1、The ABCs of RSCs,Todd Dorman Patricia Bowman Carlita Kearney Anita Beyer Jeanne Ryan,www.NIHandHopkinsCME.org www.HopkinsCME.edu,No Relevant Financial Relationships with Commercial Interests,Disclosures,Dr Todd Dorman Patricia Bowman Carlita Kearney Anita Beyer Jeanne Ryan,Overall Approach,Keep as m
2、uch the same as possible Improve what has to be improved to meet accreditation standards Make process transparent Train, train, train Enhance system as we go!,Major Alterations,Application Submission timeline Documentation of 3 recent needs are required Planner disclosures NIH Cmte followed by Hopki
3、ns Advisory Board review Marketing rules and reviews Elimination of post-activity web site E*Value,NIH CME Landing Page,Goals,Define RSCs Application process Administrative issues Application components Record keeping Planning notes Overall objectives communication Lecture objective(s) communication
4、 Activity announcements or marketing material Disclosure forms and public release Letters of agreement/acknowledgement of support Summary budgets Evaluations / Outcomes CVs of all speakers Sign-in lists Final list of speakers/topics Post-activity materials CME tracking Marketing Services/support/mon
5、itoring Q&A,Regularly Schedule Conferences,Definition Educational activities that occur on a recurring basis within a defined year aimed primarily at NIH faculty Examples M&M Case Conference Tumor Board Grand Rounds,Application: Admin,Accreditation cycle 1 year Records submitted every 2 months Dates
6、 Mar 1 to Feb 28, 2009 Plan to submit 3-4 months in advance of expiration All activities that were submitted previously and that started before Mar 1 and are planned to continue beyond Mar 1 are being processed,Application Components,Administrative data fields Needs Objectives Instructional design/m
7、ethods Results/evaluations Director/planner disclosuresAlso let us know if attendees include groups other than physicians,Statement of Need,Statement of need is the overall need for the educational activity that relates to the target audience and derived from the Needs Assessment Educational needs p
8、rovide the reason for offering CME activities. They may imply a deficit in knowledge, skills, attitudes and/or behavior among prospective participants,Sample Statement of Need,Rheumatic diseases are common in the population, and are causes of significant morbidity. The diseases are complex, and in m
9、any cases, pathogenesis remains incompletely understood. Futhermore, knowledge about the mechanisms, diagnosis and therapies of rheumatic diseases continues to evolve rapidly, making ongoing educational updates essential for state-of-the art practice of this discipline. This activity is designed to
10、provide both theoretical and practical information to clinicians and healthcare professionals who care for patients with the rheumatic diseases, and to offer practical and effective guidelines to understanding and managing these diseases and syndromes.,Needs,The ACCME requires each provider to use n
11、eeds assessment data to plan CME activities. What sources/data did you use to identify your intended audiences educational needs for your activity Summarize the type(s) of data and how you incorporated that data into the planning of your CME activity Three separate needs assessments are required for
12、 all activities and they must be recent (within 24 months of application submission),Why is it necessary to collect Needs Assessments?,To determine what training is relevant To determine what training will improve performance To determine if training will make a difference To distinguish training ne
13、eds from organizational problems To link improved performance with the organizations goals and bottom line,Needs,A decision-aiding tool for activity planning and evaluation A systematic set of procedures for setting priorities and making decisions A total decision-making process in which data are bu
14、t one component A process that looks at the problem at hand from many perspectives,Witkim BR, Altschuld JW. Planning and conducting needsassessment: A practical guide. 1995 Sage Publications,Select three (required),Needs Linkages,Identified needs,Objectives,Instructional design (methods),Desired res
15、ults,Objectives,The provider must communicate the purpose or objectives of the activity so the learner is informed before participating in the activityPurpose or objectives of the activity express learning outcomes in terms of physician performance or patient health (i.e. in behavioral terms), and a
16、re communicated clearly and consistently to the learner,All activities require objectives For open discussion-based activities (i.e. M&M, Case conference) objectives for the year are adequate For lecture-based activities (i.e. Grand Rounds) objectives for the year are required as part of the applica
17、tion and then a minimum of a single objective per lecture is also required,Objectives,Communication Before Activity,Series Objectives (e.g. those listed in application) shall be sent to all faculty via email with OCME ccd Specific lecture objective (e.g. Grand Rounds) must be communicated to all lea
18、rners in advance. Commonly this is accomplished by prominently displaying in learner environment A slide could be displayed as people enter An initial slide within speaker lecture A print version placed with sign-in sheets/electronic system A poster or sign on doors/at entry into room Documentation
19、of these communications is required This is a commonly missed step!,Writing Better Objectives,Definition,Goal Broad statement of purpose The aim of the activity Objective Clear statement of anticipated results Focus primarily on what participants will do/learn as a result of attending the activity B
20、est when measurable,Components of High Quality Objectives,Condition Commonly a disease, state, process, step Behavioral verbs Tells what is expected from the learner Published standard Allows performance to be measured against some standard,Examples,Goal Improved behavior management in patients with
21、 dementia Objective After attending this activity, the participant should be able to- Design treatment strategies based upon nationally published guidelines that improve behavior management in patients with dementia According to NIH guidelines, select an appropriate treatment option for mood stabili
22、zation in a patient with dementia,Importance of Words,Some verbs are better than others Those that relate to specific actions or behaviors are critical,Unacceptable Words,Know, learn, understand, improve, increase Think critically, really know, expand horizons, appreciate, growThese words should be
23、rarely if ever used as they are not measurable and are viewed as unacceptable words by the ACCME,Effective Words,Involve cognitive outcome domains Knowledge, application, synthesis, evaluation Involve affective outcome domains Receiving, responding, valuing Involve psychomotor outcome domains Percep
24、tion, adaptation, origination,Blooms Taxonomy,Example of Effective Learning Objectives,After attending this activity, the participant should be able to-Outline the current clinical practice for the treatment of primary and metastatic brain and spinal cord tumors in adults and children Discuss the pr
25、ocess of translating laboratory research into clinical trials for patients with malignant gliomas Describe current advances in molecular biology, immune therapy, stem cell therapeutics and drug delivery systems for brain tumors Review challenges caregivers face in caring for patients with brain tumo
26、rs Identify quality of life issues for patients with brain tumors and the effectiveness of measurement tools,Behavioral Verbs: Cognitive,Behavioral Verbs: Affective,Behavioral verbs: Psychomotor,Cognitive Pyramid,Lower,Higher,Examples,Given a healthy child, list the routine vaccines for a two year o
27、ld that are currently recommended by the CDC In a simulation of ventricular fibrillation, you will direct a team through appropriate ACLS protocol until the mannequin shows a normal cardiac rhythm For your terminally ill patient, successfully defend your position on physician assisted suicide in an
28、ethics committee meeting,Instructional design/methods,Research has repeatedly shown that learners attention and focus are significantly improved by the instructional design and assessment process. If the instruction focuses primarily on the correct identification of factual information, learners wil
29、l merely direct their time and energy toward the memorization of facts and definitions On the other hand, if the instruction requires learners to demonstrate a more complex understanding, learners will concentrate their effort on acquiring the relevant skills This leaves the instructor with the task
30、 of implementing measures that accurately reflect the desired educational objectives & outcomes,Results/evaluations,The provider must evaluate the effectiveness of its CME activities in meeting identified educational needsAccredited CME activities are to be evaluated consistently for effectiveness i
31、n meeting identified educational needs, as measured by practice application and/or health status improvement Ideally evidence is sought for improvement in Competency (knowledge + ability to act) Practice Outcomes,Disclosure,The activity director(s) and planner(s) must include global disclosure as pa
32、rt of the applications Forms completed, signed, and included,Evaluation Cycle,Evaluations are required for all activities They must be done on at least a yearly basis and submitted with yearly material Ideally they would be done on an activity, monthly or quarterly basis in order to further improve
33、the educational experience for all,2008-2012: New Standards,Needs Standards of care, gap analysis, barriers Objectives Focus on application to practice, competency Design Interactive, serial education, contracts to improvement Outcomes Serial evaluations, vignette or assertions, pre/post, Certificat
34、e based on completion of series,Record Keeping,Planning notes Overall objectives communication Lecture objective(s) communication Activity Announcements or Marketing Material Disclosure forms and public release Letters of agreement/Acknowledgment of Support Summary budgets Evaluations / Outcomes CVs
35、 of all speakers Sign-in lists, electronically submitted on templated Excel spreadsheet Final list of speaker/topics (Program) Post-Activity Materials,Files must be saved for 6 years,Planning Notes,As previously discussed, recent needs assessments are required for all activities A planning session i
36、s required and is part of the needs assessment process and helps provide evidence of educational intent The planning session also provides an opportunity to establish the linkage between needs, objectives, instructional design, and results/outcomes,Sign-In Documents,Every activity must maintain sign
37、-in documents for 6 years They will be electronic in MS Excel, you can obtain this spreadsheet at http:/www.nihandhopkinscme.org/ We must receive in our office after the conclusion of the activity for the year Email the spreadsheet to CMETechSupportjhmi.edu and we will import the participants and cr
38、edits into the CME database within two business days OCME will inform participants once the transcripts are available to print for the activity Certificates will not be printed unless requested by a participant,Sign-in Sheets,Do not utilize a page with signatures scribbled on it If tracking on paper
39、, the name should be typed with a space for a signature next to it Check the excel spreadsheets as demographic info is needed Either have separate sheets for physicians and they should be labeled as such, or have a check box next to the name,Sample Excel Spreadsheet,Disclosures,All speakers must sig
40、n a disclosure form before the lecture begins If the activity is open forum discussion in design, then only the moderator or facilitator must fill out the disclosure form in advance Disclosure must be made to learner in advance of learning. The disclosure form does not suffice A copy of actual discl
41、osure that was made to learners is required in the file (slide, printed sheet, etc) This is a commonly missed component!,LOAS/FINANCIAL,When seeking commercial support, an LOA (letter of agreement) must be executed. Signatures are required by the company representative, the activity director, and th
42、e Associate Dean for CME Original will be sent to commercial supporter and a copy will be retained for the accreditation file for the RSC Monies must come through our office LOAs are required with any and all partners, like a MECC or meeting facilitator,Food at CME Accredited Events,A commercial sup
43、porter cannot provide food directly or arrange its delivery. Policy requires that an LOA be executed, the funds provided to the provider (CME office budget for RSC) and then the RSC sponsor (the NIH) orders, arranges delivery and pays for the food Dennis Lott, Manager Accreditation, ACCME July 2005,
44、Commercial Support from industry/ control on the content of the CME activity (SCS 1.1),In past years it may have been acceptable to ask a commercial entity to suggest a speaker or a topic, while the activity still maintained ultimate control. Recently, the accrediting body for CME has changed the re
45、gulationCME providers can receive commercial support from industry. CME providers cannot receive or request any advice or guidance, either nuanced or direct, on the content of the activity or on who should deliver that content. CME providers must ensure the content of the activity remains beyond the
46、 control of any commercial interest,Evaluations are Required,Suggest to have 5-10 questions Basic core questions to ask: Was content appropriate? Can you name any changes that should be made? Was there any commercial bias? If so, when? By whom? Have you changed your practice based upon the content o
47、f this activity? If so, please describe Followed by other related questions: topics for further lectures? Are there any topics unclear to you? Etc. We are working with E*Value to craft an evaluation system and process,Evaluations,Each attendee should receive an evaluation to complete Course director
48、 should review for comments and/or suggestions by attendees Course director can use as a planning need for the renewal of the RSC Evaluations should be tallied and provided to us in a summary format and this should include all comments and any suggestions for future improvements,Additional Items,CVs
49、 of all speakers Final list of speaker and associate topic Simple list of dates, topics and presenters,Lessons from Onsite Monitoring,Sign-in sheets (paper or electronic) Acknowledgement of commercial support Objective for that lecture Disclosures for speakerThe last 3 are the most common cause of n
50、on-compliance during on-site monitoring,Suggestion,Collect Disclosure and objectives from speaker Obtain our sample slides from web Make a disclosure and objective slide for the speaker Send these to speaker and have them add to the beginning of talk Ask for confirmation that they are received and embedded,
