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Of all the changes in American higher education in the twentieth century, none has had a greater impact than the rise of the two-year, junior college. Yet this institution, which we now take for granted, was once a radical organizational innovation. Stepping into an educational landscape already populated by hundreds of four-year colleges, the junior college was able to establish itself as a new type of institution—a nonbachelor’s degree-granting college that typically offered both college preparatory and terminal vocational programs. The junior college moved rapidly from a position of marginality to one of prominence; in the twenty years between 1919 and 1939, enrollment at junior colleges rose from 8,102 students to 149,854 (U.S. Office of Education 1944, p. 6). Thus, on the eve of World War II, an institution whose very survival had been in question just three decades earlier had become a key component of America’s system of higher education. The institutionalization and growth of what was a novel organizational form could not have taken place without the support and encouragement of powerful sponsors. Prominent among them were some of the nation’s greatest universities—among them, Chicago, Stanford, Michigan, and Berkeley—which, far from opposing the rise of the junior college as a potential competitor for students and resources, enthusiastically supported its growth. Because this support had a profound effect on the subsequent development of the junior college, we shall examine its philosophical and institutional foundations. In the late nineteenth century, an elite reform movement swept through the leading American universities. Beginning with Henry Tappan at the University of Michigan in the early 1850s and extending after the 1870s to Nicholas Murray Butler at Columbia, David Starr Jordan at Stanford, and William Rainey Harper at Chicago, one leading university president after another began to view the first two years of college as an unnecessary part of university-level instruction.

Since its origins at the turn of the century, the junior college has had a complex, and at times uneasy, relationship with a public that has looked to the educational system as a vehicle for the realization of the American dream. Despite its self-portrayal as “democracy’s college” and its often heroic efforts to extend education to the masses, the two-year institution has faced widespread public skepticism. For to most Americans, college was a pathway to the bachelor’s degree, and the junior college—unlike the four-year institution—could not award it. Moreover, the early public junior colleges were often tied administratively and even physically to local secondary schools, a pattern that compounded their problems in gaining legitimacy as bona fide institutions of higher education. The two-year institution’s claim to being a genuine college rested almost exclusively on its promise to offer the first two years of a four-year college education. Yet the junior college was never intended, despite the high aspirations of its students, to provide anything more than a terminal education for most of those who entered it; indeed, at no point in its history did even half of its students transfer to a four-year institution. Nonetheless, for at least the first two decades of its existence, almost exclusive emphasis was placed on its transfer rather than its terminal function. As the early leaders of the movement saw it, the first task at hand was to establish the legitimacy of this fragile institution as an authentic college. And this task could be accomplished only by convincing the existing four-year institutions to admit junior college graduates and to offer them credit for the courses that they had completed there. If the pursuit of academic respectability through emphasis on transfer dominated the junior college movement during its first decades, by the mid-1920s a countermovement stressing the role of the junior college as a provider of terminal vocational education began to gather momentum. Arguing that most junior college students were, whatever their aspirations, in fact terminal, proponents of this view saw the institution’s main task not as providing a platform for transfer for a minority but, rather, as offering vocational programs leading to marketable skills for the vast majority.

According to the International Organization for Standardization (ISO), the ‘Medical laboratories—Requirements for quality and competence (ISO 15189:2012) BS EN ISO 15189:2012’ accreditation is defined as ‘a procedure by which an authoritative body gives formal recognition that an organization is competent to carry out specific tasks’. Accreditation is delivered by the ‘competent authority’ based on a set of defined standards and the continual internal audit of the laboratory processes and infrastructure against these standards to achieve conformance. Additionally, the ‘competent authority’ periodically undertakes assessments to ensure compliance with the standards. These assessments vary in frequency and nature depending upon the assessment body. In some instances (e.g. UK Accreditation Service, UKAS), the assessments are annual and based on a four- year cycle covering the whole laboratory repertoire and infrastructure. The HSE is responsible for the inspection and licencing of microbiological containment level 3 and 4 facilities. The HTA is responsible for legal registration of laboratories that process and store human tissue, and is mainly histology related. The MHRA provides guidelines on good laboratory practice, good clinical practice, good clinical laboratory practice, and good manufacturing practice, largely around clinical trial work. It is also responsible for accreditation of blood transfusion laboratories. Finally, it provides guidance on the In Vitro Diagnostic Medical Device Directive (IVDMDD, 98/ 79/ EC) and the regulation of medical ‘devices’ including diagnostic devices, where a ‘device’ is defined as including reagent kits and analytical platforms. EFI provides guidance and standards for transplantation and tissue typing laboratories across Europe. Until 2009, CPA provided accreditation for the majority of UK pathology services. CPA was acquired by the UK Accreditation Service in 2009. UKAS is a government- appointed national accreditation body for the UK that is responsible for certification, testing, inspection, and calibration services, and is the competent authority for all ISO standards, not just pathology. It covers various sectors, including healthcare, food production, energy supply, climate change, and personal safety. The majority of UK pathology services will be UKAS ISO15189 accredited by 2018, including transitional ‘dual’ CPA standards/ ISO15189 accreditation between 2015 and 2018. It also provides ISO22870:2006 accreditation that is point of care specific, as well as ISO17025:2005, which applies to calibration standards.

American accrediting agencies have been under increasing pressure from the government, employers, and other policy makers. These agencies are being asked to hold accredited educational institutions accountable for student learning outcomes, on-time retention and completion, and other key indicators of institutional and student success. At the same time, accreditors are often accused of stifling innovation in education with unnecessarily restrictive policies, bureaucratic and burdensome procedures, and a peer review process that is biased against new ideas and entrants into the sector. We faced these dynamics in seeking approval for Minerva to affiliate with the Keck Graduate Institute and to offer its programs in a delivery modality that had never been seen before. The process required us to build support for innovation while demonstrating the evidence-based foundation for our curriculum and teaching methods and to balance the new with generally accepted and traditional indicators of quality.

The wide range of U.S. institutions of higher learning face a number of challenges such as the balance between faculty research, teaching, and service expectations, the high and, sometimes, prohibitive cost of a college education, eroding academic standards, heated debates over curriculum issues, administrative bloat, and the contentious nature of promotion and tenure decisions. Risk management is often the key to dealing with these issues.