The University of Utah Continuing Medical Education (UUCME) FAQs
General and Logistical Questions
UUCME Office Location
Where is the UUCME Office Located?
The UUCME Office is located in RM AC113 on the “A” Level of the School of Medicine (near Medical Graphics and Photography). Take the last hallway to the right before exiting the south doors of the School of Medicine. The office is midway down the hallway on the left side. Please see the map below for a pictorial view.
CME Course Certificates of Attendance for non-physician health professionals
Does the School of Medicine designate CME credit for nurses, nurse practitioners, and physician assistants?
The School of Medicine does not designate credit for these health professionals, but does issue course Certificates of Attendance for non-physician health professionals. A Certificate of Attendance references AMA PRA Category 1 Credit, to help them document their attendance at certified educational activities.
Where do I find out what Courses, Regularly Scheduled Series, and other activities are being offered?
A listing of these activities can be reviewed by going to the main navigation link on the UUCME homepage entitled, Activities. You can also find information on the UUCME calendar. For further information about the activity please get in touch with the point of contact noted for the activity or call the UUCME office, 581-8664.
How do I register for a CME Course?
The UUCME office does not perform the course registration functions. Please contact the individual listed as the course point of contact for information regarding registration.
Typical Accreditation Related Questions
See ACCME FAQs for a greater breadth of questions
Commercial Interests and Resolving Conflicts of Interest
What is considered a commercial interest?
A ‘commercial interest’ is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
What is meant by a relevant financial relationship or interest referenced on the planner and speaker disclosure/attestation form?
A relevant interest is any financial relationship in any amount occurring within the past 12 months that creates a conflict of interest. It is a relationship relevant to the role of the individual participating in the activity to control or influence content development. This might include grants, research support, consultant relationship, stockholder, paid honorarium, etc.
When do relationships create “conflicts of interest”?
The ACCME considers financial relationships to create actual conflict of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest.
Is the disclosure and attestation form sufficient to identify and resolve conflicts of interest?
No, CME activities are now being held to a higher standard than simple disclosure in assuring independence from commercial influences. The ACCME does not accept simple disclosures or disclaimers, on their own, as a mechanism to resolve conflict of interest. The disclosure must be used in conjunction with another mechanism such as peer review to identify and resolve conflicts of interest.
What if I am a planner (or presenter) with a conflict of interest?
This raises a very important question concerning your personal financial conflicts of interest. If you are planning with another peer who may also have conflicts of interest, you may ask, whether you can peer review each other. This is not about peer review, but the Accreditation Council for Continuing Medical Education (ACCME) requirement that everyone in control of content must resolve their personal financial conflicts of interest.
We suggest your viewing a couple of videos entitled, Resolving Conflicts of Interest and Commercial Support. Go to the UUCME Website: www.medicine.utah.edu/cme and click the "Tools and Resources" button along the left margin, and then go to the section titled, ‘Videos for Course Planners and Directors'. Finally, click on the videos.
The key factor is whether or not your reported relationship constitutes a conflict of interest. As the video explains, a conflict of interest occurs when an individual has an opportunity to affect CME content about the products or services of a commercial interest with which s/he has a financial relationship. Your role as planner gives you the opportunity to affect CME content, but does your course's content intersect in any manner with any products or services of the commercial interest that you have reported a relationship? One potential answer could be that the commercial interest does not manufacture any products related to the content of the CME activity or to your presentation; therefore there is no influence from the commercial interest. These two items will determine whether or not you have a conflict of interest (COI) that disqualifies you as a planner in that content area. The same applies to your co-planner, who also disclosed financial relationships.
One solution (not the exclusive approach) might be that you and your co-planner divide the planning responsibilities for your course so that each of you plans only those areas where you are COI-free, and each of you recused yourself from all discussion and planning concerning those areas for which you do have a COI.
Another possibility (alluded to previously) may be that the course content or the presentation does not intersect with any health care goods or services of the commercial interest that you have a relationship with. In this case, the conflict of interest reviewer can say something like, "None of the faculty or planners have any relevant financial relationships to disclose since the content does not cover any products/services of the (specify) commercial interest." This can also be used as your process for resolving conflict of interest, by simply stating that the content has nothing to do with products/services of commercial interest, therefore, there are no relevant financial relationships with commercial interests, thus no COI to resolve.
Exhibitors
Is an Exhibitor contract required?
No, an exhibitor contract is not required, but is recommended as a good business practice.
Can commercial interests receive exhibit space in exchange for providing CME grants for the CME activity?
No, receiving exhibit space in return for providing an educational grant would be placing a condition on the grant and that is not allowed. Selling exhibit space to commercial interests is considered to be a business transaction. Income from selling exhibit space is not considered to be commercial support as defined by the Accreditation Council for Continuing Medical Education. Educational grants should be kept completely separate and distinct from the purchase of exhibit space.
Letters of Agreement for Educational Grants
Who must sign the letter of agreement with the commercial interest?
The letter of agreement must be signed by a representative of the commercial interest, the UUCME office staff, and a member of the department receiving the educational grant or in-kind support prior to the activity.
Credit for teaching in CME activities
Can speakers be awarded credit for teaching in CME activities?
Yes, faculty can be awarded two (2) AMA PRA Category 1 Credits for each hour they present at a live activity designated for such credit. This credit acknowledges the learning associated with the preparation for an original presentation. Faculty may not claim simultaneous credit as physician learners for sessions at which they present. Credit may only be claimed once for repeated presentations.
How can speakers be awarded CME credit for speaking at a provider’s designated live activity?
There are two ways that credit can be awarded.
- The first method is claiming credit directly from the AMA. Physicians can either claim them on their AMA PRA certificate application or apply to the AMA for an AMA PRA Category 1 Credit certificate specific to that activity. The presenter applies using the AMA form entitled, ‘Direct Credit Application AMA PRA Category 1 CreditTM. To obtain the form to go the AMA web link at: www.ama-assn.org/go/cme or call the AMA (312) 464-5296.
-
The second method to document "Learning from Teaching" in a University of Utah live CME activity is to go to the UUCME website and link to 'Activities' and go to the 'Learning from Teaching' link. Follow the instructions on the form.
UUCME's CME Planning Forms: Plan for a CME Activity and Plan for a Regularly Scheduled Series
Q: When should I start using these new CME planning forms?
A: Begin using the new CME planning forms now. They are designed to lead you through the steps that will make your CME activity comply with the Accreditation Council for CME (ACCME)'s Updated Compliance Criteria. The Updated Compliance Criteria went into effect in September 2007, which is why you need to start using the new forms now. Don't fail to answer all the questions because missing data means the UofU will be unable to demonstrate compliance.
Q: What was wrong with the old CME planning forms?
A: The forms had to change because the vast majority of ACCME's Updated Compliance Criteria are new and weren't covered by the old form. Your responses to each question, coupled with the actual artifacts (e.g. Grand Rounds announcement, audience handouts, audience disclosure of commercial relationships, save-the-date cards, course brochure and syllabus etc.) are important because they form the basis for the UofU's re-accreditation...and that's what will allow the UofU to continue offering CME credit. You are an extension of the CME office. Each question in these new planning forms has a purpose and each has been engineered to demonstrate to the ACCME how the UofU meets expectations.
Q: Is there a fundamental difference between the new and the old planning forms?
A: Yes, there has been a philosophical shift. Now the goal for CME is improving practice. Acquiring knowledge for knowledge's sake or validation of current practice used to be sufficient, but no longer. CME is now all about improvement. That is why the new CME planning forms start by asking you to identify what needs to be improved. That points the direction for how you're going to design the educational activity to accomplish the desired result. Evaluation has also undergone a big change. Now evaluation involves determining if the desired educational result was accomplished. That's all new to CME. That's why UUCME created these new planning forms.
Q: The needs analysis section of the forms asks for an explanation of what needs improvement. Can I just write down what the faculty or audience suggested for topics, or cite something just published in a respected medical journal?
A: Need for improvement implies that there is a distance between ‘actual' practice vs. what is ‘ideal/achievable'. Expert opinion about the topic or some recent publication probably won't show a gap. However, you may be able to uncover that gap by probing further: ask ‘why?' For instance, suppose the planning committee decided one of the topics should be "Update on < topic>". Is "Update on <topic>" considered a gap just because the planning committee decided that the audience needed an update? No, it's not a gap because "Update" doesn't demonstrate a distance between ‘actual' practice vs. what is ‘ideal/achievable'. However, by probing deeper and asking ‘why?' the basis for the gap might become evident, but if not, the list of suggested questions might help.
Q: Do I need to answer each of the suggested questions in Question 1(a) (both of the planning documents)?
- What are some patient care scenarios that you find difficult to manage or resolve?
- What are the key issues or obstacles to care you or your colleagues encounter?
- What areas of practice in your hospital or clinical practice setting need improvement?
- What areas of practice is there broad variation among your physicians?
- Which clinical situations make you uncomfortable or keep you awake at night?
A: The suggested questions are just one method for getting planners' creativity going, but they don't necessarily need to be answered.
Q: What's the difference between ‘knowledge', ‘competence' and ‘performance'?
A: After you have identified the gap between ‘actual' practice vs. what is ‘ideal/achievable', the next step is to assign the root cause for the gap. Analyze if the identified gap is caused by insufficient knowledge (e.g. factual information, or knowing that), improving competence (e.g. strategies or knowing how), or improving performance (e.g. failure to carry out a plan, doing). At this point you should be able to develop the desired result for this educational activity.
Q: Does ‘competence' and ‘competencies' mean the same thing?
A: No, these words have different meanings, and both terms are used in these CME planning documents. Competence means the simultaneous integration of knowledge, skills, and attitudes required for performance (e.g. developing strategies or knowing how). . Competencies are general descriptions of the skills and abilities needed to perform the role of being a physician.
Q: Is it OK to erase or type over the hints listed in the table in Question 1(b) of 'The University of Utah School of Medicine Plan for a Regularly Scheduled Series'?
A: The wording hints are there to assist you. They are only for your benefit and can be erased. You'll notice there are two boxes that have been grayed-out so don't put anything in those two boxes.
Q: How many boxes in the table do I need fill in?
A: In the table in question 1(b) for both of the planning documents, write down at least 1 gap and at least 1 desired result, categorized according to whether the cause is in the realm of knowledge, competence, performance or patient outcomes. Even though it is necessary to identify only one gap and desired result, it's often helpful for planners to write down more than one. The ‘Plan for a Regularly Scheduled Series' form differs from the ‘Plan for a CME Activity' form because there is space for developing up to 3 themes for the series, with each theme developed around an area of improvement, though the minimum requirement is only 1 theme.
Q: How many objectives do I need to print in brochures and announcements?
A: It has never been simpler. You don't need any objectives. None. Now the planning steps now are (1) identify gaps in your own learners, (2) link those gaps with the desired results of your education, (3) select the proper educational methods, and target the desired physician competencies, and then (4) determine how effective your education was, in terms of improving competence, performance or patient outcomes. Question 2(e) of the Plan for a CME Activity form is optional, though planners often find forming objectives to be helpful for sharpening the focus about the goals/purpose of the course.
Q: I thought measurable objectives are necessary because they are part of the adult learning principles.
A: There's not just one single learning model. The Updated Compliance Criteria are based on a newer educational model that does not involve creating learning objectives.
Q: How is it possible that the evaluation can show our education caused improvement in physician competence, performance or patient care? That will take a lot more resources than we have.
A: A qualitative rather than a quantitative approach is OK. It's not necessary to show a direct cause and effect relationship between your educational activity and improvements. You don't need to do pre- and post-testing to measure the effectiveness of the educational activity. You only need to evaluate whether there has been evidence of improvement in physician competence (e.g. strategies/knowing how), performance (doing), or patient outcomes. Your education was one of many things contributing to improvements in practice, though not necessarily the only factor. Physician self-reports are valid indicators of actual practice, so the simplest method is for the evaluation to ask your learners to relate their improvements in practice. Remember: you don't have to do all the heavy lifting because hospitals like UUMC are already collecting a lot of data measuring performance. Team up with some group already involved with system improvement that is already collecting and analyzing data, such as the QI, or Risk Management departments. Perhaps there's some state agency already tracking epidemiological data that you can use.
Q: What is ‘commitment to change' (Question 3-Plan for a CME Activity)?
A: Commitment to change is a simple way of discovering actual changes in the learner's practice that resulted from the educational activity. At the very beginning of the course, the audience is given an NCR form (e.g. ‘no carbon required') and instructed to write down as they listen during the sessions those changes in their practice they intend to implement. At the end of the course, the audience splits the form, taking one copy for themselves and leaving one copy with the course representative. At 1-3 months in the future, the learner is contacted and asked about the status of implementation of the intended changes, barriers identified, and the next steps identified. They can be used for evaluation at the performance level. The UUCME office can provide you with more details and assistance with instituting the commitment to change strategy.
Q: What are ‘vignettes' (Question 3-Plan for a CME Activity)?
A: Case vignettes are a low tech version of simulation because they allow direct measurement of learners' application of learning through case-based scenarios. They are simple to set up and can be used for evaluation at the performance level. The UUCME office can provide you with more details and examples.
Complying with the ACCME Standards for Commercial Support
Q: Who needs to identify their personal financial relationships (Question 5-Plan for a CME Activity and Question 4 Plan for a Regularly Scheduled Series)?
A: Identifying personal financial relationships is the first step in a 3-step process for assuring the public that the UofU is an honest broker of CME. The process begins with everyone in a position to control content disclosing their financial relationships. It's not just the presenters who must disclose, but includes everyone who has any decision-making role whatsoever in the curriculum, including all planners and approvers. However, those persons whose only role is logistical support and have no role in the curriculum design or selection should not be asked to disclose because their disclosure is irrelevant and causes a distraction from those who have relevant financial relationships.
Q: How should we identify personal financial relationships (Question 5-Plan for a CME Activity)?
A: It is wise to be aware of speaker's personal financial interest very early in the planning process in order to avoid being faced downstream with a relationship for which there can be no easy means for its resolution. In the Plan for a CME Activity, there are a series of 3 short screening questions listed in Question 5. Whether planning a course or a Regularly Scheduled Series, these screening questions are best asked when the presenter verbally agrees to be a speaker, moderator or panelist. Note that these screening questions do not appear in the Plan for a Regularly Scheduled Series form.
Q: Is disclosing a personal financial relationship sufficient for resolving a conflict of interest?
A: No. Since May 2005 the ACCME has required there be a separate process for resolving conflicts of interest.
Q: What is the 3-step process for identifying and resolving conflicts of interest and disclosing financial relationships to the learners?
A: All 3 steps are necessary:
- Everyone in a position to control content must disclose their relevant financial relationships. This includes all planners, speakers, moderators, all approvers and any others who can create or influence the instructional content in any manner.
- All conflicts of interest are resolved and that resolution documented through the UUCME process.
-
Prior to their encountering the instructional content, learners are informed of any relevant personal financial relationships or the absence of relevant financial relationships for everyone who is in a position to control content. The details of what precisely was disclosed to the learners must be documented.
Q: How should the learners be informed of any relevant personal financial relationships or the absence of relevant financial relationships?
A: When there is a relevant financial relationship, the learners need to be informed of the name of the person with the relationship, the name of the company with whom the relationship exists, and the nature of the relationship. No dollar amounts are to be disclosed to the learners. When there is nothing to disclose, language similar to the following can be used: "<Name of presenter > and no one in control of content, including planners, have any relevant financial relationships to disclose." The method for disclosure may be one or more of the following:
- Printed at the front of the course syllabus or on the speaker's handout
- As part of the any announcements and reminders that are printed or distributed electronically by e-mail
- Inserted as the 2nd slide in the presenter's PowerPoint series
-
Verbally disclosed from the podium, with a written attestation, signed by someone who was present in the room at the time, containing precise language that demonstrates the required information was disclosed to the audience, with that attestation dated within 1 month.
Q: What needs to be disclosed to the audience when the educational activity receives commercial support from the pharmaceutical or medical device industry?
A: There are two methods for industry to provide money, but only one of these methods is considered commercial support by the ACCME. That is when the company provides money or in-kind items without getting anything in return. In contrast, when the course charges a fee for display or advertising space, this type of transaction is not considered commercial support, and like any rental arrangement, it is a straight business transaction. Any mention in course materials of those companies renting vendor space should be separated from the listing of those companies providing commercial support. Prior to the actual education, the names of companies providing commercial support, either by direct payment or in-kind donation needs to be disclosed to the learners. In addition to the company name, a company logo may also appear, but never a logo alone. There can be no product-specific references.
Q: An out-of-town speaker happens to be in town because s/he has been brought here for another purpose. Can we use that person to speak at a CME-certified activity?
A: It depends on what was the purpose of the trip and who paid that person's expenses. If the person's travel expenses were paid for by a commercial interest (e.g. pharmaceutical or medical device industry) or the trip was for commercial purposes, then that speaker most likely has an irresolvable conflict of interest.
Course Management Fee Structure
Q. For CME Course Activities, can you clarify what you mean by the term ‘registrant'?
The term ‘registrant' relates to the CME management fee structure. For purposes of calculating this management fee, the term "registrant" means all healthcare personnel registered for the course, excluding the course director, course faculty, and course administrative staff along with observers, fellows, residents, medical students and other full time students.
Physicians can attend CME Course activities without registering for them. It would be similar to auditing a college class without registering for the class. The knowledge is free, but when a physician or other health care professional wants to get CME credit, then she/he must register for the course. The CME office will charge ($35) for the registrant; and non-registrants are not part of the calculation because they're not registered.
So a physician that opts out of registering for CME can still listen to all the lectures and you can give them whatever educational materials you want to (including the syllabus), but the physician will not get CME credit for attending. This includes other healthcare professionals who opt out of registering, but want to attend the activity. They will not get a certificate of participation for attending the CME activity.
When you are accepting registrations for your CME Activity it is critically important that you clearly distinguish between those registering and those who are non-registrants. Be sure that the individual learner attending your course also understands what it means to be registered (CME credit) vs. a non-registrant (no CME credit).
Q. Why is it necessary for a representative of the CME office to attend a live CME activity?
The UUCME office as an accredited CME provider is responsible to ensure that all activities are in compliance with the ACCME accreditation Essential Areas, policies and accreditation criteria. If any inquiries or concerns are raised to the ACCME about the conduct of a Live CME activity that is accredited by the UUCME office, the UUCME staff must be in a position to respond to these inquiries or concerns from the ACCME. Thus onsite observation of the CME activity is a means for the UUCME office to verify that the activity is in compliance.
Offsite Fee:
For courses conducted outside of Salt Lake City, there is an additional charge for all travel-related expenses including per diem and lodging for a member of the CME staff to be an on-site monitor, to assure compliance with ACCME policies, Standards for Commercial SupportSM and ACCME compliance criteria.