The American Academy of Family Physicians (AAFP) provides CME designed to help family physicians improve the care and service they offer their patients while increasing the vitality and efficiency of the organizations in which they practice. The AAFP will present scientifically valid and commercially unbiased content based on principles of effective adult learning in group activities, self-study / enduring materials, and journals using a variety of media and in practice-based settings where possible and evaluate its effectiveness. The goal of AAFP CME is to integrate current research findings and clinical practice guidelines presented with quantifiable levels of evidence, to incorporate continuous quality improvement (CQI) into a physician’s practice, and improve physician performance. --Adopted by the AAFP Board of Directors in March 2004
Standards for Industry-Supported Multimedia Educational Activities
AAFP CME Mission Statement
Why Multimedia?
The AAFP has always been a leader in CME. Now it is leading the way in multimedia education, both for physicians and for their patients. We set out to develop each new multimedia activity using the media most appropriate to the content and purpose – media that include print, audio tape, audio CD, video tape, CD-ROM, DVD, interactive programs for computers, personal digital assistants (PDAs) and the Web. By careful design and selection of media, we can help ensure that AAFP multimedia activities are as effective as possible for educating the audience and moving them to action.
Guiding Principles
Our chief goal is to produce top-quality activities that meet the educational and informational needs of family physicians and their patients. Our activities support high-quality health care and promote the health and well-being of the public. All AAFP activities are free of commercial bias, evidence based, peer reviewed, as scientifically accurate and up-to-date as possible at the time of publication, and professional in all respects.
Adherence to CME Standards
Educational activities for physicians carry CME credit and are developed in accordance with the following policies and guidelines:
CME activities developed by the AAFP are accredited by the AAFP for Prescribed Credit. All AAFP-developed activities are submitted for AAFP accreditation. In addition, AAFP chooses to follow the same guidelines in our development of consumer education materials.
Openness
We believe that users of our activities should be able to develop their own informed opinion of the reliability and integrity of the content. We inform users of pertinent facts about an activity’s history – the division of labor, the names of any funding organizations involved, and other special circumstances – either at the outset of the activity or in the activity’s content.
Authorship
We clearly identify authors at the beginning of each activity. We ask authors, editors, and reviewers to disclose any conflicts of interest or circumstances that might be deemed to affect the integrity of the content, and we resolve any conflict of interest prior to their participation. The AAFP recognizes the standards for authorship as described in the American Medical Association Manual of Style, 9th edition.
Editorial Control
The AAFP has complete, final control over the editorial content of all AAFP products and activities.
Role of Corporate Support
Funding
AAFP educational activities may be supported by educational grants from one or more commercial entities. Supporters may not supply additional funding independently to authors or anyone else involved in developing the activities they support.
Acknowledgment of Support
AAFP acknowledges financial support clearly in promotional materials and at the outset of each activity – typically on the packaging or inside front cover of printed material, on the opening screens of computer activities, and in the first few moments of audio or video presentations. Forms of acknowledgment differ depending on the intended audience:
- In activities designed for physician audiences, the form of acknowledgment is usually “supported by an educational grant from [name of organization]” or similar phrase. Specific products will not be mentioned in the acknowledgment. In online presentations, the name of a supporting organization can be linked to the organization’s corporate home page or an unbranded Web site, with an intermediate page alerting the user that he or she is leaving the AAFP Web site.
- In activities designed for lay audiences, the acknowledgment may mention a product in wording such as the following: “supported by a grant from [name of organization], makers of [product name].” In online presentations, the name of a supporting organization can be linked to the organization’s corporate home page, to a product-specific Web site or to an unbranded Web site, with an intermediate page alerting the user that he or she is leaving the AAFP Web site.
Relationship with Supporters
In keeping with ACCME and AAFP guidelines, the AAFP may invite supporters to suggest authors or provide relevant reference works (for example, articles from peer-reviewed scientific journals) to help us develop a multimedia activity, but the AAFP will make the final selection of author(s) and maintain control over the content of the activity. Supporters may have the opportunity to review activities once content is final but before the activity is released to ensure that the programs comply with federal regulations, but they may not recommend points to be covered or emphasized or take any other action intended to influence the content of the activity. A supporter may arrange to distribute some or all materials associated with an activity providing that they do not carry CME credit. Elements that carry CME credit must be distributed by the AAFP only.
Advertising
Institutional or corporate advertising – that is, advertising that makes no reference to individual products – may be included at the discretion of the AAFP as long as it does not violate ACCME Standards for Commercial Support or relevant AAFP policies. Product-specific advertising is permitted only in activities intended for lay audiences. Ads that include specific product names are not permitted to appear adjacent to editorial content on the same topic in materials published by AAFP.
Promotion of Multimedia Activities
Corporate supporters may disseminate information about an AAFP multimedia activity they support only at the request of and with the express permission of the AAFP; any such information produced must identify the activity as having been produced by the AAFP. AAFP must approve all promotional materials.
FDA Regulations
AAFP multimedia activities are educational, rather than promotional, and they comply with all FDA regulations concerning product labeling, promotion, and advertising. In all activities, unlabeled uses of pharmaceuticals are so identified, and where trade names are mentioned, those of several companies are typically used.
Ownership of Copyright
By letter of agreement, the supporter of a given activity supports development and initial distribution to a defined audience. The AAFP retains all rights to the original content of AAFP educational activities, including copyright. On completion of the project, the AAFP may choose to make the activity materials available for sale, for instance through the AAFP Catalog. The AAFP also reserves the right to modify and reuse the content for different applications. The original supporter may not be acknowledged in new applications of the content.
AAFP's Development Process
AAFP may invite potential supporters to provide grant support for AAFP activities. In addition, potential funders may approach the AAFP with an interest in supporting activities on a specific disease or health care issue. In that case, the AAFP evaluates the topic suggestion based on its educational needs assessment and organizational priorities. Based on the outcome of the needs assessment, the AAFP may suggest programs on the topic or may decline to pursue a project on the topic at this time, for instance on the grounds that it is not in keeping with the needs of the audience or too tightly focused on the realm of a particular product to avoid promotional overtones.
Where a subject and general approach can be agreed upon, the AAFP will prepare a proposal and cost estimate for discussion with the potential supporter. In the course of reviewing the proposal, we will also provide and review a copy of this Multimedia Standards document. Based on the outcome of the discussion, we will prepare a letter of agreement for the signatures of all parties.
On receipt of the signed letter of agreement and initial payment, the AAFP will immediately begin work on the activity by identifying an appropriate medical editor for the activity – typically a family physician with practice experience, knowledge of the subject area, and experience in writing and editing. The medical editor will be responsible for ensuring that the contents of the activity are current, accurate, balanced, and independent.
Working with the medical editor, the AAFP will review the literature, consult with subject-area experts to establish learning objectives, and select the best available faculty for the activity. (As mentioned above, the supporter may suggest faculty for consideration as part of this process. However, the AAFP gives priority to family physicians and those with no potential conflict of interest.) Depending on the scope of the activity, the AAFP may also arrange focus groups or other preliminary research.
When the faculty has completed draft materials for the activity, the AAFP will select two or more appropriate independent peer reviewers and ask them to review for accuracy, clarity, balance, and so on. As the results of the review process dictate, the AAFP will work with the faculty to revise the materials or work with the medical editor to produce an edited version that addresses points raised by the reviewers and meets the criteria of accuracy, clarity, and balance, as well as compliance with applicable guidelines and regulations, appropriateness to the intended audience, and suitability for the intended media. At the discretion of the AAFP, the edited drafts may be submitted to further layers of peer review and faculty revision.
When the content of the activity is essentially complete, but before final production, the AAFP will notify the supporter and, on request, send the supporter a copy for regulatory review. The supporter is expected to respond with any concerns within the specified deadline. If the supporter does not respond by then, AAFP will assume the supporter has no concerns and proceed with the project. If the supporter identifies concerns, AAFP will work with the faculty and medical editor to evaluate whether changes should be made to the activity. The activity will then be produced and distributed in accordance with the provisions of the letter of agreement.
Where a subject and general approach can be agreed upon, the AAFP will prepare a proposal and cost estimate for discussion with the potential supporter. In the course of reviewing the proposal, we will also provide and review a copy of this Multimedia Standards document. Based on the outcome of the discussion, we will prepare a letter of agreement for the signatures of all parties.
On receipt of the signed letter of agreement and initial payment, the AAFP will immediately begin work on the activity by identifying an appropriate medical editor for the activity – typically a family physician with practice experience, knowledge of the subject area, and experience in writing and editing. The medical editor will be responsible for ensuring that the contents of the activity are current, accurate, balanced, and independent.
Working with the medical editor, the AAFP will review the literature, consult with subject-area experts to establish learning objectives, and select the best available faculty for the activity. (As mentioned above, the supporter may suggest faculty for consideration as part of this process. However, the AAFP gives priority to family physicians and those with no potential conflict of interest.) Depending on the scope of the activity, the AAFP may also arrange focus groups or other preliminary research.
When the faculty has completed draft materials for the activity, the AAFP will select two or more appropriate independent peer reviewers and ask them to review for accuracy, clarity, balance, and so on. As the results of the review process dictate, the AAFP will work with the faculty to revise the materials or work with the medical editor to produce an edited version that addresses points raised by the reviewers and meets the criteria of accuracy, clarity, and balance, as well as compliance with applicable guidelines and regulations, appropriateness to the intended audience, and suitability for the intended media. At the discretion of the AAFP, the edited drafts may be submitted to further layers of peer review and faculty revision.
When the content of the activity is essentially complete, but before final production, the AAFP will notify the supporter and, on request, send the supporter a copy for regulatory review. The supporter is expected to respond with any concerns within the specified deadline. If the supporter does not respond by then, AAFP will assume the supporter has no concerns and proceed with the project. If the supporter identifies concerns, AAFP will work with the faculty and medical editor to evaluate whether changes should be made to the activity. The activity will then be produced and distributed in accordance with the provisions of the letter of agreement.
Other Policies of Note
- Supporting companies may not use or refer to the AAFP name, seal, logos, or other AAFP proprietary materials in any medium or format or without prior written approval from the AAFP.
- The AAFP has established online funding guidelines (http://www.aafp.org/funding.xml) to ensure that we produce top-quality, unbiased activities that meet the educational and informational needs of family physicians and their patients.
For additional information, please contact:
Denise German
Corporate Development Manager
AAFP Corporate Development
800-274-2237, Ext. 4430
dgerman@aafp.org
Lori Foley
Director of Corporate Relations
AAFP Foundation
800-274-2237, Ext. 4454
lfoley@aafp.org
Developed 09/20/02; Updated 03/10/05
Corporate Development Manager
AAFP Corporate Development
800-274-2237, Ext. 4430
dgerman@aafp.org
Lori Foley
Director of Corporate Relations
AAFP Foundation
800-274-2237, Ext. 4454
lfoley@aafp.org
Developed 09/20/02; Updated 03/10/05
