Knowledge, Attitude and Compliance with Accreditation Standards among Respiratory Therapy Faculty in the Philippines

Anna Monina Palma Dela Cruz¹, Susana C. Bautista²

¹University of Perpetual Help System Laguna, PHILIPPINES

University of Perpetual Help-Dr. Jose G. Tamayo Medical University, PHILIPPINES

²University of Perpetual Help System Laguna-Philippines, PHILIPPINES

ABSTRACT: This descriptive-correlational study aimed to assess the knowledge, attitudes, and compliance with accreditation standards among respiratory therapy faculty members in the Philippines, and to explore the relationships between these factors and demographic variables. Using stratified random and purposive sampling, data were collected from 53 respiratory therapy faculty members (87% response rate) from nine accredited programs through a validated four-part questionnaire. The study investigated faculty members’ understanding of five major accreditation components, their attitudes towards the accreditation process, and their level of compliance with established standards. Results revealed advanced levels of knowledge across all accreditation components: governance and management (M=3.50), teaching and learning (M=3.60), professional exposure and research (M=3.49), student support (M=3.52), and community relationships (M=3.51). Faculty demonstrated proactive attitudes toward accreditation standards (M=3.71) and high compliance levels (M=3.56). Demographic analysis showed that the majority of respondents were mid-career professionals aged 30-39 (32.1%), predominantly female (52.8%), and single (66.0%), with Bachelor’s degrees (43.4%) and 1-2 years of service (26.4%). Statistical analysis revealed no significant differences in knowledge, attitudes, and compliance when grouped according to demographic variables. Compliance with accreditation standards was consistent across demographics, with no significant differences based on age, gender, civil status, education, or experience.  Regression analysis showed that both knowledge (p<0.001) and attitude (p<0.001) significantly predicted compliance levels, explaining 56% of the variance in compliance (R²=0.560). This highlighted a strong correlation between knowledge, attitude, and compliance, emphasizing that equipping faculty with accurate information and fostering positive attitudes significantly enhance adherence to accreditation requirements.

KEYWORDS: Knowledge, Attitude, Compliance, Accreditation Standards, Respiratory Therapy Faculty, Quality Education

1. INTRODUCTION

The development of the era in the 21st century is a form of external change that must be faced by higher education institutions in the whole world. A nation must equip its human resources through higher education with global competitiveness so that graduates are able to be accepted in the national and international labor market. (Adiatma,2022). Healthcare education plays a critical role in shaping the future of healthcare professionals and building a stronger healthcare system (Perini,2023), particularly in fields requiring specialized skills like respiratory therapy. Respiratory therapy is a critical healthcare profession that has seen significant growth and development in recent years, particularly in the Philippines.

While accreditation standards have been established, little is known about how well they are understood, perceived, and implemented by faculty members in respiratory therapy programs across the Philippines. Padro et al (2019) study reveals that faculty member’s level of knowledge was influenced by factors such as years of experience, previous involvement in accreditation activities, and administrative responsibilities. In the study by Blouin and Tekian (2019) they identified a range of attitudes, from seeing accreditation as a valuable quality improvement tool to viewing it as burdensome bureaucratic process. While in the study of Siriwardena et al (2021) faculty attitude revealed that while most faculty recognized the importance of accreditation, many expressed concerns about time and resources required for the process. Oermann (2020) The high levels of compliance weren’t simply a matter of individual faculty effort, but rather the result of a supportive ecosystem within the institution. In the study of Alrebish et al (2020) findings underscore the uneven nature of compliance across different aspects of accreditation standards, suggesting that institution may excel in some areas while struggling in others.

Faculty members are key stakeholders in the accreditation process, in the study of Lee and Kim (2023) they highlighted the effectiveness of peer mentoring programs, regular workshops and involving faculty in the development of accreditation criteria. Understanding knowledge, attitude and compliance of faculty is essential for identifying potential gaps in implementation and areas for improvement in the accreditation process. However, while accreditation standards aim to enhance educational outcomes, the knowledge, attitudes and level of compliance among faculty members- who are pivotal to the accreditation process- vary widely. Faculty understanding of these standards and their commitment to upholding of them significantly influence the accreditation outcomes and the overall quality of respiratory therapy programs.

This study aimed to examine the knowledge, attitudes, and compliance with accreditation standards among respiratory therapy (RT) faculty. By doing so, it sought to identify any gaps between the established standards and actual practice within educational programs. This research also aimed to explore faculty members’ attitudes toward accreditation. Understanding the knowledge, attitudes, and compliance of respiratory therapy faculty regarding accreditation standards had significant implications for both educators and institutions. Notably, there was a lack of studies focusing on respiratory therapy programs, making this research particularly relevant and necessary. Addressing this gap highlighted areas where faculty needed further training or support, if necessary, and provided valuable insights into improving compliance with accreditation standards, ensuring that RT programs met and exceeded the required educational and professional benchmarks.

1. METHODS

This study on the knowledge, attitudes, and compliance with the accreditation standard along with major components of accreditation of respiratory therapy faculty members in the Philippines, utilized the descriptive-correlational research design. The population of the study consisted of 53 Respiratory Therapy faculty members who taught professional courses under the respiratory therapy program in the Philippines. Stratified random sampling and purposive sampling were used to ensure representation from different regions of the Philippines. For the purposes of generating the needed primary data, a 4-part research-made questionnaire was used. Part (1.) Demographic Profile, (2.) Knowledge of Accreditation Components, (3.) Attitude towards Accreditation, (4.) Compliance with Accreditation Standards. The questionnaire underwent validation by a panel of experts consisting of a researcher, a statistician, an accreditation specialist, and senior respiratory therapy educators, who thoroughly reviewed them and offered some suggestions for its improvement. Further, the tool was subjected to a reliability test using Cronbach’s alpha. the results of the analysis indicated that the faculty members possessed a strong understanding, positive attitude, and solid compliance with the accreditation standards, which are crucial for ensuring the quality of education and professional practice in respiratory therapy programs. Upon validation of the questionnaire, the researcher sent letters of request to the Deans or Department heads of accredited Respiratory Therapy programs in the Philippines, seeking their approval and assistance in disseminating the questionnaires. Distribution of informed consent forms and implementation of the survey were conducted online using a Google Form, a secure survey platform. Follow-up emails and calls were made to ensure a high response rate.

The study utilized various statistical tools to analyze and interpret the results. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to describe the respondents’ demographic profiles and summarize their levels of knowledge, attitude, and compliance. Pearson’s correlation coefficient was applied to assess the relationship between knowledge, attitude, and compliance with accreditation components. To identify significant differences in knowledge, attitude, and compliance based on demographic variables such as years of teaching experience and educational attainment, one-way ANOVA and t-tests were conducted. Additionally, multiple regression and linear regression analyses were employed to determine which factors significantly predicted compliance with accreditation standards. The study was conducted with utmost consideration for ethical principles in research.

III.  RESULTS AND DISCUSSION

1. The demographic profile of the respondents in terms of Age, Gender, Civil Status, Educational Attainment and length of service.

Table I. Profile of the Respondents in terms of Age

The age distribution of the respondents showed a diverse range of age groups, as seen in Table I. Most of the faculty members fall within the 30-39 age range (32.1%), indicating that most are likely in the mid-career stage of their professional lives. Following this group, 24.5% of the respondents are aged 20-29, suggesting that there is a notable proportion of younger faculty members. The 40-49 age group accounts for 26.4%, showing a relatively balanced representation of mid-career professionals. A smaller percentage of faculty members were in the 50-59 (11.3%) and 60-69 (5.7%) age ranges, reflecting fewer senior faculty members. This distribution indicates a relatively youthful and active workforce in the field of respiratory therapy education, with a considerable presence of both early-career and mid-career faculty.

Table II. Profile of the Respondents in terms of Gender

The gender distribution among the respondents as reflected in Table II was fairly balanced, with 52.8% of the respondents being female and 47.2% male. This suggests that gender is not a significant factor influencing the participation of faculty members in this study, and both male and female faculty members are fairly represented in the field of respiratory therapy education. The close-to-equal distribution points to a level of gender equity in the professional composition of faculty in this area.

Table III. Profile of the Respondents in terms of Civil Status

In terms civil status, most respondents were single, with 66.0% reporting this civil status. In contrast, 34.0% of respondents were married. The higher percentage of single faculty members may indicate that younger faculty members, who are more likely to be single, dominate the sample. This trend is in line with the age distribution, where younger faculty members constitute a significant portion of the sample.

Table IV. Profile of the Respondents in terms of Educational Attainment

In terms of educational attainment, majority of the respondents held a Bachelor’s degree (43.4%), with a significant proportion having attained a Master’s degree (37.7%). Only 18.9% of the respondents held a Doctorate degree. This suggests that while a substantial number of faculty members have pursued advanced education beyond a Bachelor’s degree, the field still has a notable proportion of faculty with only undergraduate-level qualifications.

Table V. Profile of the Respondents in terms of Length of Service

The length of service distribution revealed that faculty members were fairly evenly spread across different stages of their careers. The largest group (26.4%) had between 1 to 2 years of service, suggesting a relatively high turnover or influx of new faculty. The groups with 3 to 5 years (22.6%) and 6 to 10 years (22.6%) of service each made up roughly one-fifth of the respondents, indicating that a substantial number of faculty members had a moderate level of experience. The 11 to 15 years group represented 20.8%, while only 7.6% of faculty members have been in service for more than 15 years. This distribution suggests that the profession in the Philippines is likely experiencing some renewal, with newer faculty members making up a significant portion of the workforce, while those with longer service are fewer in number.

2. The level of knowledge of the respondents on accreditation standards

Table VI. Summary Table of the Knowledge of the respondents on Accreditation Standards

Table VI presents the summary table for respondents’ level of knowledge on the accreditation process. As seen, rank one was the quality of teaching and learning (mean = 3.49), second was support for students (mean = 3.52), third rank was relationship with the community (mean = 3.51), fourth was governance and management, and last was professional exposure, research, and creative work (mean = 3.49). An overall weighted mean of 3.52 revealed that respondents had advanced knowledge and were very much aware of the major components of accreditation and its related standards. This means faculty members share a robust understanding of these accreditation standards.

This is supported in a study by Lumagsao and Dellosa (2019) found that four of the five areas were strengths, namely government and management, quality of teaching and learning, support for students, and relationship with the community. However, the quality of professional exposure, research, and creative work was considered a weakness. But according to Gatdula (2023), it is crucial to identify ways to improve the quality of research and creative work in HEIs. One possible solution is to implement a quality assurance system that involves the participation of all stakeholders in the academic community, including students, faculty members, administrators, and external partners.

3. The attitude of the respondents towards accreditation standards

Table VII. Attitude of the Respondents Towards Accreditation Standards

Table VII showed the attitude of the respondents towards accreditation standards, with an overall mean score of 3.71, indicating a predominantly proactive stance. This suggest that the faculty members view accreditation as an essential process for ensuring the quality of respiratory therapy education and for maintaining accountability within the program.

The highest mean scores were recorded for statements highlighting the importance of accreditation in enhancing the program’s credibility (mean = 3.83), providing clear goals for faculty (mean = 3.85), and promoting continuous improvement (mean = 3.83). These results reflect a strong belief in the value of accreditation for advancing both the educational standards and the reputation of respiratory therapy programs.

However, a few items received lower mean scores, particularly those related to the perceived burden of accreditation. Respondents indicated that accreditation could sometimes add unnecessary strain (mean = 3.11) and that the time and resources spent on accreditation might be better allocated elsewhere (mean = 3.11). Despite these concerns, the responses still suggested a supportive view rather than resistance, with scores falling within the “Supportive” range. This indicates that while faculty recognize the challenges posed by the accreditation process, they continue to value its role in promoting collaboration, innovation, and a high standard of education.

The study of Blouin and Tekian (2019) supported the results of this study that explored faculty attitude towards accreditation in health professions education identified a range of attitudes, from seeing accreditation as a valuable quality improvement tool to viewing is a burdensome bureatic process, but the authors emphasized the importance of institutional leadership in shaping positive attitudes towards accreditation. However Siriwardena et al (2021) investigated attitudes towards accreditation among dental school faculty reveal that while most faculty recognized the importance of accreditation, many expressed concerns about time and resources required for the process thus the study suggested that clear communication about the benefits of accreditation could improve faculty attitudes.

4. The level of compliance of the respondents with accreditation standards

Table VIII. Level of Compliance of the Respondents with the Accreditation Standards

Table VIII presented the level of compliance of the respondents with accreditation standards, with an overall mean score of 3.56, indicates a proactive approach towards meeting these standards. The more proactive they are the higher the level of compliance suggests that the respondents are generally well-versed in accreditation requirements and consistently integrate these guidelines into their teaching and clinical practices. Key areas of strength included familiarity with accreditation standards (mean = 3.62), alignment of course materials and assessments with accreditation standards (mean = 3.60), and active participation in departmental or program activities focused on meeting accreditation standards (mean = 3.49). These findings demonstrate the faculty’s commitment to maintaining high educational and clinical competencies in respiratory therapy.

Despite the overall proactive compliance, a few areas were identified with slightly lower scores, such as the active seeking of information on accreditation updates (mean = 3.42) and the receipt of sufficient support from administration (mean = 3.45). However, these responses still fell within the “Proactive” category, indicating that while faculty may encounter challenges in these areas, they remain engaged and committed to fulfilling accreditation requirements. The results highlight a strong, collective effort by faculty members to maintain compliance with accreditation standards, reflecting a positive attitude towards continuous improvement and adherence to best practices in respiratory therapy education.

The results of the study show connection to the research of Oermann et al. (2020) in his study focusing on nursing education that examined factors influencing compliance with accreditation standards. They found that institutional support, clear guidelines, and regular training were key factors in promoting high levels of compliance among faculty members. Another research finding indicates that while overall compliance was satisfactory, areas such as research output and community engagement needed improvement, thus emphasizing the importance of continuous monitoring and support to maintain compliance Alrebish et al.,(2020).

5.1. Level of knowledge on the accreditation standards when grouped according to profile variables.

Table IX. Difference Between Level of Knowledge on the Accreditation Standards when Grouped According to Profile Variables

As seen in Table IX, there were no significant differences in the level of knowledge on accreditation standards when grouped according to the respondents’ profile variables, including age, gender, civil status, educational attainment, and length of service. The p-values for all variables were greater than the standard threshold of 0.05, indicating no statistically significant variations. For example, the F statistic for age was 1.31 with a p-value of 0.278, while the t statistic for gender was -0.226 with a p-value of 0.822, both of which suggested that knowledge levels were consistent regardless of these factors. Similarly, the F statistic for educational attainment was 0.826 (p = 0.444), and the t statistic for civil status was -0.581 (p = 0.564), reinforcing the conclusion that these variables did not contribute to differences in knowledge.

These findings suggest that the respondents’ knowledge of accreditation standards is relatively homogenous across different demographic and professional profiles. Factors such as age, gender, civil status, educational attainment, and length of service do not appear to influence the level of knowledge significantly. This uniformity implies that knowledge dissemination and training efforts related to accreditation standards are reaching all groups equally. As such, interventions to enhance knowledge on accreditation standards could be implemented universally, without the need for tailoring to specific profile variables.

In the study of Doherty et al (2022) in how the demographic factors influence faculty engagement with accreditation processes in health professions education. They found that factors such as years of experience, academic rank, and prior involvement in accreditation activities significantly affected the knowledge levels and attitudes towards accreditation. And one of the most significant factors identified was years of experience in academia with a higher level of knowledge about accreditation processes.

5.2         Attitude towards the accreditation standards when grouped according to profile variables.

Table X. Difference Between Attitudes Towards the Accreditation Standards when Grouped According to Profile Variables

As depicted in Table X, there were no significant differences in attitudes towards accreditation standards when grouped according to the respondents’ profile variables, such as age, gender, civil status, educational attainment, and length of service. The p-values for all these variables exceeded the 0.05 significance level, indicating that attitudes towards accreditation standards remained consistent across different demographic and professional groups. For instance, the F statistic for age was 1.87 with a p-value of 0.131, and the t statistic for gender was 0.686 with a p-value of 0.496, both showing no significant variation in attitudes. Likewise, the F statistic for educational attainment was 0.126 (p = 0.882), and the t statistic for civil status was -0.494 (p = 0.623), further supporting the uniformity in attitudes.

These results imply that respondents’ attitudes towards accreditation standards are not influenced by factors such as age, gender, civil status, educational attainment, or length of service. This homogeneity suggests that perceptions and sentiments about accreditation standards sre likely shaped by other factors, such as shared organizational culture, institutional policies, or collective experiences, rather than individual demographic or professional characteristics. As a result, strategies aimed at advancing positive attitudes towards accreditation standards could be implemented broadly across all respondent groups, without needing to address specific profile-based differences. In the study of Doherty et al (2022), interestingly they found that the higher-ranking faculty members were more likely to have positive attitude towards accreditation, viewing it is an essential tool for maintaining educational quality and institutional reputation.

5.3. Level of compliance with the accreditation standards when grouped according to profile variables.

Table XI. Difference Between Compliance on Accreditation Standards when Grouped According to Profile Variables

There were no significant differences in the level of compliance with accreditation standards when grouped according to the respondents’ profile variables, including age, gender, civil status, educational attainment, and length of service, as reflected in Table 10. All p-values were above the 0.05 significance threshold, indicating that compliance levels are consistent across these demographic and professional categories. For example, the F statistic for age was 1.81 with a p-value of 0.143, while the t statistic for gender was -0.816 with a p-value of 0.882, demonstrating no significant differences. Similarly, the F statistic for educational attainment was 0.743 (p = 0.481), and the t statistic for civil status was -0.155 (p = 0.878).

These findings reveal that compliance with accreditation standards is uniform regardless of demographic or professional profiles. Factors such as age, gender, civil status, educational attainment, and length of service do not appear to significantly impact respondents’ adherence to accreditation requirements. This indicates that compliance might be influenced more by organizational systems, policies, or external standards rather than individual characteristics. Consequently, efforts to improve compliance could be directed at the organization-wide level, ensuring that all individuals, regardless of their profiles, are equally supported and guided in meeting accreditation standards.

The findings are supported by the study of Doherty et al (2022) the importance of creating diverse accreditation teams within institutions. By including faculty members from various demographic institutions can benefit from range of perspective and experiences, potentially leading to more comprehensive and effective accreditation processes.

6. Correlation Analysis between knowledge and attitude towards accreditation standards significantly predict the compliance of respiratory therapy faculty members with the accreditation standards

Table XII. Correlation Analysis Between Knowledge, Attitude, and Compliance on Accreditation Standards

The correlation analysis revealed significant relationships between knowledge, attitude, and compliance with accreditation standards. The results indicated that knowledge and compliance had a strong positive correlation, with a Pearson’s r value of 0.614 (p < 0.001), suggesting that higher levels of knowledge were associated with greater compliance. Similarly, attitude and compliance exhibited a moderate positive correlation, with a Pearson’s r value of 0.551 (p < 0.001), indicating that more favorable attitudes towards accreditation standards were linked to higher levels of compliance. However, the relationship between knowledge and attitude was weak and not statistically significant (Pearson’s r = 0.220, p = 0.114), implying that knowledge and attitude may not have directly influence each other.

These findings imply the essential roles that both knowledge and attitude played in driving compliance with accreditation standards. The strong correlation between knowledge and compliance suggests that equipping individuals with accurate and comprehensive knowledge was vital for ensuring adherence to accreditation requirements. The result of this study is congruent with the findings of Pham et al (2020), that improving faculty knowledge and attitudes could lead to better compliance with accreditation standards. Additionally, the moderate correlation between attitude and compliance emphasizes the importance of encouraging positive perceptions and support for accreditation processes. This finding also collaborates with the findings of Pham et at (2020) that faculty members who viewed accreditation positively – seeing it as a valuable tool for quality improvement rather than a bureaucratic burden- were more likely to engage fully with compliance efforts.  Together, these results accentuate the need for a dual approach that enhances both knowledge and attitudes to promote higher levels of compliance effectively.

Table XIII. Linear Regression – Model Fit Measures

Model Coefficient Compliance

As pictured in Table XIII, the linear regression analysis examined the predictive relationship between knowledge, attitude, and compliance with accreditation standards. The model fit measures indicated a strong overall relationship, with an R value of 0.748 and an R² value of 0.560. This meant that 56% of the variance in compliance could be explained by the combined influence of knowledge and attitude, emphasizing the effectiveness of the model in predicting compliance levels.

The model coefficients further revealed that both knowledge and attitude were significant predictors of compliance. Knowledge had a positive and significant effect, with an estimate of 0.516 (p < 0.001), indicating that higher knowledge levels contributed substantially to increased compliance. Similarly, attitude also showed a positive and significant impact, with an estimate of 0.508 (p < 0.001), suggesting that more favorable attitudes led to higher compliance. The intercept was not significant (p = 0.764), meaning the baseline compliance level without considering knowledge and attitude was negligible. These findings accentuate the importance of enhancing both knowledge and attitudes to promote better adherence to accreditation standards.

1. CONCLUSION AND RECOMMENDATIONS

The majority of the respondents are mid-career professionals, predominantly female, single, and adults with a bachelor’s degree. Most are neophytes in the field, having only 1-2 years of teaching experience. Respondents demonstrated advanced knowledge and a strong awareness of the major components of accreditation and its related standards, indicating a robust understanding of these processes. Faculty members perceive accreditation as an essential mechanism for ensuring the quality of respiratory therapy education and maintaining program accountability. Despite recognizing the challenges associated with the accreditation process, they value its role in fostering collaboration, innovation, and high educational standards. Faculty members also exhibit compliance with accreditation standards and maintain a positive attitude toward continuous improvement and adherence to best practices in respiratory therapy education.

Significant findings revealed that knowledge of accreditation standards was relatively uniform across various demographic and professional profiles, and attitudes toward accreditation were not influenced by factors such as age, gender, civil status, educational attainment, or length of service. Similarly, compliance with accreditation standards remained consistent regardless of these demographic and professional variables, suggesting that shared organizational culture, institutional policies, or collective experiences may play a more significant role than individual characteristics. Furthermore, both knowledge and attitude strongly influence compliance with accreditation standards. A strong correlation was observed between knowledge and compliance, highlighting the importance of equipping individuals with accurate and comprehensive information. Additionally, favorable attitudes significantly contribute to higher compliance, demonstrating that cultivating positive perceptions toward accreditation is equally crucial for ensuring adherence to standards.

Based on the findings and conclusions of this study, several recommendations are proposed. The school administrator should organize regular training sessions on accreditation procedures and requirements, targeting mid-career and neophyte faculty, to emphasize the significance of compliance and practical strategies to meet standards. Faculty with advanced knowledge should take leadership roles in accreditation committees as resource persons. Digital tools or software should be implemented to automate repetitive tasks, improving efficiency. A recognition program, such as awards, professional growth opportunities, or a “faculty wall of fame,” can boost morale and motivation. Designating faculty leaders to mentor peers and promote excellence can further leverage positive attitudes. While faculty knowledge of accreditation is relatively uniform, specialized expertise in specific accreditation areas should be developed. Administrators should provide updated guidelines, training materials, and support to ensure knowledge translates into compliant practices, integrating accreditation into daily operations to foster a culture of continuous improvement. The action plan should be monitored and evaluated for effectiveness and sustainability. Finally, future research could explore variables such as training program effectiveness, institutional support, workload impact, demographics, teaching benefits, and barriers to compliance.

1. ACKNOWLEDGMENTS

Research Respondents, for allotting your time and giving consent to participate in the surveys which made this research possible

My research panelists, Antonio D. Yango, PhD, Pedrito Jose Bermudo, PhD, Marilou C. Urbina, DBM, are greatly appreciated for their insightful comments and recommendations that have helped me refine my work;

Dr. Consuelo Mison-Obillo, for her word of encouragement that inspire me to surpasses all the trials and challenges while completing this manuscript.

Bona, Daniel, Dale, Ezra, Eunice, Ancy, Jr, Kate, Nina, Ann, Tricia, Majeng and my family, for their unending support and motivation throughout the process of reaching my goal;

RT family and PSRTE family for their cheers, support, and enthusiasm;

Above all, thank you Almighty God for giving me the wisdom, hope, strength to go on despite the trials and challenges encountered along the way. Thank you, Lord!

VII.  DISCLOSURE

The author declares no conflicts of interest that could influence the findings or interpretations presented in this study.

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