as inspectors. Inspectors scrutinize facilities and provide a report to NAME for accreditation. Deficiencies cited by the inspectors can be of two types: phase 1 deficiencies, which are less serious; and phase 2 deficiencies, which bar accreditation (for example, if a medical examiner performs more than 350 autopsies per year). Full accreditation lasts 5 years. Provisional accreditation is possible if deficiencies are corrected within 1 year (and is renewable each year over the next 5 years). NAME views its accreditation process as a catalyst for improving offices throughout the country. But unlike hospital accreditation by the Joint Commission on Accreditation of Healthcare Organizations, for example, accreditation by NAME is not a requirement for funding of medical examiner and coroner offices.

Steven C. Clark

In 1998, NIJ promulgated the first guidelines for death-scene investigations. The publication was the culmination of a 5-year process that had been triggered by a national needs-assessment survey: in 1994, 60% of medical examiners and coroners had reported their dissatisfaction or extreme dissatisfaction with the level of investigative service that they received, either externally or internally. CDC and NIJ funded the development of the guidelines. The guidelines were reviewed by the National Medicolegal Review Panel, a review group of 263 members in 46 states. The guidelines cover 29 specific kinds of duties and 148 tasks.

To translate the guidelines into action, performance criteria for each were established. A trainer curriculum was later developed and implemented at instructor-training academies. The purpose of the academies was to establish a core of certified trainers skilled in both investigative and pedagogic skills. The academies also offer continuing education to medical examiners, coroners, and law-enforcement personnel.

When the guidelines were tested on 100 coroners and deputy coroners in Indiana, researchers from Occupational Research and Assessment, Inc. found that nearly 80% failed the examination. The dismal results prompted Indiana to mandate training programs for death-scene investigation. Later tests in other states revealed similar