CPD Accreditation Case Clinic Khalid Azzam and Kate Marsden October 1, 2018

Conflict of Interest Disclosure Dr. Khalid Azzam Relationships that may introduce potential bias and/or conflicts of interest: Receive stipend from McMaster University as the Assistant Dean for Continuing Health Sciences Education Program Receive stipend from Hamilton Health Sciences as Site Chief of Medicine at Hamilton General Hospital Chair of the Board of Directors and Shareholder of MetaClinician Inc.

Conflict of Interest Disclosure Ms. Kate Marsden Relationships that may introduce potential bias and/or conflicts of interest: Paid employee of the Royal College of Physicians and Surgeons of Canada

Disclosure of Commercial Support The 10th National CPD Accreditation Conference has received NO COMMERCIAL financial support. The 10th National CPD Accreditation Conference has received NO COMMERCIAL in- kind support.

Learning Objectives At the end of this session, participants will be able to: Evaluate applications against current Royal College CPD accreditation standards. Provide feedback to applicants on how to improve submissions to meet Royal College CPD accreditation criteria. Identify at least one area for enhancement in their CPD programs.

The Plan Introductions Part 1: Accreditation true or false Self-study and confidence measurement (see handout) Large group debrief Part 2: Accreditation cases Part 3: “What’s on your mind?” Blank card on your table Resources

Introductions Khalid Azzam Kate Marsden Member, CPD Accreditation Committee, Royal College Assistant Dean for Continuing Health Sciences Education Program McMaster University Kate Marsden Manager, Continuing Professional Development, Royal College

Introductions Raise your hand if you represent: A national specialty society A university office of CME A simulation program A regulatory authority Other Take a minute to introduce yourself to others at your table.

Workshop Ground Rules There are no trick questions Do not read too much into the cases Read silently Mutual respect; no judgment One case per slide

Part 1

True or False Self-Study! 15 accreditation-related statements have been provided on your handout Blue handout: Record your answer (true, false, unsure) Record your confidence in the accuracy of your answer We will come back as a group in 10 minutes New this year! We are trying to add an additional element of reflection and evaluation of the learning outcomes of this session. Participation in this process is voluntary. Those who wish to participate are asked to complete the blue handout and leave it for our team to collect after the session. You may participate anonymously or not. All participants will receive a survey in 6 weeks with the same true or false questions asking you to again record your answer and confidence in the accuracy of your answer. We will compare the results from the face-to-face session with your survey responses! When we send your results back, you will be able to reflect on both your knowledge and confidence.

Accreditation True or False? Raise the corresponding card to identify whether you believe that the statement is: True (green) False (red) Unsure (yellow)

Accreditation Statement #1 Promotional booths can be set up in educational areas if they are from a not-for- profit organization. True (green) False (red) Unsure (yellow)

Accreditation Statement #1 a/False The National Standard applies to both profit and not-for-profit organizations. National Standard 6.3: Commercial exhibits or advertisements must be arranged in a location that is clearly and completely separated from the accredited CPD activity.

Accreditation Statement #2 Self-approved rounds must comply with the National Standard of Support for Accredited CPD Activities. True (green) False (red) Unsure (yellow)

Accreditation Statement #2 a/True Self-approved activities such as rounds, journal clubs and small groups must adhere to the National Standard of Support for Accredited CPD Activities.

Accreditation Statement #3 Sponsors can sponsor Wi-Fi and use their company name as a password. True (green) False (red) Unsure (yellow)

Accreditation Statement #3 a/True It is ethically permissible if such practices provide a service to participants and do not have any influence on aspects of the planning process or scientific information.

Accreditation Statement #4 When a certificate of attendance is tied to the completion of a CPD activity evaluation, those who do not complete the evaluation will still receive a certificate of attendance. True (green) False (red) Unsure (yellow)

Accreditation Statement #4 a/True The physician organization is always responsible for issuing certificates of attendance to all participants, (regardless of their profession or specialty) for accredited group learning activities, accredited self- assessment programs and accredited simulation programs. 

Accreditation Statement #5 During an accredited Section 1 session, the presenters can use an audience response system for a pre-post-test. As long as the slides present the correct answer along with references, participants can claim Section 3 credits True (green) False (red) Unsure (yellow)

Accreditation Statement #5 a/False The self-assessment program must provide detailed feedback to participants on their performance to enable the identification of any areas requiring improvement through the development of a future learning plan.

Accreditation Statement #6 Self-approved lunch-time rounds may have their lunch provided by a commercial interest, as long as the commercial interest sends an expense report the to the planning committee. True (green) False (red) Unsure (yellow)

Accreditation Statement #6 a/False The CPD provider organization or SPC is responsible to receive any financial and in-kind support for the development of an accredited CPD activity. The rounds chair can never delegate to a commercial interest the payment of travel, lodging, legitimate out of pocket expenses for speakers, moderators, facilitators and/or, authors.

Accreditation Statement #7 Not-for-profit relationships need to be declared on a conflict of interest form. True (green) False (red) Unsure (yellow)

Accreditation Statement 7 a/True All members of the SPC, speakers, moderators, facilitators and authors must provide to the CPD provider organization a written description of all relationships with for-profit and not-for-profit organizations over the previous 2 years.

Accreditation Statement #8 Accredited symposia that are co-developed with a commercial interest may only take place at times and locations that do not interfere or compete with rest of the accredited scientific program. True (green) False (red) Unsure (yellow)

Accreditation Statement #8 a/False Accredited co-developed symposia may take place at any time during the scientific program as they have been accredited.

Accreditation Statement #9 The name of a commercial interest can be included in the name of an award. True (green) False (red) Unsure (yellow)

Accreditation Statement #9 a/True Yes, this would be ethically permissible as the activity is an award presentation, which is not considered an accredited group learning activity.

Accreditation Statement #10 Industry product specific ads may be displayed outside the areas where accredited educational sessions take place. True (green) False (red) Unsure (yellow)

Accreditation Statement #10 a/True Product-specific advertising or branding strategies may be displayed as long as they are not located in the following: any educational materials, slides, abstracts and handouts used as part of an accredited CPD activity; activity agendas, programs or calendars of events (preliminary and final); any webpages or electronic media containing educational material.

Accreditation Statement #11 In kind support (such as providing devices) does not require sponsorship acknowledgment as it is not financial support. True (green) False (red) Unsure (yellow)

Accreditation Statement #11 a/False The SPC must recognize and disclose to participants all financial and in-kind support received from sponsors of CPD activities as part of a sponsorship acknowledgement separate from the educational content.

Accreditation Statement #12 An accredited CPD provider was not able to accredit a program before the event took place. Since the program did meet the accreditation standards of Section 1 MOC credits can be provided retroactively True (green) False (red) Unsure (yellow)

Accreditation Statement #12 a/ False Royal College MOC credits cannot be assigned retroactively to an educational activity after the activity has taken place.

Accreditation Statement #13 Physician faculty members are allowed to receive honoraria that exceeds $10,000. True (green) False (red) Unsure (yellow)

Accreditation Statement #13 a/True The Royal College does not have guidelines concerning the allowable amount for an honorarium. As such, it is possible to provide a faculty member with an honorarium over $10,000.

Accreditation Statement #14 Notification of Review forms must be submitted to the Royal College on an annual basis. True (green) False (red) Unsure (yellow)

Accreditation Statement #14 a/False Accredited CPD providers must submit a Notification of Review form (NOR) to the Royal College right after the accreditation of an educational activity. If the accredited CPD Provider accredits a large amount of activities, they may submit one NOR that includes their recently accredited programs on a weekly or monthly basis.

Accreditation Statement #15 Participants of an accredited online program must log-in to a discussion forum to qualify for Section 1 credits. True (green) False (red) Unsure (yellow)

Accreditation Statement #15 a/True Asynchronous group learning activities delivered via the web must provide an opportunity for interaction between participants and faculty/facilitators. Participants must log on to the interactive component. Certificates of participation should only be given to participants after they have logged on to the interactive component.

Reflection Review your completed blue handout Reflect on your knowledge assessment Reflect on your confidence ratings Any insights?

Part 2

Accreditation Cases These are actual cases/questions that have come across the desks of Royal College staff. Remember the ground rules: There are no trick questions Do not read too much into the cases Read silently Mutual respect; no judgment

Accreditation Case #1 An accredited CPD provider receives an application for Section 1 accreditation of the the National Consortium of Heart Failure Clinics (NCCHFC) annual meeting. The NCCHFC is composed of representatives from heart failure clinics across Canada. The website indicates that the NCCHFC is a not- for-profit organization, with a governance structure and a membership composed of representatives from heart failure clinics.

Accreditation Case #1 Are there any barriers to accrediting this annual meeting?

Accreditation Case #1 The NCCHFC is not considered a physician organization. This is because their membership is composed of heart failure centres, rather than individual health professionals. In order to seek accreditation for educational courses, the NCCHFC will need to approach another physician organization and enter into a co-development relationship to develop the program.

What is a ‘physician organization’? A physician organization is defined as a not-for-profit group of health professionals with a formal governance structure, accountable to and serving, among others, its specialist physician members through continuing professional development, provision of health care, and/or research Examples of physician organizations: faculties of medicine hospital departments or divisions medical societies medical associations medical academies physician research organizations health authorities not linked to government agencies Canadian provincial/territorial medical regulatory authorities (MRAs)

Accreditation Case #2 An accredited CPD provider has accredited a workshop to be presented in Toronto, Calgary and Vancouver. Each city has a different moderator for the workshop. These moderators are required to attend a train-the-trainer in advance of the accredited workshop and are paid to attend. The commercial interest co-developing the program with you would like to pay directly for the expenses of the train-the-trainer sessions.

Accreditation Case #2 How should the accredited CPD provider manage the flow of funds in this situation?

Accreditation Case #2 In accordance with sub-element 4.1: “the CPD provider organization or SPC is responsible to receive any financial or in-kind support for the development of an accredited CPD activity.” This also applies to accredited rounds, journal clubs, and small groups (“regularly scheduled series”) as well as single-sponsored CPD activities.

Accreditation Case #3 An accredited CPD provider receives an accreditation application for a physician organization’s annual meeting. In the application’s program, there is mention of a separate pre-conference summit. This summit had a different planning committee from the annual developing the content for the Summit. The physician organization stated in their accreditation application that they would like the summit to be accredited under the umbrella of their main conference’s accreditation application.

Accreditation Case #3 Can this program be accredited as one program/application?

Accreditation Case #3 As the Summit has a separate planning committee, the Summit would need to be separately accredited.

Accreditation Case #4 An accredited CPD provider receives an application from a medical education firm who co-developed a program with the Jamaican Society of Occupational Medicine.

Accreditation Case #4 Can this co-developed program be eligible for accreditation?

Accreditation Case #4 The Jamaican Society of Occupational Medicine (JSOM) can assume the role of a physician organization if it meets the Royal College definition of a physician organization. The JSOM must follow and adhere to all of the Royal College and Canadian administrative, educational and ethical standards of accreditation.

Accreditation Case #5 An accredited CPD provider receives an accreditation application for educational program taking place in a ski resort. The topics and learning objectives of the meeting are well aligned with the identified educational needs of the target audience.

Accreditation Case #5 (cont’d) The sponsorship of the meeting is well in compliance with the National Standard. The accreditation standards were also met. The agenda for the 4 day meeting follows the same schedule each day: 7:00 -9:00: educational sessions 9:00 -15:00: free time at the ski slopes 4:00-6:00: educational sessions

Accreditation Case #5 Are there any concerns about the this educational activity?

Accreditation Case #5 Although the educational activity is in a ski resort, as long as the activity meets the Royal College’s accreditation requirements and the National standard of support, it can be accredited for Section 1 accreditation.

Part 3 What’s on your mind?

What’s on your mind? Using the blank card at your table ~as a group or individual~ write down questions, cases, issues that remain outstanding for you. Discuss the issue with your group. Can you resolve it together? Please leave the card on your table. We will collect the cards and commit to following up through further discussions, the CPD Accreditation Bulletin, FAQs or future cases.

CPD Accreditation Bulletin CPD Accreditation Unit staff Resources Royal College website www.royalcollege.ca/cpdaccreditation CPD Accreditation Bulletin CPD Accreditation Unit staff cpd-accreditation@royalcollege.ca (613-730-8177 ext. 587) Julie Lavigne jlavigne@royalcollege.ca Robin Kinch rkinch@royalcollege.ca Kate Runacres krunacres@royalcollege.ca Chanelle Goulet cgoulet@royalcollege.ca

Please remember to complete your evaluation! Thank You! Please remember to complete your evaluation!