ACCME Standards for Commercial SupportSM:
Standards to ensure independence in planning and implementing CME
activities.
Accreditation: The decision by the MMS that an
organization has met the requirements for a CME provider as
outlined by the MMS. The standard term of accreditation is four
years.
Accreditation Council for Continuing Medical Education
(ACCME): The ACCME sets the standards for the
accreditation of all providers of CME activities. The ACCME has two
major functions: the accreditation of providers whose CME
activities attract a national audience and the recognition of state
or territorial medical societies to accredit providers whose
audiences for its CME activities are primarily from that
state/territory and contiguous states/territories. The ACCME's
seven member organizations are the American Board of Medical
Specialties (ABMS), the American Hospital Association (AHA), the
American Medical Association (AMA), the Association of American
Medical Colleges (AAMC), the Association for Hospital Medical
Education (AHME), the Council of Medical Specialty Societies
(CMSS), and the Federation of State Medical Boards of the U.S.,
Inc. (FSMB).
Accreditation Decisions: The types of
accreditation offered and made by the MMS to accredited providers.
These include accreditation with commendation, accreditation,
probationary accreditation, provisional accreditation, and
nonaccreditation.
Accreditation Statement: The standard statement
that must be used by all accredited institutions and organizations.
There are two different statements that might be used depending on
the number and relationships of the organizations involved in
planning and implementing the activity.
- Directly Sponsored Activity - An activity
planned and implemented by an ACCME or state medical society
accredited provider of CME. MMS-accredited providers must use the
following statement:
The [name of the accredited provider] is accredited by the
Massachusetts Medical Society to provide continuing medical
education for physicians.
- Jointly Sponsored Activity - An activity
planned and implemented by an ACCME or state medical society
accredited provider working in collaboration with a non-accredited
entity. The accredited provider must ensure compliance with the
ACCME and MMS Essential Areas and Elements, and accreditation
requirements. MMS-accredited providers must use the following
statement
This activity has been planned and implemented in accordance
with the Essential Areas and Policies of the Massachusetts Medical
Society through the joint sponsorship of [name of accredited
provider] and [name of non-accredited provider]. The [name of
accredited provider] is accredited by the Massachusetts Medical
Society to provide continuing medical education for
physicians.
- CME activities that are cosponsored should use the directly
sponsored activity statement, naming the one accredited provider
that is responsible for the activity.
Accreditation Survey: A form of data collection
by the MMS that includes a review of the organization (structure,
administration, mission and relationships), documentation, and
activities. Its purpose is to collect data about who is responsible
for the CME program and activities, how documentation is
accomplished, and how well the MMS's accreditation requirements are
applied.
Accreditation with Commendation: The decision
by the MMS that an organization has met all the Criteria for
compliance with the MMS's accreditation requirements. The term of
accreditation is six years.
Activity: An educational intervention/event for
physicians that is based upon identified needs, has a purpose or
objectives, and is evaluated to assure that needs are met.
Activity Review: Data collection that allows
the MMS to observe an activity and document compliance with the
accreditation requirements.
Alliance for Continuing Medical Education
(ALLIANCE): The Alliance is a CME professional association
that provides educational opportunities, professional development,
information exchange, and supportive services for its membership
from hospitals, medical schools, medical associations and
societies, and pharmaceutical and device companies that are
interested in adapting to the changing health care environment,
improving CME activities offered to physicians and shaping the
future of the CME field.
American Academy of Family Physicians (AAFP):
The AAFP is the national association of family doctors. The AAFP
requires its members to demonstrate that they have participated in
150 hours of approved continuing education every 3 years. This
credit is divided into two categories "Prescribed" and "Elective."
The academy reviews submitted CME programs on a course-by-course
basis to award "Prescribed" credit.
American Board of Medical Specialties (ABMS):
The ABMS is the umbrella organization for the 24 approved medical
specialty boards in the United States. It is a member organization
of the Accreditation Council for Continuing Medical Education.
American Hospital Association (AHA): The AHA is
a national organization that represents and services all types of
hospitals, health care networks and their patients and communities.
It is a member organization of the Accreditation Council for
Continuing Medical Education.
American Medical Association (AMA): The AMA is
the largest non-profit professional advocacy and membership
organization for physicians in the United States. In 1968, the AMA
established the AMA Physicians Recognition Award (PRA) and the
related AMA PRA credit system to recognize physicians who
participate in CME activities to demonstrate their commitment to
staying current with advances in medicine. It is a member
organization of the Accreditation Council for Continuing Medical
Education.
- AMA Credit Designation Statement - The AMA
Credit Designation Statement indicates to physicians that an
activity has been certified by an accredited CME provider as being
in compliance with AMA PRA Category 1 CreditTM requirements. The
following AMA Credit Designation Statement must be included in
relevant announcements and activity materials:
The [name of accredited CME provider] designates this [learning
format] for a maximum of [number of credits] AMA PRA Category 1
Credit(s)TM. Physicians should claim only the credit commensurate
with the extent of their participation in the activity.
- AMA Physicians Recognition Award (PRA) - An
award issued by the AMA to physicians who have completed 150 hours
of continuing medical education during a consecutive three-year
period. For a standard three-year certificate, 60 AMA PRA Category
1 CreditsTM are required, and the remaining 90 may be either AMA
PRA Category 1 or 2 CreditTM.
Annual Report: Data collection by the MMS that
requires an annual submission of data from each accredited provider
and allows the MMS to monitor changes in an individual accredited
provider's program and within the population of accredited
providers.
Association for Hospital Medical Education
(AHME): The AHME, founded in 1956, is a national
non-profit professional organization involved in the continuum of
hospital-based medical education: undergraduate, graduate, and
continuing medical education. It is a member organization of the
Accreditation Council for Continuing Medical Education.
Association of American Medical Colleges
(AAMC): The AAMC is a non-profit association of medical
schools, teaching hospitals, and academic societies. The AAMC seeks
to improve the nation's health by enhancing the effectiveness of
academic medicine. It is a member organization of the Accreditation
Council for Continuing Medical Education.
Commercial Bias: A personal judgment in favor
of a specific proprietary business interest of a commercial
interest.
Commercial Interest: Any entity producing,
marketing, reselling or distributing health care goods or services
consumed by or used on patients. The ACCME does not consider
providers of clinical service directly to patients to be commercial
interests. A commercial interest is not eligible for ACCME or MMS
accreditation.
Commercial Support: Financial or in-kind
contributions given by a commercial interest that is used to pay
part or all of the costs of a CME activity. Advertising and exhibit
income are not considered commercial support. The definition of
roles and requirements when commercial support is received are
outlined in the ACCME Standards for Commercial SupportSM.
Committee on Accreditation Review (CAR): The
Committee on Accreditation Review, a special committee of the
Massachusetts Medical Society (MMS), collects, reviews, and
analyzes data from multiple sources about compliance with MMS
accreditation requirements and makes a final decision about
accreditation of an applicant/provider.
Compliance: The provider is meeting the
standard of practice for the judged accreditation requirement.
Competence: Is a combination of knowledge,
skills and performance; the ability to apply knowledge, skills, and
judgment in practice.
Conflict of Interest: When an individual's
interests are aligned with those of a commercial entity, the
interests of the individual are in conflict with the interests of
the public. The MMS considers financial relationships to create
actual conflicts of interest in CME when individuals have both a
financial relationship with a commercial interest and the
opportunity to affect the content of CME with products or services
of that commercial interest. The potential for maintaining or
increasing the value of the financial relationship with the
commercial interest creates an incentive to influence the content
of CME -- an incentive to insert commercial bias.
Continuing Medical Education (CME): Continuing
medical education consists of educational activities that serve to
maintain, develop or increase the knowledge, skills and
professional performance and relationships that a physician uses to
provide services for patients, the public, or the profession. The
content of CME is that body of knowledge and skills generally
recognized and accepted by the profession as within the basic
medical sciences, the discipline of clinical medicine, and the
provision of health care to the public. CME providers (i.e.,
organizations that produce CME programs for physicians) that are
accredited by the ACCME or state medical societies recognized by
the ACCME are authorized to certify CME activities for AMA PRA
credit in accordance with PRA guidelines.
Cosponsored Activity: A CME activity presented
by two or more accredited providers. One institution must take
responsibility for the activity.
Council of Medical Specialty Societies (CMSS):
A member organization of the Accreditation Council for Continuing
Medical Education.
Course: A live CME activity where the learner
participates in person and that is planned on a one-by-one basis
and designated for credit as a single activity (Examples: annual
meeting, conference, seminar).
Credit: The "currency" assigned to CME
activities. Requirements for the designation of credit are
determined by the organization responsible for the credit system
(e.g., AMA PRA (Category 1 and 2)TM, AAFP (prescribed and elective
credit), ACOG (Cognates)). Refer to those organizations for details
about the specific requirements for assigning credit.
Criteria: The set of performance expectations
corresponding to the Essential Areas and Elements required by the
MMS of an accredited provider.
Designation of CME Credit: The declaration that
an activity meets the criteria for a specific type of credit. In
addition, designation relates to the requirements of credentialing
agencies, certificate programs or membership qualifications of
various societies. The accredited provider is responsible to these
agencies, programs and societies in the matter of designation of
credits and verification of physician attendance.
Desirable Physician Attributes: Special skill
sets and/or competencies within a given field of medicine or
medicine in general. For example, the Accreditation Council for
Graduate Medical Education (ACGME), the American Board of Medical
Specialties (ABMS), or the Institute of Medicine (IOM)
competencies.
Directly Sponsored: An activity that is
planned, implemented and evaluated by the accredited
provider.
Director of Medical Education: A physician appointed by a hospital
or specialty society to direct the accredited provider's continuing
medical education program. The Director of Medical Education chairs
the Committee on Medical Education.
Documentation Review: Data collection that
allows the MMS to verify that compliance with accreditation
requirements has been met within a specific activity. This review
occurs during an accreditation survey.
Enduring Material: Enduring material is a
printed, recorded or computer-assisted CME activity that may be
used over time at various locations and that in itself constitutes
a planned activity. Examples of such materials for independent
physician learning include: programmed texts, audio-tapes,
videotapes and computer-assisted instructional materials that are
used alone or in combination with written materials.
Essential Areas and Elements: The ACCME's and
MMS's accreditation requirements are outlined in the Essential
Areas and Elements. Compliance with the Essential Areas and
Elements is determined by the extent to which a provider meets the
Criteria.
Faculty: The speakers or education leaders
responsible for communicating the educational content of an
activity to a learner.
Federation of State Medical Boards of the U.S., Inc.
(FSMB): The FSMB is a national organization comprised of
the 70 medical boards of the United States, the District of
Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands. The
FSMB's mission is to improve the quality, safety, and integrity of
health care through the development and promotion of high standards
for physician licensure and practice. It is a member organization
of the Accreditation Council for Continuing Medical Education.
Financial Relationships: Financial
relationships are those relationships in which the individual
benefits by receiving a salary, royalty, intellectual property
rights, consulting fee, honoraria, ownership interest (e.g.,
stocks, stock options or other ownership interest, excluding
diversified mutual funds), or other financial benefit. Financial
benefits are usually associated with roles such as employment, a
management position, teaching, membership on advisory committees or
review panels, board membership, and other activities from which
remuneration is received or expected. The MMS considers
relationships of the person involved in the CME activity to include
financial relationships of a spouse or partner.
Income: Income received from any sources other
than commercial support or advertising and exhibitor income,
including government grants, registration fees, and internal
allocations.
Internet Activity, Enduring Material: An
enduring material Internet activity is available when the physician
participant chooses to complete it. It is "enduring" meaning that
there is not just one time on one day to participate in it. Rather,
the participant determines when he/she participates (Examples:
online interactive educational module, recorded presentation,
podcast).
Internet Activity, Live: A live activity is an
online course available at a certain time on a certain date and is
only available in real-time, just as if it were a course held in an
auditorium. Once the event has taken place, learners may no longer
participate in that activity (Example: webcast).
Internet Point-of-Care Learning (POC): A
certified CME activity structured by an accredited CME provider in
which a physician engages in self-directed, online learning on
topics relevant to their practice.
Joint Sponsorship: Sponsorship of a CME
activity by two institutions or organizations when only one of the
institutions or organizations is accredited. The accredited
provider must take responsibility for a CME activity when it is
presented in cooperation with a non-accredited institution or
organization and must use the appropriate accreditation and
designation statements. A commercial interest cannot take the role
of non-accredited entity in a joint sponsorship relationship.
Journal-Based CME: A certified CME activity in
which an article within a peer-reviewed professional journal is
certified for AMA PRA Category 1 CreditTM prior to the publication
of the journal.
Learning from Teaching: A CME activity based on
the physician learner's preparation to teach a live CME activity.
Faculty may be awarded two (2) AMA PRA Category 1 CreditsTM for
each hour they present at a live activity designated for such
credit.
Manuscript Review: A certified CME activity in
which a physician learns through the critical review of an assigned
journal manuscript.
Monitoring: Data collection that allows the MMS
to note changes in the CME program between formal accreditation
reviews.
Needs Assessment/Data: A process of identifying
and analyzing data that reflect the need for a particular CME
activity. The data could result from a survey of the potential
learners, evaluations from previous CME activities, needed health
outcomes, identified new skills, etc. Needs assessment data provide
the basis for developing learner objectives for the CME
activity.
Nonaccreditation: The accreditation decision by
the MMS that an organization has not demonstrated compliance with
the standards for a CME provider.
Noncompliance: The provider is not meeting the
standard practice for the judged accreditation requirement.
Non-physician Participants: Attendees other
than MDs and DOs, such as nurses, physician assistants, and other
health professionals.
Objectives: Statements that clearly describe
what the learner will know or be able to do after participating in
the CME activity. The statements should result from the needs
assessment data.
Organizational Framework: The structure
(organizational chart), process, support and relationships of the
CME unit that are used to conduct the business of the unit and meet
its mission.
Performance: What one actually does in
practice. Performance is based on one's competence but is modified
by system factors and the circumstances.
Performance Improvement Continuing Medical Education (PI
CME): A CME activity in which an accredited CME provider
structures a long-term three-stage process by which a physician or
group of physicians learn about specific performance measures,
assess their practice using the selected performance measures,
implement interventions to improve performance related to these
measures over an interval of time, then reassess their practice
using the same performance measures.
Physician Participants: MD and DO activity
participants.
Planning Process(es): The method(s) used to
identify practice gaps and needs and assure that the designed
educational intervention meets the need(s) and produces the desired
result.
Probation: The accreditation decision by the
MMS that an accredited provider has not met all the standards for a
CME provider. The accredited provider must correct the deficiencies
to receive a decision of accreditation. While on probation, a
provider cannot jointly sponsor new CME activities.
Professional Practice Gap: The difference
between actual and ideal performance and/or patient outcomes. In
patient care, the quality gap is "the difference between present
treatment success rates and those thought to be achievable using
best practice guidelines."
Progress Report: A report prepared for the MMS
by the accredited provider communicating changes in the provider's
CME program to demonstrate compliance with the Criteria or Policies
that were found in non-compliance during the most recent
accreditation review.
Provider: The institution or organization that
is accredited to present CME activities.
Provisional Accreditation: The accreditation
decision by the MMS that an initial applicant for accreditation has
met the standards for a CME provider as outlined by the MMS.
Recognition: The process used by the ACCME to
approve state medical societies as accreditors of intrastate
providers.
Regularly Scheduled Series: A course is
identified as an RSS when it is planned to have 1) a series with
multiple sessions that 2) occur on an ongoing basis (offered
weekly, monthly, or quarterly) and 3) are primarily planned and
presented to the accredited organization's professional staff.
Examples: Grand Rounds, Tumor Boards, and M & M
Conferences.
Relevant Financial Relationships: The ACCME
focuses on financial relationships with commercial interest in the
12-month period preceeding the time that the individual is being
asked to assume a role controlling content of the CME activity. A
minimum dollar amount for relationships to be significant has not
been set. Inherent in any amount is the incentive to maintain or
increase the value of the relationship. The ACCME defines "relevant
financial relationships" as financial relationships in any amount
occurring within the past 12 months that create a conflict of
interest.
Scope of Practice: The range or breadth of a
physician's actions, procedures, and processes. Scope of practice
as defined by licensing boards is the procedures, actions, and
processes that are permitted for the licensed individual. The scope
of practice is limited to that which the individual has education
and experience and in which he/she has demonstrated competency.
Self Study Report: A report of data and
observations collected by the accredited provider to document its
accomplishments, assess areas where improvement may be necessary,
and outline a plan for making those improvements.
Test Item Writing: A certified CME activity
wherein physicians learn through their contribution to the
development of high stakes examinations, or certain peer-reviewed
self-assessment activities, by researching, drafting, and defending
potential questions.
