ration 12:1 or less?*

Yes
No

Are at least 60 hours of laboratory work logged on site?*

Yes
No

Item 5 Reference*

6. Please refer to definitions in NCCSA Standards for Surgical Assisting Programs, and list all program faculty under the following designated categories. Include all applicable credentials:

Program Director (Must meet institutional and jurisdictional guidelines)*

Medical Director (Must be a licensed physician and certified in a surgical specialty recognized by the American Board of Medical Specialties)*

Didactic Faculty (Must be qualified by education and experience, and demonstrate effectiveness in teaching the assigned subjects)*

Clinical Faculty (Must be a licensed physician and certified in a surgical specialty recognized by the American Board of Medical Specialties and experience in student training. Must have current surgical privileges at an appropriately accredited institution / healthcare facility where instruction is to take place)*

Associate Clinical Faculty (Must hold a CSA, CFA or an equivalent credential in the surgical assisting profession with a minimum of three years of current experience)*

Adjunct Clinical Faculty (Must possess commensurate licensure, certification and/or credentialing to provide clinical instruction in their professional area of expertise {e.g.: anesthesiology, pharmacy, cardiopulmonary perfusion, etc.})*

Item 6 Reference*

7. Is the total of the programmatic laboratory and didactic clock hours 550 or greater?*

Yes
No

Total Didactic Clock Hours*

Total Laboratory Clock Hours*

Are at least 60 clock hours of laboratory work logged on site?*

Yes
No

Item 7 Reference*

8. Does any portion of the program utilize distance learning?*

Yes
No

If yes, how will these hours be logged for each individual student?

Item 8 Reference*

9. Are each of the following included in the program's prerequisites?*

High School Diploma or equivalent
Basic Cardiac Life Support (BCLS)
Prior healthcare and/or surgical experience. (This may include volunteer work and/or observation at the discretion of the Program Director)

Item 9 Reference

10. Please reference each of the following subjects within your course curriculum:

Anatomy & Physiology*

Pathophysiology*

Bioscience (to include biology / microbiology)*

Chemistry*

Pharmacology*

Anesthesia*

Surgical Biohazards (to include radiation safety)*

Surgical Assisting Fundamentals and Clinical Practice (to include aseptic techniques, technical skills and management of complications)*

Medical Terminology*

Surgical Ethics and Law*

Interpersonal Skills*

Clinical Application of Computers*

11. Does the program’s clinical coursework consist of at least 400 hours?*

Yes
No

Item 11 Reference*

12. Does the program’s clinical coursework include a minimum of 240 cases as first and/or second assistant, and a minimum of 135 cases in the role of first assistant?*

Yes
No

Item 12 Reference*

13. Does clinical exposure include at least 35 cases in general surgery, with an additional minimum of 50 cases in a surgical specialty?*

Yes
No

Item 13 Reference*

14. Are clinical experiences provided in both inpatient and outpatient settings?*

Yes
No

Item 14 Reference*

15. Are clinical experiences provided along the continuum of infant to elderly?*

Yes
No

Item 15 Reference*

16. Please reference each of the following preoperative clinical activities within your course curriculum:

Patient Interview and Assessment*

Basic Interpretation of Lab Values / Diagnostic Studies*

Patient Positioning*

Skin Preparation and Draping*

17. Please reference each of the following intraoperative clinical activities within your course curriculum:

Tissue Handling*

Use of Instrumentation*

Retraction and Exposure*

Attainment of Hemostasis*

Suturing and Knot Tying*

Wound Closure*

18. Please reference each of the following postoperative clinical activities within your course curriculum:

Patient Management*

Discharge Planning*

19. Please reference each of the following laboratory activities within your course curriculum:

Use of Operating Room Equipment*

Patient Positioning*

Anesthesia / Airway Management*

Intraoperative Assisting*

Suturing & Knot Tying*

Wound Closure*

Fluid Replacement*