Joint Providership

Accreditation – The framework by which a program of CME is assessed to determine whether the program meets the accreditor’s requirements. See also “Accredited CME provider.”

Accreditation criteria – The requirements against which CME providers’ compliance is determined in order to achieve or maintain accreditation.

Accreditation statement – The standard statement that must appear on all CME activity materials and brochures distributed by ACCME-accredited providers. There are two variations of the statement; one for directly provided activities and one for jointly provided activities.

Accredited CME – The term used to refer to continuing medical education that has been deemed to meet the requirements and standards of a CME accrediting body.

Accredited CME provider – An organization accredited as a provider of continuing medical education. Accredited CME providers assume the responsibility and accountability for developing certified educational activities. ACCME-accredited providers represent a range of organizational types and offer CME primarily to national or international audiences of physicians and other health care professionals. Intrastate-accredited providers offer CME primarily to learners from their state/territory or contiguous states.

Advertising and exhibits income – Advertising and exhibits are promotional activities and not continuing medical education. Therefore, monies paid by ineligible companies to providers for these promotional activities are not considered to be commercial support under the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities^SM.

AMA core requirements – The AMA requirements that every activity certified for AMA PRA Category 1 Credit™ must meet. They can be found in the AMA PRA booklet.

AMA Credit Designation Statement – The statement that indicates that the activity has been certified for AMA PRA Category 1 Credit™, and includes the type of activity and number of credits.

AMA Direct Credit Activities – Activities that do not occur under the auspices of an accredited CME provider and for which the AMA directly awards credit to physicians who meet the requirements as listed in the AMA PRA booklet.

AMA Physician’s Recognition Award (PRA) – The AMA PRA has recognized physician participation in CME since 1968. The AMA established the PRA certificate and the related AMA PRA credit system to recognize physicians who, by participating in CME activities, demonstrate their commitment to staying current with advances in medicine. More information can be found in the AMA PRA booklet.

AMA PRA Category 1 Credit™ – The type of CME credit that physicians earn by participating in certified activities sponsored by CME providers accredited by either the ACCME or an ACCME-recognized State/Territory Medical Society; by participating in activities recognized by the AMA as valid educational activities and awarded directly by the AMA; and by participating in certain international activities recognized by the AMA through its International Conference Recognition Program.

AMA PRA Category 2 Credit™ – Credit that is self-claimed and self-documented by physicians by participating in activities that are not certified for AMA PRA Category 1 Credit™ and that the physician individually determines comply with the AMA definition of CME; and comply with the relevant AMA ethical opinions (see CEJA Opinions relevant to CME); and are not promotional; and the physician finds to be a worthwhile learning experience related to his/her practice.

AMA PRA CME credit system – Developed in 1968, the credit system initially described the type of educational activities that would qualify to meet the requirement to obtain the AMA’s PRA (See Physician’s Recognition Award). The AMA PRA Standards and Policies have evolved and now AMA PRA credit has been accepted as an educational metric for the purposes of state licensure, professional credentialing, hospital privileging and maintenance of certification of physicians.

Certified CME – Nonpromotional learning activities certified for credit prior to the activity by an organization authorized by the credit system owner, or nonpromotional learning activities for which the credit system owner directly awards credit.

CME activity – An educational offering that is planned, implemented, and evaluated in accordance with the ACCME Accreditation Criteria, Standards for Commercial Support, and policies; the AMA Physician’s Recognition Award CME credit system standards and policies; and the AMA Council on Ethical and Judicial Affairs pertinent opinions.

CME credit – The “currency” assigned to CME activities. Physicians and other healthcare professionals use credits to meet requirements for maintenance of licensure, maintenance of specialty board certification, credentialing, membership in professional societies, and other professional privileges. The requirements for credit designation are determined by the organization responsible for the credit system. Besides the AMA, other organizations in the US that administer credit systems for physicians include the American Academy of Family Physicians and the American Osteopathic Association. Please refer to those organizations for more information. See AMA PRA Category 1 Credit™ and AMA PRA Category 2 Credit™ above.

Commercial bias – Content or format in a CME activity or its related materials that promotes the products or business lines of an ACCME-defined ineligible company.

Ineligible Company – Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be ineligible companies. An ineligible company is not eligible for ACCME accreditation or participation in joint providership.

Commercial support – Monetary or in-kind contributions given by an ACCME-defined ineligible companies that is used to pay all or part of the costs of a CME activity. The requirements for receiving and managing commercial support are explained in the ACCME Standards for Commercial Support . Advertising and exhibit income are not considered commercial support.

Competence – In the context of evaluating effectiveness of a CME activity in the ACCME System, the extent to which learners know how to implement (or stop doing) what the activity intended to teach them.

Compliance – The finding given when a CME provider has fulfilled the ACCME’s/Recognized Accreditor’s requirements for the specific criterion in the Accreditation Criteria or policy.

Conflict of interest – The ACCME considers financial relationships to create conflicts of interest in CME when individuals have both a financial relationship with an ineligible company and the opportunity to affect the content of CME about the products or services of that ineligible company. The potential for maintaining or increasing the value of the financial relationship with the ineligible companycreates an incentive to influence the content of the CME—an incentive to insert commercial bias. See also “relevant financial relationships.”

Continuing Medical Education (CME) – The educational activities that serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships a physician uses to provide services for patients, the public, or the profession. CME represents that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public.

Continuing Professional Development (CPD), or Continuing Physician Professional Development (CPPD) – Includes all activities that doctors undertake, formally and informally, including CME, in order to maintain, update, develop,and enhance their knowledge, skills, and attitudes in response to the needs of their patients.

Course – A live CME activity where the learner participates in person. A course is planned as an individual event. Examples: annual meeting, conference, seminar.

Designation of CME credit – The declaration that an activity meets the requirements for a specific type of credit. The accredited provider is responsible to those organizations that administer credit systems for compliance with applicable credit requirements. Note: The designation of credit for CME activities is not within the purview of the ACCME or ACCME Recognized Accreditors. See also “CME credit.”

Directly provided activity – One that is planned, implemented, and evaluated by the accredited CME provider. This definition includes co-provided activities (offered by two accredited providers) reported by the accredited provider that awards the credit.

Enduring material – An activity that endures over a specified time and does not have a specific time or location designated for participation; rather, the participant determines whether and when to complete the activity. Examples: online interactive educational module, recorded presentation, podcast.

Faculty – The individuals responsible for teaching, authoring, or otherwise communicating the activity content to learners.

Hours of instruction – Hours of instruction represents the total hours of educational instruction in a CME activity. The information is used for the purpose of reporting the activity. For example, if a one-day course lasts eight hours (not including breaks or meals), then the total hours of instruction reported for that course is eight. Hours of instruction may or may not correspond to the number of AMA PRA Category 1 Credits™ for which the activity is designated.

In-kind commercial support – In the context of the ACCME’s Standards for Commercial Support, non-monetary resources provided by a ineligible company in support of a CME activity. Examples of in-kind support include equipment,supplies, and facilities.

Internet enduring material activity – An enduring material provided via the Internet, meaning that there is no specific time designated for participation. Rather, the participant determines when to complete the activity. Examples: online interactive educational module, recorded presentation, podcast.

Internet live activity – A live course available via the Internet at a certain time on a certain date and is only available in real-time, just as if it were a course held in an auditorium. Example: webcast.

Internet Point of Care (PoC) learning (Internet searching and learning) – An activity in which a physician engages in self-directed, online learning on topics relevant to their clinical practice from a database whose content has been vetted by an accredited CME provider.

Jointly provided activity – An activity that is planned, implemented, and evaluated by an accredited provider and one or more non-accredited entities.

Journal-based CME – An activity that is planned and presented by an accredited provider and in which the learner reads one or more articles (or adapted formats for special needs) from a peer-reviewed, professional journal.

Knowledge – In the context of educational needs for a CME activity in the ACCME System, the extent to which learners have a need for new information.

Learner – An attendee at a CME activity. See also “physician learners,” and “other learners.”

Live activity – Activity that occurs at a specific time as scheduled by the accredited CME provider. Participation may be in person or remotely as is the case of teleconferences or live internet webinars.

Manuscript review activity – Activity in which a learner participates in the critical review of an assigned journal manuscript during the pre-publication review process of a journal.

New procedures and skills training – Activity whereby accredited CME providers can train physicians on topics that may allow them to request new or expanded clinical privileges. The AMA PRA framework for new skills and procedures training consists of four levels so that accredited CME providers and physicians can clearly identify the depth and complexity of the training.

Other learners – Learners other than those who have obtained an MD, DO, or equivalent medical degree from another country.

Parent organization – An outside entity, separate from the accredited provider, that has control over the accredited provider’s funds, staff, facilities, and/or CME activities.

Performance – In the context of evaluating effectiveness of a CME activity in the ACCME system, the extent to which learners do what the CME activity intended them to be able to do (or stop doing) in their practice.

Performance Improvement CME (PI CME) – An activity structured as a three-stage process by which a physician or group of physicians learn about specific performance measures, assess their practice using the selected performance measures, implement interventions to improve performance related to these measures over a useful interval of time, and then reassess their practice using the same performance measures.

Physician learners – Activity learners who are MDs or DOs, or have an equivalent medical degree from another country.

Program of CME – The provider’s CME activities and functions taken as a whole.

Regularly scheduled series – A course planned as a series with multiple, ongoing sessions, e.g., offered weekly, monthly, or quarterly; and is primarily planned by and presented to the accredited organization’s professional staff. Examples include grand rounds, tumor boards, and morbidity and mortality conferences.

Relevant financial relationships – The ACCME requires anyone in control of CME content to disclose relevant financial relationships to the accredited provider. Individuals must also include in their disclosure the relevant financial relationships of a spouse or partner. The ACCME defines relevant financial relationships as financial relationships in any amount that create a conflict of interest and that occurred in the twelve-month period preceding the time that the individual was asked to assume a role controlling content of the CME activity. The ACCME has not set a minimal dollar amount—any amount, regardless of how small, creates the incentive to maintain or increase the value of the relationship. Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. See also “conflict of interest.”

Standards for Integrity and Independence in Accredited Continuing Education– ACCME requirements designed to ensure that CME activities are independent and free of commercial bias. The Standards comprise six standards: independence, resolution of personal conflicts of interest, appropriate use of commercial support, appropriate management of associated commercial promotion, content and format without commercial bias, and disclosures relevant to potential commercial bias.

Unstructured online searching and learning – An activity in which a physician uses Internet sites to learn about a topic. If it meets the guidelines for AMA PRA Category 2 Credit™ a physician may designate it as such and claim credit based on the time devoted to it.