In response to the American Board of Medical Specialties (ABMS) White paper on CME for Maintenance of Certification (MOC), the Alliance for Continuing Medical Education recently sent its comments to the Joint Working Group on MOC and CME.
The Alliance for CME is an association of 2,300 professionals, dedicated to accelerating excellence in healthcare performance through education, advocacy, and collaboration. The diverse membership of the Alliance includes educators from hospitals and healthcare systems, medical schools, medical specialty societies, government agencies, medical education companies, healthcare education associations, state medical societies and industry.
In its comments, the Alliance recognized that CME provider organizations’ adherence to the current standards established by the three CME accreditation agencies (AAFP, AOA, and ACCME), result in education activities that meet the criteria suggested within the white paper.
The Alliance also expressed concern over recommendation #4 of the white paper, which would develop a “standard currency” for MOC CME that would “identify the special nature of CME programming that meets the identified characteristics of MOC CME.” The Alliance stated that this recommendation suggests the operational prospect of a “tiered system” of CME, where the “top tier” would be MOC CME, as determined by the ABMS and/or its member Boards. As a result, the Alliance recognized that this would allow ABMS and member Boards to function as a secondary accreditation system. The Alliance asserted that this is an unnecessary layer of bureaucracy for the current system.
In addition, the Alliance also expressed concern about the use of the word “assist” in the white paper recommendations. They stated that this “vague statement allows for multiple interpretations” and that it suggests that all Boards will overstep the customary boundary of Boards as evaluation organizations by moving into the purview of education, a role held by CME provider organizations.
The Alliance also explained that many of the items listed are already covered by standards incorporated in the accreditation and credit systems already in existence.
Furthermore, the Alliance explained that the white paper recommendation about reducing or eliminating the influence of commercial entities is unnecessary because ACCME’s Standards for Commercial Support already put a general framework in place to address this issue. Accordingly, the Alliance Board of Directors stated that it did not “see the need to develop a new framework, although they did support the efforts of the ACCME to assure the public that these Standards are being enforced.
In this comment, the Alliance also pointed to recent research that has shown no increase in learner perceptions of content bias when compared with activities that were not supported by commercial interests. As a result, the Alliance recommended that rather than “eliminate an important source of education funding, the Working Group consider recommending the development of new sources of funding.”
Overall, the Alliance believed that the white paper was too narrow because it did not mention how the continuing professional development of physicians and other healthcare professionals could be more effective and better positioned to improve the health of the public. Moreover, the Alliance stated that the current document does not provide clear guidance to the 25 member Boards for the design, systems-based approach that translates the best science and bias-free knowledge into effective, high quality continuous professional development programs.
Ultimately, the Alliance believes that physician continuing professional development needs to be more linked with improved patient care and consideration of multidisciplinary approach to education that highlights the need for patient-centric/workplace learning, all of which should focus on the improvement of patient care and outcomes.