AAFP Credit System
AAFP Credit Activity Types
CME providers may apply for AAFP credit for activities that are relevant to family medicine because they help family physicians improve patient care; improve the family physician's professional ability; and demonstrate high educational, ethical, and medical standards. Such activities may include:
Live activities involve two or more physicians in “real time” and allow for interaction among participating physicians. These also include regularly scheduled series and training programs.
Scientific Exhibits and Posters
Scientific exhibits and scientific poster sessions are eligible for CME credit when authors are available for interaction with learners during one or more designated times during the course of a live CME activity.
To be eligible for CME credit, you must include the following information when completing the AAFP application:
- List of the session(s) on the agenda
- Title and learning objectives for each exhibit session/poster
- Description of how each exhibit session/poster will be evaluated
This type of activity is eligible for up to two credits per day of a live CME activity.
Procedural Training Skills
The Commission on Continuing Professional Development (COCPD) established the following criteria for CME activities that teach procedural skills. In the AAFP’s opinion, the criteria must be met by any activity intended to give learners the ability to independently perform a procedure or to prepare learners for preceptoring/proctoring.
- Indications for the procedure
- Contraindications for the procedure
- Informed consent/patient counseling
- Patient preparation/education
- Anesthesia, analgesia, sedation (as appropriate)
- Equipment selection
- Cleaning, disinfection, maintenance, and, where appropriate, sterilization of equipment
- Patient positioning
- Technique (including an opportunity for learners to develop psychomotor skills models, simulators, etc.)
- Pathology recognition
- Management of complications
- Practice management aspects
- Patient monitoring/resuscitation
- Outcome evaluation
In addition to the above, the trainee should be evaluated on: 1) cognitive knowledge, 2) psychomotor skills/technique, and 3) visual recognition of pathology, if appropriate.
The activity instructor(s) should have significant personal experience in performing the procedure(s) being taught and should be capable of teaching the procedure(s).
If the objective of a procedural skills CME activity is to inform and educate, but not to provide an in-depth level of skill, these criteria are not an essential part of the activity.
Series activities are a preplanned set of regularly scheduled (e.g., weekly, monthly, quarterly) conferences that occur at one location/institution during a one-year period. The conferences offer different topics related to a unifying theme under an umbrella title (e.g., Family Medicine Grand Rounds, Tumor Boards, Issues in Primary Care). The conferences must be uniform in length and may not exceed four hours or 3.75 credits each.
CME providers may submit an online CME application. Only one series application is required per year. The application should include the following information:
- Series title (example: St. Luke's 2015 Grand Rounds)
- Series begin and end dates (example: January 3 - December 18, 2015)
- Day of the week or month on which the activity will be held (if consistent)
- Anticipated maximum number of CME credits offered per year (e.g., weekly one-hour conferences of 1 credit each = 52 credits)
- List of topics with title, session specific learning objectives, speaker, and begin/end time
- List of all activity dates that have been confirmed at the time of submission
To receive AAFP credit, submit the date, topic, learning objectives, and faculty of the first session with the original application. CME providers must submit information about additional sessions (dates, topics, learning objectives, and faculty) on a monthly/quarterly basis throughout the year. CME providers may add this information by logging into the CME Provider Dashboard online.
Enduring materials are activities based on independent learning materials designed primarily as self-study activities.
Medical journals are activities based on regularly published collections of articles intended for medical professionals. The participant reads an article; engages in a self-directed phase stipulated by the CME provider that may include reflection, discussion, or debate about the article; and completes a pre-determined set of questions or tasks related to the article content.
Performance improvement (PI) activities describe structured, long-term processes by which physicians learn about specific performance measures, retrospectively assess their practice, apply performance measures prospectively over a useful interval, and reevaluate their performance. To award AAFP Prescribed credit for PI activities, CME providers must:
- Establish an oversight mechanism that assures content integrity of the selected performance measures. These measures must be evidence-based2 and well-designed (e.g., required data elements are clearly specified, data collection is feasible). Performance improvement activities may address any facet of a physician’s practice that has direct implications for patient care (i.e., structure, process, or outcome).
- Provide clear instructions to the learner that define the educational process of the PI activity (e.g., documentation, timelines) and establish how the learner can claim credit.
- Validate the depth of physician participation by a review of submitted PI activity documentation. When requested, supply specific documentation of such credit to participating physicians.
- Provide adequate background information so that physicians can identify and understand: a) the performance measures that will guide their PI activity, and b) the evidence base for those measures. CME providers may deliver this education through live activities, enduring materials, or other means.
- Have an AAFP active or life member involved in the planning/review of the overall CME activity to ensure the content’s relevance to the specialty of family medicine.
To develop a complete, structured PI activity, CME providers must ensure that participating physicians integrate all of the following three stages:
Stage A: Learning from current practice performance assessment
Assess current practice using identified performance measures, either through chart reviews or some other appropriate mechanism. Participating physicians should be actively involved in data collection and analysis.
Stage B: Learning from the application of performance improvement to patient care
Implement an intervention based on the performance measures selected in Stage A using suitable tracking tools (e.g., flow sheets). Participating physicians should receive guidance on appropriate parameters for applying an intervention and assessing performance change, specific to the performance measure and the physician’s patient base (e.g., How many patients with a given condition, seen for how long, will produce a valid assessment?).
Stage C: Learning from evaluation of the performance improvement effort
Reevaluate and reflect on performance in practice (Stage B) by comparing to the assessment done in Stage A. Summarize any practice, process, and/or outcome changes that resulted from conducting the PI activity.
The AAFP recognizes point-of-care CME as practice-based learning that takes place in support of specific patient care. The physician uses a computer-based clinical decision-making support tool at the point of care to ask a clinical question, search evidence-based sources for practice recommendations, and apply a recommendation appropriately to the patient. Even in cases when the evidence-based recommendation is not appropriate for the patient, the physician still learns something in the process.
Because this is relevant, evidence-based CME that meets a physician’s specific learning needs, it is appropriate to award AAFP Prescribed credit for documented point-of-care learning activities.
AAFP-approved point-of-care CME activities allow learners to claim 0.5 AAFP Prescribed credits for the completion of each three-step process. There must be a mechanism—either from the source or from the CME provider—to document the following elements:
- The learner's question
- The search of an AAFP-approved source
- Implementation of new knowledge into practice
It is not necessary for all three of these elements to be documented at the point of care. For example, if the point-of-care source captures the clinical question and the search, the physician may document implementation at a different time (e.g., at the end of the clinic day), or the point-of-care CME provider may capture implementation data from the physician as a part of documentation of earned credit.
It is the CME provider's responsibility to ensure that the three parts of the point-of-care learning experience are properly documented. AAFP members can claim up to 20 credits per year toward membership re-election.
Point-of-Care CME Activity Approval
Any CME provider is eligible to use a point-of-care source to provide point-of-care CME activities and apply to the AAFP for credit. The CME provider must submit an online application.
The CME provider must do the following:
- Ensure the CME properly documents the three required elements of the point-of-care learning activity (i.e., the clinical question, the search history, and the implementation in practice)
- Involve an AAFP active or life member in the planning/review of the overall activity. The CME activity must have an AAFP active or life member directly involved in the planning of the activity to ensure the content’s relevance to the specialty of family medicine.
- Provide learners with the AAFP activity number and documentation of completion of the activity (i.e., CME certificate or letter of participation). Note: AAFP Prescribed credit is accepted by the American Medical Association (AMA) as equivalent to AMA PRA Category 1 Credit™ toward the AMA Physician's Recognition Award (PRA).
- Evaluate the activity
- Maintain participation records for one year
CME providers may also add a Translation to Practice component to any live, enduring, or medical journal activity using a three-step process that complements CME activities already approved for AAFP Prescribed credit.
Learners will have the opportunity to apply what they learned in the CME activity and document how learned concepts were translated into practice.
The three-step process:
Step 1: Commitment to Change – Learners complete a Commitment to Change statement stating what it is they wish to change in their practice.
Step 2: Implement Change – Learners implement indicated change into practice.
Step 3: Post-Activity Response – Learners evaluate whether the implemented change resulted in improved patient care.