Continuing Medical Education: Looking Back, Planning Ahead

11. Instituting National Standards for Continuing Medical Education: The Accreditation Council for Continuing Medical Education

118 Murray Kopelow, Kate Regnier, and Tamar Hosansky chapter 11 Instituting National Standards for Continuing Medical Education: The Accreditation Council for Continuing Medical Education The Accreditation Council for Continuing Medical Education (ACCME®) was founded in January 1981 in order to create a national accreditation system. The ACCME purpose is to oversee a voluntary , self-regulatory process for the accreditation of institutions that provide continuing medical education (CME) and develop rigorous standards to ensure that CME activities across the country are independent, free from commercial bias, based on valid content, and e√ective in meeting physicians’ learning and practice needs. The ACCME was created as the successor to the Liaison Committee for Continuing Medical Education (LCCME) and the American Medical Association (AMA) Committee on Accreditation of Continuing Medical Education. A notfor -profit organization based in Chicago, the ACCME is governed by its board of directors, which sets the strategic direction for the organization . Seven member organizations make up the ACCME: the American Board of Medical Specialties (ABMS), the American Hospital Association (AHA), the AMA, the Association for Hospital Medical Education (AHME), the Association of American Medical Colleges (AAMC), the Council of Medical Specialty Societies (CMSS), and the Federation of State Medical Boards (FSMB) of the United States. Each of the member ∫ 2009 Accreditation Council for Continuing Medical Education organizations nominates individuals to serve on the ACCME board of directors. Representatives from the federal government and the public also serve on the board. TheACCMEmissionistoidentify,develop,and promote national standards for quality CME that improve physician performance and medical care for patients and their communities. Throughout its almost 30-year history, the ACCME has been resolute in its commitment to carry out its mission , ensure compliance with its standards, and maintain a relevant and responsive accreditation system that supports CME as a strategic asset to US health-care quality and safety initiatives. Establishing Accreditation Requirements In 1982, the ACCME proposed and its member organizations ratified guidelines for accreditation that are referred to as the Seven Essentials. The guidelines outlined the approach CME providers should take to program management and education development. The guidelines were developed originally by Rutledge Howard, MD, with the AMA Committee on Accreditation of CME. By instituting the Seven Essentials, the ACCME began to articulate its philosophy regarding accredited CME. The ACCME believed that providers should use a curriculum planning model to create CME activities. National Standards for CME / Kopelow, Regnier, & Hosansky 119 To be eligible for accreditation, CME providers had to create a written continuing medical education mission statement, describing the goals and scope of the program, characteristics of potential participants and an overview of the activities and services provided; use a needs assessment process to plan educational activities; develop educational objectives for each activity, and communicate those objectives to prospective participants; design and implement activities that met physician needs and the educational objectives ; evaluate the e√ectiveness of their overall CME programs and use these evaluations in future planning; establish and document an organizational structure that was e√ective in fulfilling its CME mission; and accept responsibility for meeting the requirements of the Essentials when jointly sponsoring an activity with a nonaccredited organization. The Seven Essentials laid the foundation for creating a highly respected national accreditation system. Beginning with the Essentials, the ACCME initiated the process of assuring physicians and the public that accredited CME activities met accepted standards of education. By granting accreditation to institutions based on their compliance with the Essentials, the ACCME encouraged CME providers to improve their programs , thus raising the quality of CME across the country. Empowering the State Accreditation System Since the AMA Physician’s Recognition Award had been established, medical societies in the United States and its territories had been accrediting CME providers. These intra-state accredited providers o√ered CME primarily to learners from their state or contiguous states as opposed to a national or international audience. In 1983, the ACCME created its Committee for Review and Recognition (CRR) to oversee the accreditation of intra-state providers. Rather than take over the role of accrediting local providers , the ACCME decided to recognize the states and territorial medical societies as accreditors through the CRR. This recognition process formalized an infrastructure, made up of the partnership of the ACCME and the state/territory medical societies, that was able to review and accredit more than 2,000 intra-state accredited providers. Howard Madigan, MD, who chaired the CRR for its first seven years, faced significant challenges . When the CRR...