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Basic CME planning https://amicnow.org/260 |
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https://accme.org/rules/criteria/
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Educational needs Also known as the Professional Practice Gap (PPG), it is a description of "What's the problem?"
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Designed to Change You can think of this as "learning objectives" but it's more than that. We are used to identifying learning objectives on an evaluation handout, but sometimes our goal is fewer transfusions, universal handwashing. If we can demonstrate change in physician behaviors or patient outcomes, then the learning objectives for a CME activity are superfluous.
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Appropriate Formats This can be lecture, but other teaching formats may be more effective. Interactive discussions like journal club, case review, online learning, role playing, may have more impact than talking at a crowd over lunch. A common trap is to start out with, "let's bring in a speaker".
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Competencies Also known as Desirable Physician Attributes, these include good patient care, but aren't limited to that. Use of informatics, communication skills, hands-on skills, are all valid.
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Analyzes Change Did our CME activity (and all the time, effort and $$ we put into it) actually make a difference? A common answer is, "yes, our learners circled 4s and 5s on the evaluation sheets." Imagine if we could instead say, "yes, our infection rates improved" or "patients gave higher ratings for discharge instructions from both physicians and nurses". An equally valid answer is, "No, we found that the numbers didn't change, and need a different approach." The point is that we analyzed, we measured, we paid attention.
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Standards for Integrity and Independence
This is where most CME programs have trouble. A financial disclosure form is required for everyone in control of educational content, including CME committee members, activity planners and faculty. Any relationships with Ineligible Companies (dating back 24 months) must be identified, mitigated and disclosed to the learners prior to the start of the activity. Ineligible companies include drug and device manufacturers, marketers and such. The term refers to their ineligibility to offer CME activities like when they take us out to fancy restaurants.
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Commendation Criteria Once the basic requirements are met, we get a 4 year accreditation. With Commendation Criteria, we get 2 extra years.
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Cultural and Linguistic Competence, and Implicit Bias training These are required for CME activities offered by California CME providers.
Lastly, there are specific CME accreditation and credit designation statements that we are required to use, pretty straightforward. |
In addition to the above Educational Planning and Evaluation criteria, there are requirements for the overall CME program, which include:
- a Mission Statement, a statement of what we want to do. It should include our expected results, expressed in terms of physician competence, physician performance or patient outcomes.
- Program Analysis, a formal discussion of whether we actually met the Mission Statement
- Program Improvements, a description of changes we implemented in order to meet the Mission Statement (sometimes it includes changing to Zoom calls during pandemics).
https://accme.org/wp-content/uploads/2024/05/626_20211221_Accreditation_Requirements.pdf
The old rules for CME involved criteria which were numbered. The CME program was responsible for criteria 1 through 13, and each learning activity was constructed according to criteria 2-11.
ACCME now uses the criteria above, and sometimes you see comments like, "Designed to Change (formerly Criterion 3), or "Analyzes Change (formerly Criterion 11)"
- Mission Statement: We need to start with a mission statement, and follow it.
- Address practice gaps: figure out where you need to improve. Have some rationale for determining practice gaps. "It's interesting" doesn't cut it.
- Create learning objectives designed to increase physician competence, physician performance, patient outcomes, or some combination of these. Learning objectives should not simply increase knowledge. This is a common mistake.
- Choosing the target audience is no longer required. But we keep it as part of the planning process.
- We should choose the appropriate teaching format, venue. Lecture isn't always the best way to change how physicians practice. Another common mistake.
- Address "Desirable Physician Attributes". Not everything is about patient care. Sometimes it's about professionalism, sometimes just learning informatics. Rarely a reason to fail an audit, it's usually where we spot the inexperienced CME providers.
- Get financial disclosures from everybody in control of course content and resolve potential conflicts of interest before the educational activity. Disclose to learners whether or not there was a relevant financial relationship. Document that you did it. This is a VERY common reason to fail an audit.
- Follow our honorarium policy, and if you have commercial support, there's some rules to follow.
- If you have commercial support, there are some rules to follow.
- Make sure you are teaching medicine and not advertising a product.
- Evaluate whether your teaching activities were successful. Lotsa ways to do this. Periodically review whether these learning activities are helping you meet your Mission Statement.
- Periodically review whether your CME program is going the way you intended. You can do this at midnight the weekend before your reapplication is due, or you can do it ahead of time.
- Figure out how to adapt the CME program based on the lessons learned in step 12.
- The accreditation is for 4 years. With "commendation criteria" it can be increased to 6 years. Commendation criteria (criteria 23-39) are pretty straightforward, but need conscious planning.
- Cultural and Linguistic Competency (CLC) is a requirement for all CME accreditation originating in California. The idea is to address disparities in health care related to culture and language.
- soon we will have the requirement to address "implicit bias". Worthwhile, but not clear how we will do that.
- There is specific wording that should be followed when offering CME credit. Best to have the phrase, El Camino Hospital is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians. El Camino Hospital designates this live internet activity for a maximum of 1 AMA PRA Category 1 credit TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.