Continuing Education in Simulation

Profession

Accrediting CE organization

Physicians

Accreditation Council for Continuing Medical Education (ACCME)

Nurses

American Nurses Credentialing Center (ANCC)

Pharmacists

Accreditation Council for Pharmacy Education (ACPE)

Respiratory care

American Association of Respiratory Care (AARC)

Paramedics/emergency medical services (EMS) personnel

Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS)

Accreditation Council for Continuing Medical Education (ACCME)

The ACCME, founded in 1981, is a nonprofit corporation based in Chicago, Illinois [1]. The ACCME accreditation system provides accreditation to US institutions that offer continuing medical education (CME) to physicians and other healthcare professionals. The mission of the ACCME is “the identification, development, and promotion of quality continuing medical education utilized by physicians in their maintenance of competence and incorporation of new knowledge to improve quality medical care for patients and their communities” [1].

Participation in accredited CME assists physicians in meeting the requirements for maintaining licensure, maintaining board certification specialties, credentialing, sustaining membership in professional societies, and upholding other professional privileges. State medical boards vary in the specific number of CME hours required for license renewal. While some states have no CME requirements for license renewal, others require up to 50 credits per year [4]. Approximately 700 organizations are ACCME-accredited as CME providers, including medical schools, nonprofit physician organizations, healthcare delivery systems, publishing and education companies, government and military organizations, and insurance and managed-care companies. Approximately 23 million healthcare professionals attend more than 125,000 ACCME activities/programs annually [1].

The American Nurses Credentialing Center (ANCC)

The ANCC is the nation’s leader in accreditation of continuing nursing education and provides standards to ensure quality programs. The mission of the American Nurses Credentialing Center is “to promote excellence in nursing and healthcare globally through credentialing programs” [2]. ANCC has both accredited providers, which are organizations that provide their own continuing education activities, and accredited approvers, which are organizations that approve continuing education activities for nonaccredited organizations. Nursing CE requirements for license renewal also varies by state.

Accreditation Council for Pharmacy Education (ACPE)

The ACPE establishes the standards for the education of pharmacists [3]. In 1975, the ACPE started accreditation for continuing pharmacy education. The Board of Directors of the ACPE is chosen from the American Association of Colleges of Pharmacy, the American Pharmacist Association, the National Association of Boards of Pharmacy, and the American Council on Education. A list of ACPE accredited providers can be found on the ACPE website (https://www.acpe-accredit.org).

Joint Accreditation

These three organizations, the ACCME, ANCC, and ACPE, have collaborated to develop a joint accreditation opportunity for providers, granting a Provider of Interprofessional Continuing Education designation to qualifying entities. Organizations that retain this accreditation may also offer continuing education credit for physicians, nurses, or pharmacists separately.

Steps in Planning Simulation-Based CE Activities

The planning steps for providing continuing education are similar across most of the healthcare disciplines.

Assess learner needs and professional practice gaps. Learner needs are assessed by various methods, including surveys of the target audience, self-recognition through pretesting, clinical quality indicators, focus groups, and literature and regulatory review, just to name a few. A practice gap will exist when new evidence or guidelines are released that require learners to update their knowledge [5].

Identify the learner population. The learner’s stage of professional development and area of specialty will define the scope and content of the CE activity [5]. Some activities are designed for a single discipline, while others are developed with an interprofessional focus.

Create a planning committee. The planning committee should consist of the following: a planner from each discipline represented within the learner population, an education specialist, a content expert, and a member of the target audience. If ANCC credits are being offered, a nurse planner must also participate in planning the CE content [2].

Identify learning objectives for the activity. The planning committee will develop overall goals for the educational program as well as specific objectives that address identified learner gaps. Each individual activity will have specific learning objectives containing an action component, a subject component, and a measurable outcome.

Develop a budget. A budget, developed early in the process, will guide the planning committee on how much can be spent on faculty, printing, audiovisual needs, room fees, etc. Also, if expected revenue is intended to cover expenses, a budget will assist in setting registration fees.

Develop activity content and corresponding learning formats. Content for the educational activity is developed under the direction of the planning committee. The planning committee is charged with developing targeted and effective content to provide interventions for identified learner gaps. Content can be developed in a number of ways, but it is always under the guidance of needs-based assessment findings. Instructional strategies, delivery methods, learner feedback mechanisms, and the learning resources/modalities are all components of the content development process.

Select facilitator/faculty. The course director and faculty are instrumental in developing the specific learning objectives, cases, prerequisites, and evaluation methods for the learning activity. Thus, the selected faculty participants should be content experts specific to the discipline and knowledgeable of the overall goals of the learning activity.

Resolve potential conflicts of interest. Disclosures of financial interest should be obtained from all activity planners and presenters to identify existing financial, professional, or personal relationships with entities producing healthcare or simulation-related goods and services. Those relationships must then be assessed to determine if the potential exists for commercial bias in the educational activity [6].

Create the evaluation methods. The planning committee and faculty will plan, design, and review evaluation tools and methods. Most CE activities use an evaluation survey, or “happy sheet,” to capture the reaction of the learners which is the lowest of Kirkpatrick’s levels of evidence [7]. Faculties are encouraged to find ways to evaluate learner changes in knowledge and behavior. Knowledge acquisition can be measured by pre- and posttests of participants, as well as through observations. Behavior changes are more difficult to measure because the desired changes typically occur over time.

10.

Apply for CE credit through an accredited approver. If an organization is not accredited, but wishes to provide continuing education activities, CEUs can be obtained through an application process to an accredited approver. A list of accredited approvers can generally be found on each accrediting organization’s website [1–3]. When applying for CE through an accredited approver, the lead planner for the educational activity is required to complete an application process and provide supporting documentation, fees, and post-activity documents. The sponsoring organization can choose to offer CE credits for one or multiple disciplines. If applying for ANCC credits, a lead nurse planner must be identified.

11.

Promote and advertise the activity. After the activity is planned and the CE credits are approved, promotion of the program occurs. A cost-effective way to promote the CE activity is through emails to target audience members and on Internet websites.

12.

Implement activity logistics. The planning committee develops and implements the infrastructure for the entire educational activity. The logistical implementation of the learning activity is often assisted by meeting coordinators and event professionals proficient in handling educational activity management.

13.

Maintain activity records. Providing comprehensive reports about the learning activity process is essential in order to precisely detail all undertakings/actions associated with the activity. Thorough records include planning committee minutes, communication regarding content development and learner assessment, faculty disclosure statements, documentation of resolutions to identified faculty conflicts of interest, industry support documentation of any financial or in-kind support given to the educational program, certificates of attendance, participant and faculty listings, financial documentation, and final course promotional materials.

Providers of Continuing Education in Healthcare Simulation

Listed below are some of the major national and international interdisciplinary organizations that provide continuing education in simulation.

Society for Simulation in Healthcare (SSH)

The Society for Simulation in Healthcare (SSH) is the world’s largest professional organization representing the field of healthcare simulation. The society is multidisciplinary, representing all fields and specialties in healthcare.

The society first convened in 1995 and 1996 in Rochester, NY, as a group of anesthesia educators interested in simulation. The society officially came into existence in 1998 and 1999 at a joint conference with the Society for Technology in Anesthesia (STA). Known as the International Meeting on Medical Simulation (IMMS), early organizers broadened the scope of the conference to include other medical specialties and healthcare providers. At the time, the meeting was small with between 100 and 250 participants. The IMMS continued as part of STA for several more years, and participation steadily increased. It became evident to leaders that a critical mass had been reached and the time had come to establish an independent society. The Society for Simulation in Healthcare was officially established in 2004.

The society annually hosts the largest international gathering of simulation educators and researchers at its International Meeting on Simulation in Healthcare (IMSH). The annual offering in 2012 broke attendance records with over 3,100 participants registered from 37 different countries.

The CE program designed for IMSH offers a comprehensive selection of continuing education courses for healthcare simulation administrators, managers, educators, researchers, and simulation technicians. Over 300 individual courses are offered throughout the 5-day meeting. Each of these individual learning activities is designed using the ACCME and ANCC criterion for the development of continuing education activities. Continuing education units (CEUs) are awarded after learner participation has concluded.

There are various learning formats offered at IMSH. The plenary sessions showcase leaders in healthcare simulation, as well as inspirational and innovative speakers who are on the cutting edge in related disciplines. Didactic lectures, expert panels, round table discussions, and hands-on workshops offer venues to accommodate varied learning styles. At IMSH are the immersive courses, in which faculty and learners re-create simulated learning environments, design and develop curriculum and delivery methods, train faculty, and perform various assessment techniques.

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