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328 Judith G. Ribble and John R. Kues chapter 28 The National Commission for Certification of Continuing Medical Education Professionals and Its Certification Program As with any new field of endeavor, discussion and debate have surrounded the question of raising continuing medical education (CME) to the level of a profession since early in its evolution. Individuals engaged in developing CME have come from a variety of disciplines, including medicine, nursing, adult education, and other related fields. They have brought content, theory, and experience with them, but few attempts have been made to describe the underlying knowledge and competencies needed to develop e√ective CME programs and content. CME is as old as Hippocrates, but it entered a more formal era in 1968 with the advent of the American Medical Association (AMA) Physician ’s Recognition Award. The creation of the Accreditation Council for Continuing Medical Education (ACCME) in 1981 added a layer of regulation that required CME programs to incorporate basic principles of adult learning into certi fied CME activities. The field generated unique theories and corresponding research through its journal Mobius, which evolved into the Journal for Continuing Education in the Health Sciences. Critical books like Changing and Learning in the Lives of Physicians (published in 1989) and Physician as Learner: Linking Research to Practice (published in 1994) linked learning theory with clinical practice and patient outcomes. An outside observer would likely point to a period somewhere between the mid-1980s and mid-1990s as the time when CME had become su≈ciently mature to declare itself a unique discipline . It required another 10 to 20 years to develop and implement professional certification. Along the way, debate has continued as to what it means to be a CME professional. The Founding of the National Commission for Certification of CME Professionals In 1980, two icons of the CME community wrote a memo that now resides in the archives of the National Commission for Certification of CME Professionals (NC-CME). The intent of the memo, authored by Lewis Miller, MS, and Richard Wilbur , MD, and addressed to William Felch, MD, executive director of the Alliance for Continuing Medical Education (‘‘the Alliance’’), was clear: the CME community could benefit from a certification program that would assess and reward the competence of individuals employed in the CME community. No action resulted from the memo. In 1993, Miller championed the certification concept again. And again, no further activity ensued. In summer 1997 at the Alliance External Relations Committee meeting in Santa Fe, New Mexico, the topic of certification for CME professionals was on the agenda. The committee adjourned for dinner at a local restaurant famous National Commission for Certification of CME Professionals / Ribble & Kues 329 for its margaritas, and by the end of the evening the members had dubbed themselves ‘‘The Margarita Group,’’ dedicated to the proposition that CME professionals deserve a certification program. Members of the venerable Margarita Group were Phil Dombrowski, MBA; Miller; Jackie Parochka, EdD; and Judith Ribble, PhD (chair). The committee formally recommended that the Alliance initiate a certification program for CME professionals; however, once again no action was forthcoming. In fall 2004, Ribble experienced an ‘‘aha’’ moment when she saw a panel truck bearing the message ‘‘Be sure your chimney sweep is certi- fied.’’ The idea that the chimney sweep profession had progressed to the point of having a certification program, but that CME professionals —those individuals responsible for developing , administering, accrediting, marketing, and funding the CME activities that the nation’s physicians and physician assistants depend upon— had not, made a powerful impression on her. At a New York City conference, Ribble broached the topic with Minnie Baylor-Henry, JD, then with Johnson & Johnson. On the spot, Baylor-Henry agreed to provide meeting space for a two-day retreat to sort out options. Eighteen CME umbrella organizations received invitations to the retreat asking that each send a representative. In February 2005, the following eleven colleagues attended a retreat in Lafayette Hill, Pennsylvania : Jann Balmer, RN, PhD; Martin Cearnal; John Kelly, MD; John Kues, PhD; Pam Mason; Miller; Karen Overstreet, EdD, RPh; Phil Puckorius ; Ribble; Marissa Seligman, PharmD; and Jon Ukropec, PhD. On the first evening, the attendees examined the certification programs of other health-care organizations. The next day a SWOT analysis was performed to project anticipated strengths, weaknesses, opportunities, and threats. The group accepted the definition of competence described on the Alliance Web site...

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