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Application for Accredited Continuing Education

Dignity Health - East Valley Office of Accredited Continuing Education

Dignity Health - East Valley is accredited by the Arizona Medical Association to provide continuing medical education for physicians.

Credit: AMA PRA Category 1 Credit(s)tm
1.Activity Type
2.Activity Date(s) and/or Pattern
3.Activity Title (include Department)
4.AMA PRA Category 1 Credit(s) can be applied to participating Boards for their continuing education requirements, such as Maintenance of Certification. Please select the Board you would like learners data reported to.
5.Professional Practice Gap(s): State the professional practice gap(s) of your learners, on which the activity was based (Knowledge, Competence, and/or Performance). The difference between what physicians are currently doing in practice and what is considered best or ideas practice. 

Example:  Not all providers are aware of changes to current standards of care in genomic testing for breast cancer patients and how it establishes better chemotherapy benefits.  (Required.)
6.Educational Need: Based on identifying the gap(s) what is the need? Example: This activity will provide knowledge/strategy (what specifically) to help close the practice gap(s).

Example: Clinicians need to adhere to current standards of care, including the entire cancer team. Recent literature reviews and sources (list source) show genomic testing for breast cancer to improve chemotherapy targeting. Also, mammoprint has been shown to be better than Oncotype DX for prediction. There is a need to compare Oncotype DX to mammoprint, as outlined in literature and follow optimal testing protocols.
(Required.)
7.Include supporting material for the educational gap (peer reviewed journal, professional society data/article, hospital data, national data, etc.
8.2-3 overall objectives (see list of verbs below for measurable verbs to use and avoid)

Example: Select which patients will benefit from chemotherapy; Utilize optimal genomic testing protocols(Required.)
9.Topics that will be included in your agenda
10.DESIGNED TO CHANGE: competence, performance, or patient outcomes(Required.)
11.Educational Format(Required.)
12.Target Audience(Required.)
The provider develops activities/educational interventions in the context of desirable physician attributes (competencies)
13.Competencies demonstrated in this activity:
Analyzes Change
The provider analyzes changes in learners (competence, performance, or patient outcomes) achieved as a result of the overall program's activities/educational interventions.
The accredited provider is asked to collect data and information about the changes that result from it's educational interventions, including changes it expects learners to make, changes that learners actually make, and/or the impact on patients. Using this data and information, the provider is asked to look across all it's activities and analyze its impact on terms of those changes. 
The Office of Accredited Continuing Education will provide an evaluation to analyze changes in learners competence and/r performance achieved as a result of the overall activity.
Standards for Integrity and Independence in Accredited Continuing Education


The Standards for Integrity and Independence in Accredited Continuing Education are designed to ensure that accredited continuing education serves the needs of patients and the public, is based on valid content, and is free from commercial influence. 
Ineligible companies are defined as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. 

Owners and employees of ineligible companies are considered to have unresolvable financial relationships and must be excluded from participating as planners or faculty, and must not be allowed to influence or control any aspect of the planning, delivery, or evaluation of accredited continuing education (there are 3 exceptions the Office of Accredited Continuing Education will consider on case-by-case basis)
Standard 1: Ensure Content is Valid Review Standard 1
14.I attest as Course Director I have reviewed and will comply with Standard 1
Standard 2: Prevent Commercial Bias and Marketing in Accredited Continuing Education  Review Standard 2
15.I attest as Course Director I have reviewed and will comply with Standard 2
Standard 3: Identify, Mitigate, and Disclose Relevant Financial Relationship Review Standard 3
16.I attest as Course Director I have reviewed and will comply with Standard 3
Standard 4: Manage Commercial Support Appropriately Review Standard 4
17.I attest as Course Director I have reviewed and will comply with Standard 4
Standard 5: Manage Ancillary Activities Offered in Conjunction with Accredited Continuing Education Review Standard 5
18.I attest as Course Director I have reviewed and will comply with Standard 5
19.Course Director(Required.)
20.Planning Members
Course Director(s) and Planning members must complete a Disclosure Form annually, please forward this link DISCLOSURE FORM
21.The CME department does not provide marketing services or is a funding source for the activity. We will secure exhibitors and/or educational grants with your assistance identifying sources. Your CME activity will be listed in the CME Calendar accessible via our website CME Activities Website
22.The CME department will provide on-site registration and evaluation support for accreditation purposes, but does not provide on-site logistical (food, beverage, gifts) or Audio Visual support.
23.Please submit your agenda/schedule to staci.king@commonspirit.org or shelly.imburgia@commonspirit.org including presenter name, topic, and contact information as soon as possible.
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