Graham McMahon, who began his tenure as President and Chief Executive Officer of the Accreditation Council for Continuing Medical Education (ACCME) last month, announced a new resource that CME providers and other stakeholders can use and distribute to communicate the value of accredited CME. “The resource describes how accredited CME promotes engagement with healthcare professionals by providing them with opportunities for relevant, practice-based, independent education and improvement in a system that meets their needs, and promotes quality in patient care,” he states. The document includes facts about CME’s effectiveness, independence, and responsiveness to the evolving healthcare environment.
View the resource here: The Value of Accredited Continuing Medical Education
The document consolidates much of the reports, research, and policies that the ACCME has articulated in the past few years.
First, research shows that CME has a positive impact on physician learning, performance, and patient outcomes, notes the ACCME, which provides a link to a comprehensive study released last year that convincingly demonstrates the impact of CME on physician performance. The research also demonstrated that “CME is most effective if it is founded on practice-based needs assessment and is ongoing, interactive, and focused on outcomes that are considered important by physicians.”
The ACCME then outlines how CME promotes physician learning and improved outcomes:
- Each CME activity is designed to meet the practice-based educational needs of the learners.
- Each CME activity addresses one or more of the professional competencies established by the Accreditation Council for Graduate Medical Education (ACGME)/American Board of Medical Specialties (ABMS), Institute of Medicine (IOM), or Interprofessional Education Collaborative (IPEC).
- Each CME activity must be designed to change competence, performance, or patient outcomes. CME providers are then required to analyze the changes achieved as a result of the activities.
- Almost 100% of activities are designed to change competence. More than 50% are designed to change performance. More than 20% are designed to change patient outcomes.
- More than two-thirds of accredited CME programs demonstrate that they integrate CME into the process for improving professional practice.
- About two-thirds of accredited CME programs demonstrate that they participate within an institutional or system framework for quality improvement.
- With 140,000 activities comprising one million hours of instruction delivered annually, accredited CME offers an array of resources to promote quality, safety, and the evolution of medical care
ACCME also describes how CME can be delivered in flexible and diverse formats in order to meet the needs of individual learners. “Accredited CME offers multimodal educational opportunities” including “simulation, online courses, self-directed performance improvement projects, participatory group learning, hands-on training, and just-in-time learning at the patient's bedside,” they state. The ACCME allows for providers to choose the format the best meets their objectives and notes “[a]ll activity formats (eg, didactic, small group, interactive, hands-on skills labs) are perfectly acceptable and must be chosen based on what the provider hopes to achieve with respect to change in competence, performance, and/or patient outcomes.”
The ACCME next identifies the “perception versus reality” of industry-funded CME. “The hallmark of accredited CME is its independence from commercial influence and bias,” they state. The resource outlines a number of important facts about industry funding of continuing medical education:
- Most CME revenue is not derived from commercial support. Commercial support accounted for 26% of revenue in the accredited CME system in 2013.
- The majority of CME activities (83%), accounting for 80% of participants, do not receive commercial support.
- Since 2010, the first year the ACCME presented data about commercial support at the activity level, the percentage of activities receiving commercial support has decreased 3%.
- The ACCME Standards for Commercial Support have evolved into a common interprofessional standard shared by continuing education accreditors across the health professions. The value of the Standards has been recognized by government, regulators, and industry.
- Research has demonstrated that commercial support does not increase the risk for commercial bias when CME providers abide by the ACCME Standards for Commercial Support. (see the report entitled “Is There A Relationship between Commercial Support and Bias in Continuing Medical Education Activities? An Updated Literature Review”)
The ACCME also outlines how accredited CME has contributed to public health initiatives. They indicate that the recognition that accredited CME is independent of commercial bias “has enabled public health collaborations that include commercially supported CME.”
For example, the Food and Drug Administration (FDA) mandated that industry fund accredited CE about safety and risk issues involved in prescribing opioid medications. The FDA is now considering other ways to work together with the CE community to advance public health, the ACCME states. The ACCME also provides ongoing support for the initiative led by the National Human Genome Research Institute, National Institutes of Health, to improve the integration of genomics into health professionals’ continuing education and practice. Further, the ACCME convenes Public Health Imperatives Forums at its CME as a Bridge to Quality™ Accreditation Workshops, which bring together government representatives and accredited providers to identify opportunities for CME to be a strategic partner in addressing public health priorities.
The ACCME also “partnered with its colleague accreditors in nursing and pharmacy to create the only interprofessional continuing education (IPCE) unified accreditation program in the world—Joint Accreditation for Interprofessional Continuing Education™,” states the ACCME. “Joint Accreditation offers organizations the opportunity to be simultaneously accredited to provide medicine, pharmacy, and nursing continuing education activities through a single, unified application process, fee structure, and set of accreditation standards.”
Finally, the ACCME resource outlines how they have responded to evolutions in the healthcare community. They include, for example:
- The Standards for Commercial Support were updated in 2004 to further strengthen the separation of education from promotion.
- The ACCME has increased accountability and transparency in recent years. The accreditation process was accelerated to ensure more timely and rigorous oversight of issues related to independence. The ACCME published more data about accredited providers, including information about which providers accept commercial support.
- The ACCME released new accreditation requirements in 2006 to reposition CME as a strategic asset to the quality and safety imperatives of the US healthcare system.
- The ACCME implemented changes in 2014 to simplify the accreditation requirements and process and offer greater flexibility, while retaining the Plan-Do-Study-Act cycle which is integral to the ACCME’s expectations. These changes reflect the ACCME’s ongoing process of engagement with the CME and stakeholder communities.
- As part of the ongoing engagement process, the ACCME issued a proposal for new commendation criteria. Developed collaboratively with the CE community, the proposed criteria aim to respond to current and emerging health priorities. The proposed criteria reward CME programs that address the integration of health data, interprofessional collaborative practice, individualized learning activities, and higher levels of outcomes measurement.