AAFP CME Credit System
AAFP CME Credit Activity Types
CME activities that have relevance to family medicine by helping family physicians improve patient care, improving the family physician's professional ability, and demonstrating high educational, ethical and medical standards may apply for AAFP CME credit. Such activies may include:
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Activities that involve two or more physicians in “real time” and allow for interaction among participating physicians. These activities also include medical staff series and training programs.
Self-study activities, including audio, CD ROM, online, print, and video.
Collection of articles in audio, online, print or video format.
Performance improvement (PI) activities describe structured, long-term processes by which a physician or group of physicians can learn about specific performance measures1, retrospectively assess their practice, apply performance measures prospectively over a useful interval, and reevaluate their performance. To award AAFP Prescribed credit for PI activities, 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). Improvement activities may address any facet (i.e., structure, process or outcome) of a physician’s practice with direct implications for patient care.
- Provide clear instructions to the learner that define the educational process of the PI activity (documentation, timelines, etc.) and establish how they 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 behind those measures. Providers may deliver this education through live activities, enduring materials or other means.
- Have an Active, Life, or Supporting AAFP member involved in the planning/ review of the overall CME activity.
To develop a complete, structured performance improvement activity, providers must ensure that participating physicians integrate all three stages described below.
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.
- A clinical performance measure is a mechanism that enables the user to quantify the quality of a selected aspect of care by comparing it to a criterion. (Institute of Medicine, 2000.)
- Evidence-based medicine is "the integration of best research evidence with clinical expertise and patient values." (Sackett DL, Strauss SE, Richardson WS, et al. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. London: Churchill Livingstone; 2000.)
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 then 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 continuing medical education 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 Prescribed credits for the completion of each 3-step process. There must be a mechanism either by the sources 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. The 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 CME credit. The CME provider will need to submit an online application.
It is the responsibility of the CME provider to:
- Plan the educational activity in collaboration with and utilizing an AAFP-approved point of care source.
- 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 Active, Life, or Supporting AAFP member in the planning/review of the overall activity.
- Provide learners with the AAFP activity number and documentation of completion of the activity (CME certificate or letter of participation). Note: AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 Credit™ toward the AMA Physician's Recognition Award.
- Evaluate the activity.
- Maintain participation records for one year.
AAFP-Approved Point of Care Sources
- Essential Evidence Plus
- Physicians Information and Education Resource (PIER)
Approved Life Support Courses
The Commission on Continuing Professional Development (COCPD) has awarded Prescribed credits for the activities listed below.
REQUIRED: AAFP CME CERTIFICATION
All ALSO and BLSO CME providers are required to submit a CME activity application. Once the official credit approval is sent, the AAFP CME certification statement may be used on promotional materials.
|ALSO||Advanced Life Support in Obstetrics, sponsored by the American Academy of Family Physicians.|
|Provider Course||Maximum 19 Prescribed|
|Instructor Course||Maximum 9 Prescribed|
|BLSO||Basic Life Support in Obstetrics, sponsored by the American Academy of Family Physicians.|
|Provider Course||Maximum 8 Prescribed|
OPTIONAL: AAFP CERTIFICATION
AAFP members may self-report Prescribed credit for completing the following life support activities without documentation.
CME providers have two options:
1. Do not apply for AAFP CME credit. However, no reference to AAFP certification can be made on promotional materials.
2. Submit a CME activity application. Once the CME provider receives the official credit approval, the AAFP CME certification statement may be used on promotional materials.
|BLS||Basic Life Support, sponsored by the American Heart Association.|
|ACLS||Advanced Cardiac Life Support, sponsored by the American Heart Association.|
|Adult Provider Course|
|Adult Instructor Course|
|PALS||Pediatric Advanced Life Support, jointly sponsored by the American Heart Association and the American Academy of Pediatrics, administered by AHA.|
|NRP||Neonatal Resuscitation Program, jointly sponsored by the American Heart Association and the American Academy of Pediatrics, and administered by the American Academy of Pediatrics.|
|ATLS||Advanced Trauma Life Support, sponsored by the American College of Surgeons.|
|Student Course||2 days - 19 Prescribed|
|2 1/2 days - 19.5 Prescribed|
|Student Refresher Course||1/2 day - 5 Prescribed|
|Student Refresher Course||1 day -7.5 Prescribed|
|Instructor Course||15 Prescribed|
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 in the course of a live CME activity.
To be eligible for CME credit the following information is required to be included when completing the AAFP application:
- The session(s) must be listed on the agenda.
- Submit the title and learning objectives for each exhibit/poster.
- Provide a description of how each poster/exhibit session will be evaluated.
This type of activity is eligible for up to two (2) credits per day of a live CME activity.
Procedural Training Skills
The Commission on Continuing Professional Development (COCPD) established the following criteria to be used for activities which teach procedural skills. In the opinion of the AAFP, the criteria must included in any activity intended to lead to the ability to independently perform a procedure or to lead to readiness 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 instructor(s) in the activity should have significant personal experience in performing the procedure(s) that is being taught and should be capable of teaching the procedure.
If the objective of a procedural skills activity is to inform and educate, but not 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 in 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. The AAFP requires that CME activities of four hours or more in length include a fifteen-minute break.
CME providers may submit an online CME application or complete the Application for Approval of Live Activities in Word. Only one application is required per year for each type of series activity a CME provider produces. The application should include the following information:
- Series title (example: St. Luke's 2009 Grand Rounds)
- Series beginning and ending dates (example: January 3 - December 18, 2009)
- Day of the week or month on which the activity will be held (if regularly scheduled)
- 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 beginning/end time
- List of all activity dates that have been confirmed at the time of submission
To receive AAFP CME credit, the first date, topic and speaker (or speaker source) must be submitted with the original application to AAFP for CME approval. CME providers must submit their additional dates (sessions), topics, speakers, and learning objectives on a monthly/quarterly basis throughout the year. They may add this information as additional sessions by logging in online. Providers should include a copy of the official CME credit approval form or application number with this additional information. A new credit approval form will be sent by e-mail showing the additional credits approved.