Wednesday, April 16, 2014

Continuing Medical Education (CME) for Physician Assistants

Continuing Medical Education (CME) for Physician Assistants
After you have finished the PANCE and thought you were all done with the NCCPA, you were wrong! So wrong! Continuing medical education credits are the next place they have come to steal your money, right before the next NCCPA exam, the PANRE. The six areas of PA competencies these CME credits evaluate are: medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning and improvement, and systems-based practice.

  • PAs must log 100 CME credit hours (with a $130 certification fee) every two years to maintain their national certification, per AAPA’s requirements.
  • Your CME earning and logging window is May 1st of the year your current certification was issued through December 31 of the certification expiration year.
    • If you have met your requirements for your current CME cycle, you can begin earning and logging credits for the next cycle on May 1st during the certification expiration year of your current cycle.
  • Additionally, each state may have their own specific CME requirements, which you can check here.
  • Of the 100 CME credits you must earn and log
    • At least 50 must be Category 1 CME
    • The remaining 50 credits can be Category 1, Category 2 or a combination of both.
  • CME can be classified as a Certification Program, Category 1 or Category 2.

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Category 1 CME
By definition, all Category 1 activities are sponsored (approved for credit) by one of the following:
  • American Academy of Family Physicians (AAFP)
  • American Academy of Physician Assistants (AAPA)
  • American Medical Association (AMA)
  • American Osteopathic Association (AOA)
  • Royal College of Physicians and Surgeons of Canada (RCPSC)
  • The College of Family Physicians of Canada (CFPC)
  • Physician Assistant Certification Council of Canada (PACCC)
Some Category 1 CME credits can be earned by attending seminars, conferences and online webinars. The CME program provider will issue you a certificate or letter of completion, indicating the number of CME credits you've earned during each program.

NCCPA advises you to keep Category I CME documentation for your *current CME cycle and your last CME cycle* as they may be audited.

The CME provider is the organization that offered the seminar, conducted the training, etc. Usually, providers are associations, hospitals, schools, pharmaceutical companies, or other health care organizations. You will need to enter the provider name when you log your Category 1 CME credits.

Types of Category I CME:
  • Live Program - formal lectures (including to PA students or medical professionals if the attendees are preapproved to receive Category I CME; otherwise, Category II), workshops, live teleconferences, and webinar instructions
  • Enduring Material Program - educational materials that may be used over time at various locations, retained for your own personal library, and which, constitute a planned educational activity. Approved for one year beginning from the activity start date. You need to reapply once the year of approval is over to ensure any new scientific developments are incorporated in the activity. Includes online activities, CD-ROMs and DVDs.
  • Self-Assessment CME - see below
  • Performance Improvement (PI) CME - see below
  • Regularly Scheduled Series - Hospitals, health systems, clinics, medical schools and other duty-of-care providers use this application for regularly scheduled series (RSS) including grand rounds, tumor boards, and M&M conferences.
  • Category I CME for Preceptors - PA programs may submit an annual application to receive eligibility to award their PA preceptors Category I CME. Maximum of 10 hours per calendar year. For more information visit AAPA.
  • Constituent Organization CME - conferences

How to Become Approved for Category I CME
For more information on how to become approved for Category 1 CME credit, please visit AAPA’s CME Providers. You’ll find information about approval guidelines and supporting documents at the bottom as well as a fee schedule. All CME requests are submitted online to AAPA here.

Category I Certification Programs
Certification and recertification programs include programs pre-approved by AAPA for a maximum number of Category I credits regardless of who is presenting the program or where they are presented. You must complete the entire program to log it as CME. You may earn and apply CME credits for the same certification program once per calendar year and no more than twice per logging cycle. You may also earn these credits as an instructor of a course.
A list of pre-approved certificate programs can be viewed here.
Examples include:
  • BLS
  • ACLS
  • PALS
  • ATLS

Category 1 PI & Self-Assessment CME
As of 2014, PAs will begin to transition to a new certification maintenance process. As part of this new process, PAs must earn and log at least 100 CME credits, including at least 50 Category 1 CME credits.

Additionally, each cycle 20 of those 50 Category 1 CME credits must be PI-CME and/or self-assessment CME credits. Acceptable activities are certified for AAPA Category 1 PI-CME credit or AAPA Category 1 Self-assessment CME credit.
  • At the end of 8 years (four 2-year CME cycles) you must have earned at least 40 category I CME credits through self assessment AND at least 40 category I CME credits through PI-CME activities
    • This means 40 of each = 80 credits total.
    • There are no requirements for PI or self-assessment CME in the 5th CME cycle.
  • This change applies to those who pass the PANCE in 2014 and practicing PAs who recertify in the 2012-2014 cycle. Others (including new graduates prior to 2014) transition after their next recertification cycle. You can also confirm your transition by logging into your NCCPA account and scrolling to the bottom by reading the “Transition to the New CME Process.” For more information visit AAPA.

Performance Improvement (PI) CME
PI-CME focuses on your own practice’s improvement needs in the context of team based care and consists of three stages:
  1. An initial assessment of your current practice in a specific clinical area with national benchmarks, performance guidelines and data submitted by other PAs
  2. Develop a plan of action to improve your practice based on your assessment and follow that plan by educating, creating resources, etc.
  3. Re-evaluate your practice to measure the effects of your improvements.
This CME does not require actual improvement to receive credit, but is meant to be reflective. A list of Performance Improvement (PI) CME can be found here.  

Here's a practical example from the NCCPA: the American Academy of Family Physicians' METRIC program includes modules on asthma, chronic obstructive pulmonary disease, coronary artery disease, depression, diabetes, geriatrics, hypertension and immunizations for high-risk adults. Participants select 10-15 patient charts, enter data into an online interface, and receive a report showing how their patients are doing relative to national standards or norms. The report also suggests areas where changes may make a positive difference. Participants implement the change(s) over the course of several months, and then enter another set of sample charts for a final report on the impact of the change. PAs can participate in a METRIC module and fulfill the 20-credit requirement for just $25.

Self-Assessment CME
In self-assessment CME activities, you will conduct a review of your own performance, knowledge, or skill set. The idea is to improve your performance, expand your knowledge, and hone your skills.
These activities are essentially in-depth medical knowledge tests.

This “assessment” is literally what it sounds like - an assessment. As such, you’re allowed to take it numerous times to gauge your own knowledge gaps. This way you can identify where you need help most. A list of Self-Assessment CME can be found here.

Category 2 CME
Category 2 CME is any medically related activity that enhances the role of a PA. Category 2 credits are earned on an hour-by-hour basis. There is no minimum requirement for Category 2 activities and no maximum on the number of credits that you can earn for any Category 2 activity. Category 2 credits are also not audited. They include:
  • Journal reading, listening to medical podcasts, medical text reading
  • Any practice-related program that is not eligible for Category I CME credit (educational programs provided by pharmaceutical companies and medical device manufacturers)
  • Any practice-related postgraduate course, excluding courses taken in actual PA programs
  • Precepting PA students and students of other professions
  • Lobbying activities on behalf of the PA profession
  • Committee work performed for PA or other healthcare organizations

With your AAPA membership, you can access Learning Central, an online portal with access to CME resources including CME post-tests. AAPA post-tests are approved for Category I CME credit. You can also access JAAPA post-tests much more by logging in. 70% is considered a passing score for earning CME credit. You may retake the exam more than once. For more information, visit AAPA.

AAPAs CME Calendar
AAPA lists a calendar full of CME events year-round that is free to members and non-members. In additional, you can use MyCME as an additional resource for events.

How to Log CME
Step by step instructions for logging CME credits can be found at NCCPA’s website here. You aren’t required to pay the CME logging fee the first time you log any credits, but you will be required to submit payment prior to submitting your documentation. You can get a print out of the CME you’ve logged by signing into your personal certification record and clicking on the “CME History” link. Before logging CME credit hours with NCCPA, make sure you have the following information:
  • Title of the program
  • Provider (organization administering the program)
  • Number of credits)
  • Sponsor (organization that designates the program for CME credit)

CME Auditing
To ensure the accuracy and professionalism of CME logging and to strengthen the value of the PA-C, NCCPA randomly audits the Category 1 CME credits of certified PAs. To complete the CME audit, randomly selected PAs must submit supporting documentation for at least 50 Category 1 credits logged during the cycle for which they are being audited.
  • PAs selected will be notified by e-mail and postal mail.
  • NCCPA will provide you with a CME Audit Transcript that will list all Category 1 activities logged for the cycle being audited.
  • If you are so lucky to be selected for a CME audit of your Category I CME (remember Category 2 is not audited), you’ll need to submit supporting documentation including certificates received upon completion of an activity from the CME provider, a hospital-generated list of programs attended, or written verification of attendance or credits earned from the provider of the CME activity.
  • Other documentation may be considered at the discretion of the NCCPA. Documentation should state that the activity has been approved by one of the CME sponsors and it should also indicate the number of credits awarded for the activity. If it does not state these requirements, it cannot be considered Category I CME! This is important! Make sure all of your documentation is in line after each activity!!
    • Example: If your documentation says the activity is for “contact” hours or “CEU” credit - this means the activity is NOT approved for Category I CME and the NCCPA cannot verify the credits logged unless the activity has already been pre-approved.
  • 6 weeks is given to submit your documentation for the audit and your exact deadline is listed in the e-mail and mailed notification and posted on your “My Record” page. However, you can request an extension for time to submit your documentation - a one-time 30-day extension.
  • The process takes 7-10 business days to complete an audit. You will be notified via e-mail or telephone.
  • If you cannot provide documentation for your credits being audited, you can supply documentation for additional credits not documented, but they must have been obtained during that same window.
  • If you fail your initial CME audit, you will NOT lose your certification. You will be audited for your next cycle and you must log your hours on paper. Acceptable documentation for all new hours acquired must be obtained. In addition, you must earn and log additional hours to replace those that could not be accounted for in your initial audit. You will also have to pay a $100 re-audit fee and you will be audited at least one time within your next three CME cycles.

For any other questions you may have, please visit NCCPAs FAQ or any of the links provided in the Sources section below.

PA Companion - pg 40 and 41

1 comment:

  1. This website was... how do I say it? Relevant!! Finally I have found something which
    helped me. Many thanks!


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