14th Armenian Medical World Congress July 3-5, 2025 Madrid, Spain |
Information for faculty and presenters at the 14th AMWC
amicnow.org/253 updated 16 October 2024
I intended this to be more brief, but here it is.
AMADeA (Asociación Médica Amigos De Armenia) is applying for CME/CPD credits from the US, Europe, and Armenia. The US credits are being obtained through the Armenian American Medical Society (AAMS), with the help of Jerry Manoukian, who is assisting with the application. The credit requirements for the US, Europe, and Armenia are largely similar.
The Mission Statement of the Congress is:
"Our mission at AMWC 2025 is to foster meaningful connections and collaboration between Armenian health professionals and international experts to drive tangible improvements in healthcare for Armenia. Through knowledge exchange, networking, and scientific discourse, we aim to translate cutting-edge medical insights into actionable strategies that enhance healthcare outcomes. By bringing together professionals from both the public and private sectors, we seek to create lasting partnerships and contribute to the sustainable development of Armenia's healthcare system, while also strengthening the global Armenian medical community."
The Mission Statement describes connections, collaboration, exchange, networking, discourse, insights, strategies, bringing together, partnerships, and strengthening the global Armenian medical community. You will notice that the Mission Statement does *not* mention latest medical techniques or past successful projects. These are important, but consider that the real value in discussing medical topics is what the audience will do with the information. What we believe will drive change in Armenia are connection, cooperation, collaboration, coordination. (camaraderie, companionship, collegiality - "the Cs" - communication, contribution ...)
Now let's get down to business.
What we need from you:
- Financial Disclosure form
- Educational needs (practice gap, description of what you would like to fix)
- Designed to Change (learning objectives, desired results, preferably something we can measure)
1. Financial Disclosure Form You can download a form HERE
Everyone in control of course content: speakers, activity planners, CME committee, should submit a financial disclosure form. We are looking for any financial relationships during the past 24 months with "ineligible companies" (formerly called commercial interests) and you can find the definition BELOW. Hospitals, clinics xray facilities and other businesses that deliver direct patient care are not considered ineligible companies. We don't ask you to disclose the financial amount.
The following elements of CME planning are taken from the ACCME website at https://accme.org/rules/criteria/ They are also found on the AAMS planning form for CME activities. Further discussion of this form can be found at amicnow.org/238
As a participant in the Congress, you can focus your attention to #2 and 3, which are Practice Gap and Learning Objectives. Section headings with ACCME core criteria are written in upper-case.
2. EDUCATIONAL NEEDS Professional Practice Gap
This is a description of the problem you are trying to fix. Think of it as the big problems: cancer and CVD mortality, war injuries, diabetes
These "big problems" have a myriad of underlying educational needs:
(smoking cessation, air pollution, BP screening & control, underuse of mammography & other cance screenings, mental health screening & treatment, prosthetics and physical medicine, diet, dietary habits, economic system that allows high soda pop sales)
Where do you fit in? You will want to describe the problem, but also recognize that the underlying educational needs could be numerous. Thus we might not address CVD or diabetes in a 20-minute lecture. What can we address in a 20-minute discussion? Think this through carefully. It might be a proposal to address dietary habits. It might be a solution to high drug prices. It might be a plan to create safe routes for walking or biking to the market.
Here is a discussion of Practice Gap and Learning Objectives that hopefully will clarify:
What practice-based problem (gap) will this education address?:
This is like asking, "what problem are you trying to fix?", or "what do we need to do better?" It might be to describe a new technique (it didn't exist before, and now we gotta learn it) or a medical statistic we would like to improve.
The Congress aims to improve connection, collaboration, cooperation, coordination. This has been a challenge. Devising protocols and tools to overcome these challenges is already CME-worthy. Let's name a few:
- Limited scope of healthcare stats in Armenia - where do we find this data? How do we identify ongoing workers and projects?
- navigation of Ministry of Health, NIH
- navigation of projects supported by Diasporan groups
- access to funding
- fatalistic view that nothing changes
- language barriers
- our busy lifestyles
- concerns about corruption, siphoning of funds
- և այլն, և այլն
Next, presumably our networking and collaboration ought to serve some purpose, and those needs are endless:
- Cancer mortality, diagnosis, treatment
- Cardiovascular disease
- diabetes
- war-related injury and illness
- mental health (war, ethnic cleansing and just plain depression)
- Infant nutrition
- infectious diseases - TB, HCV, HIV, STDs, COVID
What is the reason for the gap, and how are your learners involved?
There are many ways to approach a practice gap. For instance, if the issue is high breast cancer mortality rates in Armenia, the underlying causes might include a lack of awareness about screening techniques, limited access to screenings, misinterpretation of results, poor mammogram reading by radiologists, or inappropriate treatment by surgeons and oncologists. Any or all of these could be addressed in a CME activity.
However, trying to cover every aspect of breast cancer in a single lecture is unlikely to make a significant impact. Instead, there should be an outline of what the overall program would look like (perhaps at a governmental level), with a focus on how the audience can actively get involved.
3. DESIGNED TO CHANGE Learning Objectives: "As a result of this activity, the learners will ..."
CME is intended to change physician behavior. Increasing knowledge is not enough, unless that knowledge confers the ability to do something.
There are 4 commonly used terms for what we are trying to improve in CME activities, In CME lingo, we call them K, C, P, O. as below:
KNOWLEDGE (awareness, understanding, insight) is important, but it is not sufficient for granting CME credit. Nobody wants to be killed by a smart doctor.
COMPETENCE is the ability to do something. Gaining competence is one impostant goal of CME activities. It is commonly rated with a paper evaluation form or online survey, in which the learner attests an increased ability to perform a task or duty.
PERFORMANCE is a measured change in physician behavior. It could reflect increased use of an order bundle, increased prescribing of aspirin after a heart attack, increased screening of patients for a disease condition. The important thing is that we are measuring it.
OUTCOMES: This is a change in how the patient(s) fare as a result of the CME activity. If we can measure that the patients are doing better that's great!
CME activities in the US require an evaluation of whether C, P or O were improved. C is easy to measure but provides limited information. P and O are great to measure, but that's usually more work.
Examples:
#1 the poop example
K: I know colon cancer is bad and that screening tools exist.
C: someone described occult blood testing to me and I think I could do it.
P: Our doctors have actually done some occult blood testing.
O: we found a positive test, sent the patient to a higher level of care, and they had a polyp (or cancer) removed.
#2: my Armenia project
K: you know about my project, how many patients we saw, some stats about disease in Armenia
C: We described some areas and clinics in Armenia and contacts for you in case you would like to go. You think you are up to the job.
P: you actually go work in Armenia, using the info I gave you
O: You helped at least one patient in Armenia
#3: Armenia project with focus on networking
K: you know about my project, how many patients we saw, some stats about disease in Armenia
C: We created a system of networking so that you could find colleagues to help you
P: you actually made some contacts with others and went on a mission
O: You collectively helped at least one patient. (OK I intentionally made this sound easy)
The discussion below is optional, but useful.
Definition of ineligible company
An ineligible company is any entity whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients. For specific examples of ineligible companies visit accme.org/standards.
The term is given because these companies are ineligible to provide accredited CME (because of concerns about commercial bias). Please note that entities that provide direct patient care do not fall under this definition of ineligible company.
We ask about all financial relationships with ineligible companies. It is the responsibility of the CME committee to decide if it is relevant to the educational material.
When a CME planner, faculty etc discloses a financial relationship with an ineligible company (we don't ask about the dollar amount), then we must mitigate the possibility of introducing bias into the educational activity. We can do that by peer-reviewing slides, assigning that person to a different part of the discussion or other ways.
APPROPRIATE FORMATS
Many CME activities default to lecture, but you can't always change physician behavior with the "I talk, you listen" format.
Alternative formats include round-table discussion, journal club, role-playing, hands-on skills, and many others. For purposes of a symposium, any tricks to increase audience involvement will probably help. Quizzing the audience, interactive phone-based surveys, and even games (medical Jeopardy is easy to find online) will keep the audience involved and interested.
COMPETENCIES (Desirable Physician Attributes)
This is a confusing word in CME-speak. We want to be competent to practice medicine. We also discussed improved Competence in the DESIGNED TO CHANGE section above. In this 3rd case, we ask what positive qualities we want to develop as a result of the teaching. Often it is medical knowledge and patient care - no surprise. But other qualities can include professionalism, communication skills, ethics, informatics. See also this cheat sheet from Morehouse School of Medicine
ANALYZES CHANGE
How will we evaluate the success of your presentation? Pass out a paper evaluation sheet that indicates how learners improved ability to do the things listed in your learning objectives? That is a Competence measure.
That's one way to do it. But imagine that we are trying to enhance connection, collaboration, cooperation, coordination. If we form new partnerships and develop programs as a result of your talk, that is a Performance measure. If these new partnerships actually deliver improved care to patients, then that could be an Outcomes measure.
Think two steps ahead, asking, "what do I want the audience to do with what I've just told them?"
The items above make up the basic planning, or ACCME's core criteria, what's required for AAMS to keep their accreditation.
There is a "next level" of CME planning that is called commendation criteria. Besides earning an extra 2 years of accreditation for AAMS, you will find that it leads to more in-depth planning, better teaching, deeper learning.
We may approach you about including commendation criteria in your CME activity. Here are the basic elements:
- Team-based education
- Addressing Public Health Priorities
- Enhances skills
- Demonstrates educatioinal leadership
- Achieves outcomes
These are discussed on the ACCME website at https://accme.org/rules/criteria/