Forms Required for Programs Directly or Jointly Sponsored by the Carver College of Medicine

Introduction

The Carver College of Medicine is nationally accredited to provide category 1 (CME) credit by the Accreditation Council of Continuing Medical Education (ACCME). The following forms are required for any educational activity requesting category 1 (CME) credit. To review the ACCME's Updated Standards for Commercial Support, please follow this link.

Forms

Application.

Please note that due to new ACCME criteria for accreditation, we updated our CME application in May, 2009. We therefore ask that you do not use our previous application. Because of the complexity of some of the new criteria, we also require a face to face meeting with the course director prior to submitting your application.

Gap Analysis Documentation

You need to show evidence that a needs assessment was performed for your educational activity if you are seeking category 1 (CME credit.) This link will provide you with suggestions. Call 5-8597 if you have questions about the needs assessment process.

Brochure Template

If you have requested CME credit for your program, no announcements may be sent out without pre-approval from the CME office. This template can be used as a guide for required information and wording.

Sample Evaluation Form

Every CME activity must have an evaluation process that links outcomes to educational objectives. As part of this process, all attendees must be asked during the evaluation process whether they detected commercial bias in the educational activity.

Written Agreement for Commercial Support

This form must be filled out and signed every time a manufacturer of commercial health care products contributes financial support to your educational activity. All commercial support must be given to the department or CME office. Speakers may not receive renumeration directly from companies. Food and catering expenses may not be purchased directly by companies: the grant money must go to the department and departmental staff may then purchase food.

Faculty Disclosures (Last updated 12/05)

Every speaker and planning committee member is now required to disclose relevant financial relationships BEFORE they present or participate in the planning of a CME activity. The Course Director must review disclosures and resolve conflicts of interest for speakers before they can be included in your program. The CME Division has created a disclosure database - call 5-8597 for information. Please make sure all your speakers and program planners receive Content Validation Guidelines to use in preparation of their talk.

Per updated ACCME standards, anyone who does not disclose may not be involved in the planning or presentation of a CME activity. (see Standard 2.2)

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 4 elements of this policy before offering your speakers honoraria.

Script for Verbal Disclosure to the Audience

All financial disclosures must be made known to attendees BEFORE their presentation. Audience disclosures may be made in a variety of ways. For example: in a slide; verbal disclosure by the presenter or moderator; or in a handout included in the syllabus. The CME office can produce this report from our disclosure database. Call 5-8597 if you wish to request a hard copy report. This is a sample script that speakers and instructors can use to verbally disclose their financial relationships and/or mention of non-FDA-approved products.

Course Director Verification

PLEASE NOTE: THIS FORM IS TO BE COMPLETED BY THE DIRECTOR OF THE CME PROGRAM ONLY - NOT THE SPEAKERS. This form is to be filled out and signed by the course director within two weeks of the program, confirming that personal financial disclosures were reviewed prior to each session and conflicts of interest were resolved. This form also confirms that disclosures were made to attendees.

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 Category 1 (CME) credit can be assigned accordingly.

Check List

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