Effects of NCAAA Accreditation on Health Sciences Educational Programs: Faculty Experiences at KSAU-HS

Introduction

Academic accreditation is recognized globally as an important mechanism to ensure accountability in managing and sustaining quality in higher education.¹ The accreditation process is vital for educational institutions to ensure that they comply with recognized academic and performance standards.² In the Kingdom of Saudi Arabia (KSA), the higher education sector has undergone substantial reforms over the last two decades to align the country’s academic institutions with international academic standards and to achieve the goals of Vision 2030 to prioritize human development and toward a knowledge-based economy.³ Within medical education in the Kingdom, the focus is on improving competency-based education to produce highly competent graduates who are prepared to enter the medical profession.⁴

In order to achieve the desired reforms and larger goals of Vision 2030, the NCAAA was created to oversee quality assurance in KSA higher education.³ The objective of accreditation, however, has moved beyond mere quality assurance to involve quality improvement and the maintenance of sustained enhancements. This shift encourages institutions to actively participate in improvement practices and supports high-quality educational experiences for students.¹

The process of achieving NCAAA accreditation is comprehensive and requires detailed assessments of the structure, methods, practices, procedures, and outcomes of academic programs. The work of achieving and maintaining NCAAA accreditation is costly and demanding on the part of academic institutions and their faculty and staff.⁵ Faculty and staff are expected to take part in committees and task forces, collect extensive data on performance and outcomes, and work in an efficient manner with NCAAA personnel. The result is often that faculty view the process as a burden rather than something that helps their institutions.¹ Faculty and administrative leaders have noted that the process of achieving accreditation can provide benefits in terms of educational quality and program efficiency. However, they also noted that the process of accreditation requires a lot of people and resources and can be a hindrance to normal day-to-day tasks.⁶

Regardless of the effort that is involved or the opinions of faculty and staff, achieving NCAAA accreditation in Saudi Arabia is mandatory.¹ This is important because achieving and maintaining NCAAA accreditation is something that is part of the way in which faculty and staff operate. They must think about how their programs operate, how improvements might be made, and the outcomes that are achieved by their students. In this regard, achieving and maintaining accreditation has become a normal part of the way in which educational institutions in the Kingdom operate.

The problem, however, is that there is little empirical research regarding the perspectives of faculty and staff about the effects of NCAAA accreditation on their programs. This is an important gap in the literature, given that the requirement for educational institutions to achieve and maintain accreditation is relatively new in Saudi Arabia as compared to other countries. More research is needed about how academic faculty and staff perceive the effect of accreditation on program-level outcomes, teaching, assessment, and general improvement in overall performance. This information is important because it can be useful not only to understand how accreditation is impacting educational programs in the Kingdom, but also how the accreditation process might be adjusted to achieve the larger goals of improving educational performance and outcomes.

The purpose of this study is to explore the perspectives of faculty at KSAU-HS regarding how accreditation influences teaching, assessment, and program improvement. The objective of this study is to examine how faculty perceive accreditation and its impact on how the program operates, from teaching to assessment, and whether improvements have occurred.

Literature Review

NCAAA and Quality Assurance

Academic accreditation is an important tool within higher education. Accreditation serves as a means of quality assurance in academic institutions.⁷ Higher education institutions are evaluated by people outside of the institutions using established criteria and standards deemed to be important in producing competent graduates who can perform in professional settings.⁸ For health and medical programs, accreditation is a vital part of ensuring the quality of those programs, consistency in how they deliver education, and the preparedness and readiness of graduates to enter professional practice. In this regard, accreditation creates a focus of continuous improvement and alignment between program goals and high-quality academic standards.⁹

The NCAAA uses six standards when evaluating a higher education program for accreditation. The six standards are mission and goals; program management and quality assurance; teaching and learning; students; faculty members; and learning resources, facilities, and equipment.⁷ The NCAAA’s standards are used to encourage, support, and evaluate quality assurance processes within higher education institutions in Saudi Arabia. The process of receiving accreditation requires the completion of detailed documentation, including self-study reports, the collection of extensive data about the institution, its performance, and outcomes, and the review of those reports and data by external reviewers.¹⁰ NCAAA standards generally cover such areas as strategic planning, teaching and learning processes, documentation related to students, staff, and faculty, and institutional resource management.²

Impact on Educational Programs

Recent research shows the problems and issues that might arise in terms of the impact of NCAAA accreditation on educational programs. The NCAAA is accountable for accrediting educational programs that grant bachelor, master, and doctoral degrees in all different disciplines across all universities and colleges at Saudi Arabia. For example, Almurayh et al (2022) found that among four different degree programs at a university in Saudi Arabia, there was no significant relationship between NCAAA accreditation and an increase in student performance.⁷ Amoudi and AlShawwa (2023) found that an important issue impacting student performance was the amount of curricula content and the amount of time available to teach the content.¹¹ There was a perception that there was generally not enough time to thoroughly teach all of the content. This might raise the question of whether accreditation is important if there is a lack of time to teach all of the content that is available.

One other issue that may be important with regard to the impact of accreditation on educational programs may be the willingness of university faculty and administrators to change to achieve better educational performance and outcomes. Albaroudi et al (2025) found that among faculty and administrators in public and private universities in Saudi Arabia, a commitment to change in relation to accreditation was significantly related to actual accreditation effectiveness and university performance.¹² In this way, the perceptions and attitudes of faculty and staff may be of great importance as to whether achieving NCAAA accreditation results in successful improvements for higher education programs.

Faculty and Staff Perspectives

While there is limited research, there is some empirical research regarding the perspectives of faculty and staff in higher education in Saudi Arabia regarding accreditation and the accreditation process. Al-Shareef et al (2023) gathered data from a sample of administrators and faculty from the College of Medicine, College of Applied Medical Sciences, and the College of Nursing within KSAU-HS, Jeddah, regarding the NCAAA accreditation process.¹³ The researchers found that most of the participants indicated that substantial and long-term improvements were achieved by completing the NCAAA accreditation process. It is important to note that this study was a quantitative study, so in-depth information about the experiences of faculty and staff was not available.

Shaiban (2024) conducted a similar study examining the knowledge of NCAAA accreditation and its effects among a sample of 300 staff from three dental colleges in Saudi Arabia.¹⁴ The researcher found that about half of the participants believed that NCAAA accreditation was essential in attracting quality students. However, about 45% of the participants believed that stress was high before the accreditation process was completed.

Abou Hashish et al (2025) conducted a qualitative study to understand the lived experience of a sample of nurse educators and administrators from the College of Nursing-Jeddah at KSAU-HS.⁹ The researchers reported that the participants thought that the accreditation process was important in terms of increasing the quality of the program, achieving consistency in terms of how education is provided, and preparing students for their careers. However, the participants also reported that completing the accreditation process was challenging due to time constraints and time management with other day-to-day activities, the availability and allocation of resources, and the complexities of the documentation needed for the accreditation.

These studies provide some insights into how faculty and staff perceive the NCAAA accreditation process, both in terms of the impact on academic programs and the impact on the work and stress of completing an accreditation. It is important to note that only one of the studies was a qualitative study in which in-depth information from participants about their perceptions of NCAAA accreditation could be obtained. The other two studies were quantitative and did not allow for in-depth information to be gathered.

Existing Literature Gap

The Organizational Change Theory standpoint, accreditation signifies a structured institutional change that adjust roles, practices, and accountability systems; however, little is known about how those directly involved experience and interpret this change. The lack of qualitative studies regarding how faculty perceive the effect of accreditation on educational programs demonstrates the need for this study. If the willingness of faculty and staff to engage in the accreditation process and the willingness to change how their programs operate impact actual performance outcomes, then it is necessary to understand how they perceive NCAAA accreditation. The rationale for this study is to gain a better understanding of how faculty perceive the effect of NCAAA accreditation on educational programs. With this information, it is possible to provide concrete and actionable recommendations for how the NCAAA accreditation process might be changed or how faculty and staff actions and behaviors associated with the accreditation process might be changed for better outcomes to be achieved by higher education programs.

Methodology

The design for this study was a qualitative design in which one-on-one semi-structured interviews were conducted with participants from King Saud Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. The university has a robust health sciences program that allows students to obtain degrees in medicine, dentistry, pharmacy, public health and health informatics, applied medical sciences, nursing, and health sciences and professions. The reason for conducting semi-structured interviews was to allow the participants to provide as much information as possible about their perspectives on the effect of NCAAA accreditation on their educational programs.

Participants

The participants for this study were educational program directors, assistants, deans, and faculty. The participants were from a variety of specialties: medicine, audiology, speech pathology, radiology, psychology, emergency medical services, microbiology, optometry, immunology and immunogenetics, and dentistry. This study interviewed the participants in the 2024–2025 academic year. The only exclusion criterion that was used in participant selection involved program directors. Program directors who were newly assigned in the college were excluded because of the potential for a lack of involvement in NCAAA accreditation activities.

Sampling

Purposive sampling was used to obtain the participants for this study. The reason for using purposeful sampling was because of the need to obtain participants from specific jobs and roles within the university. The use of other sampling techniques would have resulted in the potential to contact large numbers of individuals who had no direct relationship to the purpose of this study. The actual sample size was dependent on ensuring that data saturation was achieved. Before beginning the sampling, it was projected that a sample of between six and 15 people would be needed to reach data saturation.

Data Collection

Each semi-structured interview was conducted one-on-one in an in-person setting. Each of the interviews took 45–60 minutes to complete and was audio recorded. Before each interview, the researcher explained the purpose of the study, the importance of each participant’s input, the voluntary nature of their involvement, and the right of the participant to discontinue the interview at any time and for any reason. Once that information had been provided to the participants, they were asked to sign a consent form.

An interview guide was used for each interview. The interview guide contained 15 open-ended questions that were directly related to the purpose and objectives of the study. Demographic information about each of the participants was obtained, including gender, years of experience, research background, academic position, and whether or not they were supervising students. The semi-structured interview guide questions addressed the following domains; participation in the accreditation process, evidence of benefits and professional influence, the perception of the significance and purpose of accreditation, effect on student learning and assessment, barriers and challenges to implementation, advantages and limitations of accreditation, organizational and strategic effects. In order to ensure the validity of the interview guide was discussed with a group of specialists in accreditation and qualitative research to be sure that the contents are relevant, understandable, and correspond to the research objectives. In accordance with their responses, some changes were done, such as rephrasing of questions to make them understandable, changing the order of the questions to create a logical flow of the questions, and the introduction of probing questions to induce more insights. Unnecessary elements were eliminated and the language was modified to be more representative of NCAAA requirements and institutional culture. These revisions made the interview guide overly content-valid and comprehensive. From that testing, it was determined that the interview guide was valid. The data saturation was deemed to be reached when there were no new insights or themes that appeared after the consecutive interviews. This has been established by the continuous analysis of data and simultaneous data analysis where repeating patterns can be identified and further interviews produce redundancy.

Reflexivity

Reflexivity was taken into consideration in the research process since its effects were recognized as to balance the impact of the researchers’ background and experiences that could affect the interpretation of the data. The major investigator is an Associate Professor of Medical Education who has a lot of experience with qualitative research and health professions education. He has already engaged in and published a number of qualitative studies, and is quite familiar with the Saudi higher education quality assurance system. His career record covers teaching accreditation and quality assurance principles such as NCAAA framework to master students in medical education. He has also worked in leadership positions in faculty development and academic evaluation departments, made up curriculum committees and worked on institutional projects that have led to accreditation of two academic programs at NCAAA. These experiences were very helpful in creating contextual insights into accreditation processes, but it demanded constant reflection to reduce possible assumptions regarding the experiences of participants. The research was done together with a master student in a medical education program who was involved in details of data organization and preliminary familiarization with the transcripts under the guidance of the main researcher. The student did not have a lot of prior experience with accreditation processes, which contributed to an introduction of a complementary perspective in the interpretation of the data. During the analysis process, the research team also discussed a lot, as it was a way of reflecting on the emerging interpretations, and when it comes to addressing the possibility of biases due to the fact that the researchers are familiar with the accreditation systems. In order to promote the reflexivity and analytical rigor, the researchers did not notch the awareness of their professional roles at the academic institutions, as well as their knowledge of the accreditation standards. In the process of data analysis, specific focus was made on basing the interpretations on the narratives of the participants instead of using the previously held assumptions regarding the NCAAA process. The researchers employed reflexive discussions to make sure that the themes were obtained inductively out of the data as well as to make sure that various perspectives of the participants were sufficiently represented.

Data Analysis

The verbatim transcripts of the interviews were recorded and inputted into NVivo, a qualitative data management program. Thematic analysis techniques were used to sort the data and identify codes. The codes were examined and combined to create the final themes and subthemes that were identified for analysis.

Results

A total of 15 people took part in the study. The sample was composed of 10 males and 5 females. Six of the 15 participants were from Medicine, while one participant each was from Audiology Speech Pathology, Radiology, Psychology, Emergency Medical Services, Microbiology, Optometry, Immunology & Immunogenetics, and Dentistry. In addition, six of the participants were university leaders, while nine of the participants were faculty members. All 15 have worked on NCAAA standards from the beginning until accreditation was obtained, and have spent time afterward observing the outcomes and attending both pre- and post-accreditation phases. The interviews focused on faculty perspectives regarding program-level outcomes related to teaching, assessment, and continuous improvement under the NCAAA framework. The three main themes that were identified in the data were Institutional quality system and continuous improvement under NCAAA, structuring teaching and assessment for validity and fairness, and operational realities and contextual adaptation in implementation. The findings highlight the systemic benefits, the structural changes required for educational validity, and the practical challenges associated with implementation. Each theme is presented with its subthemes and representative quotations.

Institutional Quality System and Continuous Improvement Under NCAAA

The first theme identified in the data was the institutional quality system and continuous improvement under NCAAA. This theme is about how the NCAAA framework mandates changes to the institutional quality system architecture, enabling better collaboration, structured action planning, and systematic benchmarking to drive continuous improvement at the program level. Under this theme, four subthemes were identified, which were quality system architecture, collaboration and organizational learning, close-the-loop and action planning, and benchmarking and Key Performance Indicator (KPI) tracking.

Quality System Architecture

Quality system architecture is the idea that a formalized and structured framework is in place that ensures that policies and processes are organized in a way that meets quality standards. Participants noted that NCAAA accreditation mandates a rigorous, structured quality system architecture, which is inherently beneficial for program outcomes and academic standing.

For example, one of the participants explained the benefit to students of having a high-quality, formalized system in place:

And even if you are looking at the community service that makes them better-rounded individuals that can contribute to society, and when it comes to extracurricular and community service, and to be honest, depends on the structure of the program itself, it also should ideally give them soft skills that you also should address and assess as well, and again, to ensure that they are really gaining the skills, so it will help them get certain soft skills such as leadership communication skills, whether written or oral, and also hopefully build in more social responsibility towards their communities. –P2,9,3

Another participant emphasized the quantification and verification role of the accreditation structure

In order to quantify educational results, accreditation attempts to ensure that the evaluation procedure is done correctly. —P1,1,1

One other participant succinctly explained what they perceived to be the advantages of NCAAA accreditation as it relates to quality system architecture

Advantages: Improved academic quality, standardized processes, enhanced student outcomes, and international recognition. —P2,7,9

Collaboration and Organizational Learning

Collaboration and organizational learning is the idea that people work together to achieve a common goal, which for these participants was achieving NCAAA accreditation. The participants generally believed that the accreditation process necessitates collaboration and forces professors to adopt a mindset of listening and learning from various stakeholders, a practice often absent in traditional higher education.

One of the participants iterated the idea that the NCAAA accreditation process forces to professors to learn and listen while also teaching them how to learn and listen:

Okay the advantage is the clear that we prove our practice we as professors at the university we use always to ask others to listen to us it is not common that professor he has to learn to listen to others but accreditation teaches professors how to listen to others that means others students colleagues peers I mean field trainers employers in order to improve the output of the university or the college of the program this is the advantage…—P1,3,3

Another participant explained that collaboration required internal training and coordination across different institutional levels:

And my job responsibilities definitely was training and coordination with the, you know, like higher management level and institution and all. —P2,4,4

Similarly, a third participant explained, with regard to collaboration that:

This is for standard three, standard, and tweaking it as I see necessary and working along with Jeddah, at least collaboratively with Jeddah. —P2,9,13

Close-the-Loop and Action Planning

An important aspect of continuous improvement is the requirement for “close-the-loop” planning, which compels faculty to use assessment results and feedback to create concrete action plans. This systematic approach ensures that identified issues lead to improvements in future course conduction or curriculum.

One participant explained how this process requires specific procedures for reviewing feedback and creating formalized course reports:

For example, I know that they have a SPEC program, a SPEC course, and at the end of the course, I have to write the course report, and I have to write it in a certain way, or a certain template, and I have to get feedback from the students and I have to close the loop on the survey analysis, and make improvements to the course conduction in the next year as an action plan. –P1,1,6

Another participant explained how this process requires that faculty follow a systematic approach to gather feedback and formalize the action plan:

I also need to gather student feedback, close the loop on the survey analysis, and create an action plan for improving the course’s conduct the following year. –P1,1,1

One other participant indicated that the accreditation framework helps the institution become more systematic in addressing operational and academic issues through clear procedures:

And I guess being a little bit more systematic, and having clear procedures for identifying any issues, developing an action plan, and feedback loop. –P2,9,13

Benchmarking and KPI Tracking

Accreditation encourages program-level improvement through benchmarking, both internally against existing standards and externally against peer institutions. This focus moves beyond basic student grades to tracking actual competencies and comparing performance using shared metrics.

One of the participants stated that standardized criteria facilitate easier external benchmarking against other institutions following the same KPIs:

But on the hypothetical, if it was not a national mandate, the useful thing is probably easier benchmarking, more accessibility to different institutions that are following the same accreditation criteria that allows you to better compare and improve as per the same KPIs and benchmarks set by the same accreditation body. –P2,9,13

Similarly, another participant explained how the process requires programs to measure themselves against internal and external benchmarks to maintain strengths and strategically plan for improvement based on evidence:

Compare yourself both at the level of internal benchmarking and external benchmarking, and this will enable you to come up with a strategic plan that’s based on solid evidence to improve as well as to maintain what is considered as strengths. -–P1,1,8

One other participant explained that prior to accreditation, the focus was often simply on students passing, rather than assessing competencies or external benchmarking:

We, our objective was only a student should pass and they will, you know, like get the grades, but when it comes to the competencies and when it comes to the, you know, like, the benchmarking thing, okay, benchmarking with other institution, benchmarking with other international institution that was not there. –P2,4,4

Structuring Teaching and Assessment for Validity and Fairness

The second theme identified in the data was structuring teaching and assessment for validity and fairness. This theme addresses how NCAAA requirements enforce structure on curriculum and assessment practices to ensure validity, auditability, and fairness, leading to improvements in the overall educational experience. Under this theme are four subthemes: learning-outcomes alignment; evaluation, defensibility and auditability; fairness/clarity improvements; and indirect gains via improved processes.

Learning-Outcomes Alignment

Learning-outcomes alignment is the idea that learning outcomes should be aligned with curriculum content and assessment methods. This process is crucial for ensuring that programs produce competent graduates whose knowledge aligns with institutional and national expectations.

A primary challenge that was identified was the necessity of aligning existing curricula with the required NCAAA standards, often involving changes and resistance:

Some of the key challenges include aligning existing curricula with NCAAA standards, ensuring faculty and staff are well-trained in accreditation requirements, managing resistance to change, and maintaining continuous documentation and quality assurance processes. –P2,7,9

Another participant explained that the accreditation process requires proper assessment based on established program learning outcomes (PLOs) and course learning outcomes (CLOs), alongside archival needs:

Also, the necessity of having proper archiving of everything, the necessity of having strategic plans, the necessity of doing proper assessment for the student space on PLOs and CLOs. –P1,1,8

One of the participants explained that accreditation helps align educational objectives from the national level down to the college and program levels, ensuring competence:

We were assessing, we are saying, yes, we are producing doctors, but competent doctors, now with this, after this accreditation involving in the whole process is extremely lining our objectives, you know, like alignment with the institution, you know, like a national level, you know, institution, then with within, you know, college, you know, university and then the college. –P2,4,4

Evaluation, Defensibility, and Auditability

Evaluation, defensibility, and auditability is the idea of a systematic process for collecting and analyzing data, providing supported justifications, and being able to independently verify systems and processes. The requirements of accreditation enhance the defensibility and auditability of teaching and assessment processes, primarily by introducing explicit criteria and verification steps. This systematic verification ensures the integrity and quality of the academic program.

As one of the participants explained, accreditation standards dictate numerous criteria related to the verification of assessment and teaching practices:

The NCAA A criteria make students and faculties and administration to take care about these the final and the final decals that very crucial to enhance the educational level because if you are following the NCAAA you have to update your curriculum every five years This update, should be based on the feedback from employers, from the field trainers, from faculties from our international standards bodies, from regulators so you have to adopt the change in order to make sure that our students got up to their knowledge in their field –P1,3,3

Another participant touched on the idea that the importance of the process lies in ensuring that students receive appropriate training leading to competence in their chosen fields:

So in the accreditation standards, if we’re talking about assessment, student assessment, there are many criteria that relate to the verification of assessment and the verification of teaching. –P2,10,14

Furthermore, the process ensures that assessment and teaching quality are strengthened across the institution strengthens the institutions reputation:

Also the importance of that because by this you will achieve multiple international recognition criteria because if you are not naturally accredited it is unlikely that you will find an external or international. –P1,1,8

Fairness/Clarity Improvements

Fairness/Clarity improvements is the idea that teaching and learning goals are clear for the students. The participants noted that the standardized structure introduced by the NCAAA led to improvements in fairness and clarity for students. This includes ensuring equitable access to materials and instruction quality, and teaching faculty the importance of calibration in assessment.

One of the participants explained that the structured approach allows for a fairer comparison of student performance, starting from a similar baseline educational level:

And I guess it’s going to be more a fair comparison, let’s say, because you’re starting off with a baseline of the same undergrad education or even pre, I’m talking like high school education. –P2,9,13

Another participant explained how they perceived the advantage of fairness for students:

One of the things that’s the fairness, that every student have the right to have the same material, the same right of having the same quality in the education, the instruction.–P1,5,5

One other participant explained that fairness is not only good for the students, but also good for faculty:

It will help you become more fair with your students and it will teach your faculty the importance of calibration. –P2,10,14

Indirect Gains via Improved Process

Beyond the direct outcomes of teaching and assessment, participants noted indirect benefits resulting from the improved structure and integrity of the program. These gains include enhanced educational quality and better management of the program’s structure and development.

One of the participants explained that an indirect benefit of NCAAA is the requirement to adhere to standards in a consistent manner:

Indirect benefits, making sure that the program following NCAAA consistency. –P1,5,5

Another participant mentioned the indirect benefit of educational quality:

Improved educational quality through structured standards. –P2,1,15

One other participant indicated that an indirect benefit is integrity with regards to program structure:

Ensure the integrity of the program structure, implementation processes, and ongoing development. –P1,1,11

Operational Realities and Contextual Adaptation in Implementation

The third theme that was identified in the data was operational realities and contextual adaptation in implementation. This theme is about the practical challenges and contextual factors that influence the daily operation and implementation of the quality system, including intense workload, documentation burdens, and the need for flexibility regarding mandated KPIs. Under this theme are four subthemes: evidence and documentation workflow; faculty training and distributed responsibility; time/pressure and administrative loan; and KPI misfit and contextual adaptation.

Evidence and Documentation Workflow

Evidence and documentation workflow is the idea that a systematic process exists for gathering and managing records and information. Maintaining a rigorous workflow for evidence and documentation was repeatedly highlighted as resource-intensive. While having good practice is essential, the accreditation process demands continuous, detailed record-keeping and evidence collection, which can be challenging, especially when staff resources are limited.

One of the participants explained the benefit of documentation, but also the work that is required when faculty are short-staffed:

I think one of the main things that I have learned is, it is really important to maintain documents and supportive evidence, as opposed to just having good practice, because that is something we struggled with, especially with the first segregation, but still now, because I say I am short staffed, basically community service is me and half an employee, or about an employee. –P2,9,13

Another participant noted that preparing for accreditation involved heavy duties related to collecting evidence, writing reports for standards, and preparing for official visits:

So then preparing for the accreditation was heavy duties on our shoulders in terms of collecting all the evidences for the programs that are going for the accreditation, writing for standards, preparing for the visit itself, whether physical or virtual, inviting members to be in the sessions for each standard, doing the mock review before the official visit. –P1,2,2

Another participant explained that having people trained in the accreditation process helps significantly in maintaining proper documentation for the long term:

The advantages, growing the reputation of the program, having all the processes ready to be used after accreditation, making assessment and teaching stronger in quality, having people trained in the accreditation process will help you maintain proper documentation for later. –P2,10,14

Faculty Training and Distributed Responsibility

Faculty training and distributed responsibility is the idea that leadership roles are shared among faculty members as opposed to only being conducted by administrators. Effective implementation depends heavily on ensuring faculty and staff are adequately trained in accreditation requirements and that responsibility for quality assurance is distributed across the institution. This often includes focused development programs and training in specific standards.

One of the participants explained the benefit to students when faculty and well-trained:

Because the main importance when you have good practice, is that you are ensuring that the students are really getting appropriate training and education that would allow them to become competent, if not excel in the fields of their choice. –P2,9,13

One of the participants directly explained that they had experience with several aspects of accreditation process:

Additionally, I have experience working with the NCAAA in standard development, faculty training, and teaching. –P2,1,5

Another participant explained his educational background:

Then I went to Vancouver, Canada where I got my master’s degree, my clinical training in prosthodontics, as well as my board certification in prosthodontics from Canada, from UBC, University of British Columbia.–P2,10,14

Time/Pressure and Administrative Load

Time/pressure and administrative load refers to the idea that the accreditation process is time consuming and places a burden on faculty and staff. The administrative burden and the intensive time commitment associated with the accreditation process are significant drawbacks perceived by faculty. This pressure can lead to demotivation if faculty feel the paperwork and calculation-heavy meetings distract from more useful academic activities.

One of the participants succinctly stated that the accreditation process requires a great deal of time, documentation, and faculty training:

Resource-intensive process (time, documentation, faculty training). –P2,1,5

Another participant explained how they became more involved in community service over time:

So over time I started getting involved in community service and the person in charge of, I think it was standard 10 or 11, I forget, which was community service left the institution and they had some concerns about how it was at that point. –P2,9,13

One other participant mentioned ASO NC3 assessment, which can help detect student problems related to the curriculum, teaching strategy, or administrative issues like scheduling:

For performance, I think, having or detecting student problems regarding either the curriculum or teaching strategy or even technical problems or even administrative problems like scheduling issues and this has been highlighted greatly in the ASO NC3 assessment. –P1,1,8

KPI Misfit and Contextual Adaptation

KPI misfit and context adaptation is the gap between an organization’s KPIs and the context of its operations. Some of the participants noted occasional issues with Key Performance Indicators (KPIs) not perfectly fitting the local context or specific program needs, requiring adaptation or flexibility from the accreditation body.

One of the participants noted the importance of external reviewers in the accreditation process:

I think it’s to have a fresh eye external reviewer to evaluate our practice at the College of Medicine and make sure that what we are delivering is actually up to the standards of the academic excellence that we are aiming to achieve but also can be validated by external entity which is NCAAA in this context. –P1,6,7

Another participant noted that some of the NCAAA standards were very rigid:

I think generally they have had more flexibility when it comes to KPIs, but sometimes they would still have very specific ones that they’re very rigid about. –P2,9,13

One other participant commented about the KPIs:

I think there’s a huge. –P1,2,2

Discussion

The purpose of this study was to explore the perspectives of faculty at KSAU-HS regarding how NCAAA accreditation influences teaching, assessment, and program improvement. The findings demonstrate that faculty perceive NCAAA standards as an important means for structural and systemic improvement across program outcomes. However, they also view the accreditation process as being difficult in terms of the work that is involved to gather data, create reports, and perform other necessary tasks.

The first theme of institutional quality system and continuous improvement under NCAAA strongly supports the idea that the NCAAA framework has successfully moved the institutional objective beyond simple quality assurance to one of sustained quality improvement. Participants indicated that accreditation requires a rigorous, structured quality system architecture, which improves practice and standardizes processes. This aligns with previous research that showed that accreditation is a vital tool for ensuring quality, consistency, and a focus on continuous improvement in academic programs. The requirement for “close-the-loop” action planning ensures that assessment data are systematically used to address identified issues, leading to tangible improvements in future course conduction. Furthermore, the findings confirm that the framework facilitates systematic benchmarking against shared KPIs. Before accreditation, the focus was often limited to student passing rates; the current system results in faculty assessing competencies and comparing performance externally. These structural requirements directly contribute to the national goals of aligning KSA academic institutions with international standards and fostering a knowledge-based economy, as outlined in Vision 2030.

An interesting finding in this study was the necessity of collaboration and organizational learning. Faculty noted that the accreditation process forced professors to actively listen to and learn from other stakeholders, which is often not a common practice in traditional university settings. This enforced the idea that stakeholder engagement is critical for improving the overall output of the educational program.

The second theme of structuring teaching and assessment for validity and fairness was directly related to program-level outcomes. Faculty reported that NCAAA requirements enforced crucial structural changes, particularly concerning learning-outcomes alignment. This process required existing curricula to be mapped to established Program Learning Outcomes (PLOs) and Course Learning Outcomes (CLOs). By ensuring proper assessment based on these defined outcomes, the university was better equipped to produce competent graduates aligned with national expectations. Participants also highlighted that the systematic nature of the NCAAA criteria enhances the defensibility and auditability of assessments and teaching practices. This verification process ensured that students received appropriate training, which strengthened the quality and integrity of the academic program. Furthermore, faculty reported improvements in fairness and clarity for students, noting that the standardized structure ensured every student received the same quality of material and instruction, and taught faculty the importance of assessment calibration. These reported process improvements support the claims made by Kayal and Khalife (2025) that quality assurance impacts educational quality and graduate attributes.¹⁵ While some studies, such as Almurayh et al (2022), have questioned the direct relationship between accreditation and student performance outcomes, this study provides evidence that faculty perceive the standards to significantly improve the integrity, structure, and validity of the educational methods.⁷

The benefits derived from the first two themes with regard to the accreditation process, however, must be tempered by the practical challenges identified in the third theme, operational realities, and contextual adaptation in implementation. The findings confirm existing literature by showing that the accreditation process is demanding on faculty and staff. Participants reported an intense administrative load, specifically regarding the evidence and documentation workflow. The continuous need to collect detailed data was resource-intensive and required significant preparation time for reports and official visits. This heavy administrative pressure found in this study confirmed the concerns raised by Qutob et al (2025) regarding the process being a hindrance to normal day-to-day tasks.⁶ Similarly, Abou Hashish et al (2025), in a qualitative study within a related college at KSAU-HS, also reported time constraints and resource complexity as major challenges.⁹ The administrative stress can lead to demotivation among faculty, potentially resulting in improvements being left at the paper level rather than being actioned in practice. This suggests that for accreditation to be truly effective, the administrative burden must be mitigated to maintain faculty commitment to change.

Finally, the theme of KPI misfit and contextual adaptation demonstrated the need for flexibility within the NCAAA framework. While external review was deemed to be essential for validating practices against standards of academic excellence, faculty noted that some mandated KPIs were specific and rigid. This occasionally resulted in the inability to fit standards to the specific local context of the program.

The primary limitation of this study involves the use of a qualitative design. The data were collected from a relatively small sample of participants at a single health sciences university. While the use of a qualitative methodology allowed for the ability to collect in-depth data from the participants, the findings may not be directly generalizable to other programs or to other universities in the Kingdom of Saudi Arabia. However, the use of qualitative methods successfully fulfilled the study’s purpose by gathering the in-depth information about faculty perspectives that was missing in previous quantitative research.

Recommendations and Conclusion

Based on the results of this study, it is possible to provide practical and actionable recommendations with regard to the NCAAA accreditation process. The following recommendations are directed toward both academic institutions and the NCAAA accreditation body to enhance the effectiveness of the quality assurance process and mitigate operational challenges.

The first recommendation is for universities to allocate specific resources for the accreditation process. The findings of this study showed that the documentation and administrative demands associated with achieving and maintaining accreditation are resource-intensive. In order to ease the burden placed on faculty, higher education institutions should establish dedicated quality assurance support teams or administrative staff to assist faculty with the requirements of collecting, organizing, and archiving data and files for the accreditation process. This action would reduce the administrative burden on teaching faculty, allowing them to redirect their time and focus toward pedagogical and academic activities.

The second recommendation is to implement institutional training and collaborative practices within higher education institutions. The requirements related to collecting evidence and writing reports requires specialized skills. Institutions should prioritize standardized, systematic training for faculty and staff on effective quality system management. This training should focus specifically on the efficient collection and utilization of assessment data for the accreditation process.

The third recommendation is for the NCAAA to increase flexibility related to KPI requirements. The participants in this study indicated that while external validation is important, some required KPIs were very specific and rigid, which occasionally led to a misfit with the specific local context of the program. The NCAAA should explore options to introduce greater flexibility in defining and measuring certain program-level outcomes, especially for specialized health sciences programs. The accreditation body could establish clearer mechanisms that allow programs to propose contextually relevant metrics or benchmarks, provided they are supported by solid evidence and alignment with the program’s learning outcomes.

The research implies a number of implications to action. In order to achieve this, institutions ought to emphasize outcome-based education, assessment literacy, and quality management competencies faculty development programs. There should be clear workload allocation, and specific time to undertake the accreditation activities to support the sustainable faculty engagement. On the policy level, increased flexibility of the accreditation standards and ease of the documentation process could contribute to implementing the processes with greater efficiency and maintaining the quality standards.

This study should be followed up by future research that involves comparing multi-institutional studies to determine differences in accreditation experiences in various settings. Also, the mixed method design incorporating both qualitative and quantitative indicators of performance may offer a more robust picture of accreditation results and their extended impact on the institution.

In general, accreditation cannot be framed as a simple compliance measure, but rather as a continuous organizational improvement process that must be supported by structures, refined policies and even through further academic analysis.