Continuing Medical Education

  • FORMS, DOCUMENTS AND REQUIREMENTS

    Application

    To receive a current application that can be filled out electronically, please call the Division of Continuing Medical Education at (319) 335-8599 and ask to speak to one of our event coordinators. We ask that you not type over your previous year's application because you may not be working with the most current document. The application must be filled out by the course director to receive approval.

    Application Guide

    This document will help you complete a successful application. Submission of an application does not ensure approval.

    Gap Analysis and Educational Needs Assessment

    You must show evidence that you have identified:

    1. A gap in physician knowledge, competence or performance
    2. How the educational intervention was designed to close that gap and improve the care of patients

    Please call our office at (319) 335-8597 if you have questions about gap analysis.

    Commercial Support

    Written Agreement for Commercial Support

    This form must be filled out and signed every time a commercial company contributes financial support to an educational activity. A commercial supporter is defined by the ACCME as a company that manufactures health care products used on patients. Examples would include pharmaceutical companies, medical device companies, and medical equipment companies. 

    • All commercial support funding must come through the CME office or your departmental administrator.
    • Please be sure you are familiar with UI Health Care's Conflict of Interest Policy.
    • Speakers may not receive payments directly from commercial companies. UI Health Care faculty are not allowed to participate in Speaker's Bureaus for industry.
    • Food and catering expenses may not be purchased directly by companies and brought to the educational program. Funding must go to the department or CME office who may opt to use the funding for meals or snacks.

    Conflict of Interest Disclosure and Review

    Every speaker and planning committee member is required to disclose relevant financial relationships before they present or participate in the planning of a CME activity. Per updated ACCME standards, anyone who does not disclose may not participate in the planning or presentation of a CME activity (see Standard 2.2). The course director or CME office must review disclosures and resolve conflicts of interest for planning committee members and speakers before individuals can be included in a program.

    UI Health Care Speakers & Planning Committee Members

    • Disclosure:  UI Health Care speakers/planning committee members should disclose through the Conflict of Interest Office's eCOI Database
    • Review:  Course Directors can view UI Health Care speakers' conflict of interest disclosures, and they can complete conflict of interest review reports at CME Division Disclosure and Conflict of Interest Review (contact Susan Zollo (5-8597) in the CME Office if you do not have access)

    Non-UI Health Care Speakers & Planning Committee Members

    Disclosure to Learners

    All financial disclosures must be made known to attendees before the program or presentation begins. This can be accomplished in a variety of ways, including in a slide, verbal disclosure by the presenter or moderator, or in a handout included in the syllabus. Click the following link for a sample script that speakers and instructors can use to verbally disclose their financial relationships:  Script for Verbal Disclosure

    Course Director Verification 

    Course Directors should fill out and sign the Course Director Verification form within two weeks of the completion of a program (at the end of the fiscal year for RSS). This will serve as confirmation that financial disclosures were reviewed prior to each session, and that conflicts of interest were resolved, as well as confirming that disclosures were made known to learners. PLEASE NOTE:  THIS FORM IS TO BE COMPLETED BY THE COURSE DIRECTOR--NOT SPEAKERS. 

    Honoraria Policy 

    The ACCME now requires the accredited provider (Carver College of Medicine) to have an honoraria policy in place to further ensure that all presentations are free of commercial bias. Please be sure to review the four elements on the last page of this policy before offering your speakers honoraria. The current cap is $2,000 per presentation.

    Additional Forms

    Change Form

    Every attendee should be given a change form to fill out if they do not attend the entire meeting (for example, if they arrive late or leave early or miss some of the presentations.) Return the completed forms to our office so that credit can be assigned accordingly.

    Checklist of Required Forms and Documentation 

    Use this list to make sure you understand and have procedures in place for all requirements.

    Brochure Template

    If you have requested CME credit for your program, no announcements may be sent out without pre-approval from the Division of Continuing Medical Education. The brochure template can be used as a guide for required information and wording, even if your only announcement is on a website or in a letter.

    Sample Evaluation Form

    Every CME activity must have an evaluation process in place that links outcomes to educational objectives.