Call for Comment Regarding Knowledge-based CME Activities

Open for comment on : 
January 22, 2010
Closes on: 
March 8, 2010

At the urging of several stakeholders of the ACCME's accreditation system, the ACCME asked the CME community: Should the ACCME add the word knowledge into Criteria 1, 3, and 11? This Call for Comment opened on January 22, 2010 and closed on March 8, 2010. 

An audio commentary with ACCME Chief Executive, Murray Kopelow, MD, explaining the call for comment is available here.

A report including the responses as well as the ACCME's analysis of the responses is available here.

The full text of the Call for Comment was as follows:

Call for Comment -- Complaints and Inquiries Process: Knowledge-based CME Activities

Until 2006, ACCME accreditation requirements allowed an accredited provider’s CME program to focus entirely on changing learners' knowledge. In response to calls from stakeholders, the ACCME changed its requirements in 2006 to better position accredited CME as a strategic asset to physician performance improvement and patient health and safety initiatives. To comply with the 2006 ACCME Accreditation Criteria, accredited providers need to design CME activities to change learners' competence (i.e., strategies/skills), or performance or patient outcomes; and measure whether their CME program achieves those goals. The ACCME recognizes that knowledge is a critical element of competence, performance and patient outcomes. The ACCME believes that Providers should try to change learners’ knowledge — when knowledge acquisition will serve the goal of improving physician competence, performance or patient outcomes.

The ACCME has received feedback from some providers and other stakeholders that pure knowledge-based activities are vital to physicians' continuing education and professional development, and that the ACCME should revisit this issue and consider rewording the Criteria. The ACCME wants to be responsive to provider and stakeholder needs, but we are concerned that activities and programs designed solely to change knowledge may not fulfill accredited CME’s responsibility to be accountable to the public and may not align with current U.S. quality and safety initiatives. According to ACCME's mission, accreditation standards should support the "incorporation of new knowledge to improve quality medical care for patients and their communities."

The ACCME is considering several options.

Option A

This option would address the concerns expressed by some stakeholders. The ACCME could add the word knowledge to the Criteria as follows (additions in bold):

Criteria 1. The provider has a CME mission statement that includes all of the basic components (CME purpose, content areas, target audience, type of activities, expected results) with expected results articulated in terms of changes in KNOWLEDGE, competence, performance, or patient outcomes that will be the result of the program.

Criteria 2. The provider incorporates into CME activities the educational needs (knowledge, competence, or performance) that underlie the professional practice gaps of their own learners.

Criteria 3. The provider generates activities/educational interventions that are designed to change KNOWLEDGE, competence, performance, or patient outcomes as described in its mission statement.

Criteria 11 The provider analyzes changes in learners (KNOWLEDGE, competence, performance, or patient outcomes) achieved as a result of the overall program’s activities/educational interventions.

Option B

This option would not represent a change in the Criteria, but would clarify ACCME's intentions. The ACCME could state:

―Providers can present some activities that are designed to change knowledge. However, the provider’s overall CME program must focus on changing competence or performance or patient outcomes. Providers must include those goals in their mission (C1) and must analyze the impact of their overall program to determine if those goals have been achieved (C11).

Audio Commentary