What is CME?
What are the CME requirements for physicians?
What are the Washington State CME requirements?
What are the categories of CME and what do they mean?
Is Physicians Insurance an accredited sponsor?
What other organizations in Washington State are CME sponsors?
What is the purpose of accreditation?
What is the process for becoming an accredited sponsor?
What criteria are used for accreditation?
How is a CME course planned?
Who is involved in CME planning?
How do we know if our CME courses have led to improvements in practice or patient health?
What is CME?
All physicians are required to participate in ongoing training, known as continuing medical education (CME). The purpose of CME is to improve the physician’s ability to care for patients.
What are the CME requirements for physicians?
Sixty state boards of medical examiners (including Wyoming, as of January 1, 2007) require an average of anywhere from 12 hours (Alabama) to 50 hours (several states, including WA) of CME per year for license re-registration. Some states (including WA) also mandate CME content, such as HIV/AIDS or risk management. Many states (including WA) also require that a certain percentage of CME be category 1.
What are the Washington State CME requirements?
The Washington State Board of Medical Examiners requires every currently licensed physician to obtain 200 hours of CME every 4 years, with at least 80 hours being in Category 1.
What are the categories of CME and what do they mean?
The American Medical Association (AMA) Physician’s Recognition Award (PRA) credit system is recognized and accepted by hospital credentialing bodies, state medical licensure boards, and medical specialty certifying boards.
- Category 1 CME is formally-planned, and meets the criteria of both AMA and the Accreditation Council for Continuing Medical Education (ACCME).
- Category 2 CME consists of non-supervised learning activities such as journal clubs, reading, teaching, and attendance at meetings with a medical content, such as the Physicians Insurance Claims and Risk Management Committee meetings.
In addition to the AMA PRA credit system, many states have their own systems for accounting for CME. The Washington Board of Medical Examiners uses the following categories:
- Category I: CME Activities with Accredited Sponsorship
The Board will accept the attendance at courses offered by organizations and institutions which have been approved by the AMA.
- Category II: CME Activities with Non-accredited Sponsorship
Physicians may claim Category II for attendance at hospital staff meetings, non-accredited CME presentations, or informal learning such as reading of medical journals.
- Category III: Teaching of Physicians or Other Allied Health Professionals
Serving as an instructor of medical students, house staff, other physicians or allied health professionals from a hospital or institution with a formal training program. The hospital or institution must first approve the instruction.
- Category IV: Books, Papers, Publications, Exhibits
A paper must be published in a recognized medical journal. A paper presented at a meeting or exhibit must be shown to physicians or allied health professionals. Credits may be claimed only once for the material presented. Credits are claimed as of the date of publication or presentation.
- Category V: Self-directed Activities
Self-assessment, board examination preparation, quality of care and/or utilization review.
Category 1 credit is subjected to the highest standards and is therefore considered to be the highest quality. Sixty minutes equals one AMA PRA Category 1 credit. Category 1 credit can only be awarded by an accredited sponsor.
Is Physicians Insurance an accredited sponsor?
Yes!
What other organizations in Washington State are CME sponsors?
Washington State currently has 28 sponsors of CME, including specialty societies, county medical societies, and hospitals.
What is the purpose of accreditation?
The purpose of accreditation of providers of CME is to assure physicians and the public that CME activities have been planned and implemented by a provider which has met accepted standards of education.
What is the process for becoming an accredited sponsor?
An organization can become an accredited CME sponsor through the national accreditation body, The Accreditation Council for Continuing Medical Education (ACCME) or the state medical association. The ACCME has developed standards by which state medical associations can accredit local institutions and be responsible for assuring compliance with these standards. The standards are known as the Essential Elements, Criteria and Standards of Accreditation. State medical association accreditation is appropriate for providers such as Physicians Insurance who design CME for a local audience (physicians within the state or its contiguous states). Whether accredited at the national or state level, the process involves completion of a lengthy application, an application fee, and a site survey by members of the accrediting organization. After reviewing the application and conducting the on-site survey, the survey team prepares a report summarizing its findings and submits the report to the WSMA CME Accreditation Committee, which makes the final decision regarding accreditation.
There are five categories of accreditation status:
- Exemplary Accreditation: six years
- Accreditation: up to four years
- Provisional accreditation (for initial accreditation only): up to two years
- Probation: up to two years maximum (with full accreditation status resumed when progress report on correction of deficiencies received, validated, and accepted by the WSMA)
- Non-accreditation: accreditation withdrawn or withheld for non-compliance
Physicians Insurance is one of six state CME providers with Exemplary status. Our current six-year accreditation period ends in February of 2008, at which time we will be scheduled for a re-accreditation survey.
What criteria are used for accreditation?
The WSMA requires institutions and organizations to demonstrate that they are capable of satisfying the essential elements and criteria before becoming accredited. These essential areas reflect those adopted by the ACCME. The WSMA collects, reviews, and analyzes data from three essential areas: Purpose and Mission, Educational Planning and Evaluation, and Administration.
- The Purpose and Mission area describes why the organization is providing CME.
- The Planning and Evaluation area explains how the organization provides CME and how well it is accomplishing its purpose.
- The Administration area defines what the organizational support and protocol are for the CME unit.
How is a CME course planned?
The first step is determining the educational need. At Physicians Insurance this is as simple as looking at our claims data for frequency and severity. More information on educational need can come from surveys to physicians, members of our committees, new practice guidelines or techniques, the medical literature, and many other sources.
The second step is to link identified education needs with desired results. This is done through learning objectives. The best learning objectives are built around a documented need that allows for measurement of results.
The third step involves evaluating the effectiveness of the CME course in meeting the identified need. The best way to do that is to demonstrate how, as the result of the course, improvements in practice, patient safety, or patient health were achieved.
Who is involved in CME planning?
The Risk Management/Education Committee at Physicians Insurance guides our choice of seminar topics and gives formal approval. A small planning group comprised of members of the target audience, the topic specialty group, and PI staff then use the information gathered on educational need to establish the learning objectives and how to best carry them out (methodology).
How do we know if our CME courses have led to improvements in practice or patient health?
If only we could capture the exact moment when, based upon learning at a CME course, a physician saves a patient’s life. While the factors involved in practice improvements are too numerous for one CME course to claim responsibility, there is a growing expectation from the accrediting bodies that CME ought to be able to prove its worth through measuring educational outcomes. Examples of outcomes measurement include:
- Before-and-after testing
- Before-and-after chart audits
- Post-course evaluations
- Follow-up surveys
Physicians Insurance has incorporated these methods into its program of CME. We continue to seek additional ways to design courses that will enable us to demonstrate that physicians are practicing better medicine for having participated.
