The Journal of Continuing Education in Nursing

CNE Article 

Impact of Accreditation Standards on the Quality of Continuing Nursing Education Activities as Perceived by the Learner

Elaine M. Novakovich, MS, BSN, RN

Abstract

Background:

Continuing nursing education (CNE) activities are increasingly becoming a requirement for RNs to maintain licensure or certification and to remain competent in practice in the fast-changing health care environment. Regardless of the health care profession, continuing education should be a quality educational experience to positively influence practice and patient outcomes.

Method:

A 15-item matrix based on the 2013 American Nurses Credentialing Center Primary Accreditation criteria was used to evaluate CNE activities. The matrix reflected the characteristics that a learner should be able to identify when participating in a Web-based CNE activity.

Results:

A measurable learner-perceived difference was observed in the quality of the educational experience between educational activities developed by organizations using accreditation criteria, compared with those that did not.

Conclusion:

Learners can use accreditation criteria as one method to discriminate high-quality educational activities that are designed to positively influence practice and patient outcomes.

J Contin Educ Nurs. 2017;48(4):157–164.

How to Obtain Contact Hours by Reading this Issue

Instructions: 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must:

Read the article, “Impact of Accreditation Standards on the Quality of Continuing Nursing Education Activities as Perceived by the Learner,” found on pages 157–164, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.

Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.

Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated.

This activity is valid for continuing education credit until March 31, 2020 (3 years from the date).

Contact Hours

This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.

Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Objectives
  • Identify the benefits of accreditation standards in the development of continuing nursing education activities.
  • Explain an outcome of the Web-based/e-learning activity.
Disclosure Statement

Neither the planners nor the author have any conflicts of interest to disclose.

Do you want to Participate in the CNE activity?

Abstract

Background:

Continuing nursing education (CNE) activities are increasingly becoming a requirement for RNs to maintain licensure or certification and to remain competent in practice in the fast-changing health care environment. Regardless of the health care profession, continuing education should be a quality educational experience to positively influence practice and patient outcomes.

Method:

A 15-item matrix based on the 2013 American Nurses Credentialing Center Primary Accreditation criteria was used to evaluate CNE activities. The matrix reflected the characteristics that a learner should be able to identify when participating in a Web-based CNE activity.

Results:

A measurable learner-perceived difference was observed in the quality of the educational experience between educational activities developed by organizations using accreditation criteria, compared with those that did not.

Conclusion:

Learners can use accreditation criteria as one method to discriminate high-quality educational activities that are designed to positively influence practice and patient outcomes.

J Contin Educ Nurs. 2017;48(4):157–164.

How to Obtain Contact Hours by Reading this Issue

Instructions: 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must:

Read the article, “Impact of Accreditation Standards on the Quality of Continuing Nursing Education Activities as Perceived by the Learner,” found on pages 157–164, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.

Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.

Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated.

This activity is valid for continuing education credit until March 31, 2020 (3 years from the date).

Contact Hours

This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.

Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Objectives
  • Identify the benefits of accreditation standards in the development of continuing nursing education activities.
  • Explain an outcome of the Web-based/e-learning activity.
Disclosure Statement

Neither the planners nor the author have any conflicts of interest to disclose.

Do you want to Participate in the CNE activity?

With the quickly evolving health care environment, it is essential that health care professionals embrace lifelong learning to remain current and competent in practice. Continuing education (CE), or continuing professional development, has become a cornerstone for ongoing professional development. Multiple stakeholders have a vested interest in ensuring health care professionals remain competent, including licensing and certifying bodies (state regulatory boards, specialty boards, or certifiers); organizations employing health care professionals; individual health care professionals (nurses, physicians, pharmacists, social workers, and similar); and patients and families. The health care environment is complex, and health care professionals often have limited time to participate in lengthy educational activities or programs. It is important that health care professionals participate in high-quality, effective learning activities delivered in a timely and convenient way and designed to improve practice and patient outcomes.

CE is one method health care professionals use to stay current with the latest knowledge and advances in health care. Historically, CE focused on a health care professional's participation in an educational activity instead of evaluating improved performance or impact on outcomes (Institute of Medicine [IOM], 2010). However, changes within accreditation systems based on evolving evidence have positively affected how CE is planned, delivered, and evaluated. A robust body of evidence now exists to demonstrate the positive impact on performance when health care professionals participate in CE, and a weaker but still positive impact on patient outcomes (Cervero & Gaines, 2014).

Moore, Green, and Gallis (2009) addressed the importance of directing educational efforts to support providers' improved competence to promote better care and improve health care outcomes. Their outcomes framework is presented as a model of the fluid integration between assessment, educational planning, and instructional design while maintaining a focus on achieving the desired outcomes. The recent shift of objective-focused teaching toward outcomes-focused instruction has been addressed by the American Nurses Credentialing Center's (ANCC) Commission on Accreditation's (COA) white papers published in 2012 and 2014. Both publications discuss the importance of using educational design principles that focus on targeted and measurable outcomes that can be used to evaluate the effects of an educational activity on the learner and demonstrate improvement in patient care and safety. It is essential that “outcome measurement must incorporate principles of reliability and validity” as well (ANCCCOA, 2012, 2014).

McMahon (2016) focused on the importance of strengthening CE opportunities in a recently published article in the New England Journal of Medicine. He highlighted the strategic value of continuing medical education (CME) in driving change as reports demonstrate how CME not only improves physician performance but also positively affects patient outcomes and teamwork (Cervero & Gaines, 2014). McMahon addressed the importance of collaboration among educators, regulators, health care institutions, and clinicians to transform CME, as well as interprofessional continuing education (IPCE). Educators are encouraged to design activities that are learner-centric rather than teacher-centric, incorporate increasing opportunities for IPCE, and develop engaging activities to encourage professional reflection and growth. It will be through improving educational innovation and expanding the current CE environment that the learning needs of clinicians throughout the health care disciplines will be addressed. McMahon emphasized that building and strengthening competencies for team-based practice will improve clinician practices and ultimately benefit patient care and the health of the United States (McMahon, 2016).

Background

Continuing nursing education (CNE) is defined in the Nursing Professional Development: Scope and Standards of Practice (ANCC, 2015, p. 44; Harper & Maloney, 2016, p. 16) as the “provision of learning activities intended to build upon the educational and experiential bases of an individual for the enhancement of practice, education, administration, research, or theory development, to the end of improving the health of the public”. Providing nurses with high-quality opportunities for professional development should be an essential component of CNE activities. A standard setting for high-quality learning activities is not isolated to nursing. It is a current topic being discussed throughout the health care professions as all struggle to improve the quality of the educational experience for learners and positively influence practice and patient outcomes. Essential elements necessary when designing and providing high-quality continuing educational activities for health care professionals include using adult learning principles, actively engaging learners, identifying gaps in knowledge for the target audience, developing educational activities that are independent from commercial interest organizations, and ensuring that the planning process is free from commercial bias or promotion (ANCC-COA, 2012; Dickerson & Chappell, 2015; IOM, 2010).

According to the ANCCCOA (2012), “Accreditation provides evidence of the quality of education that supports nursing professional development” (p. 1). The current ANCC accreditation model is based on and supports the professional development of nurses. Criteria within the ANCC system are organized into three domains based on a Donabedian framework of structure, process, and outcome (Donabedian, 1966). These criteria provide a framework for organizations to design, implement, and evaluate CNE activities, further supporting an evidence-based and unified approach. Organizations using accreditation standards are held accountable for establishing and working to achieve quality outcomes. Evaluation data are essential to support the value of CNE activities to the individual nurse, the organization, and to the broader health care community (ANCCCOA, 2014).

ANCC defines accreditation as the voluntary process by which a nongovernmental agency or organization appraises and grants accredited status to institutions, programs, or services that meet predetermined structure, process, and outcome criteria (ANCCCOA, 2012). Accreditation involves establishing and maintaining criteria based on best available evidence, recognizing organizations that have met those criteria, and holding organizations accountable for consistently adhering to the criteria during the period of accreditation. Further, accredited organizations are expected to provide evidence of outcomes to both consumers and the public, thereby demonstrating they are functioning according to specified quality standards (ANCC, 2013). Regardless of profession, the use of accreditation criteria when planning and presenting CE activities demonstrates a planning process that (a) is free from the influence of commercial interest organizations; (b) uses content that is evidence based or based on the best available evidence; and (c) is designed to improve the professional practice of health care providers and patient (i.e., client) outcomes.

The ANCC's Content Integrity Standards for Industry Support in Continuing Nursing Educational Activities (2013) serves as a resource for continuing education providers during the design, implementation, and evaluation of quality CNE activities. The standards address the importance of maintaining integrity, as well as remaining free from undue influence of commercial interest organizations when planning and providing educational activities. Federal law, core values for the ANCC Accreditation Program, and the ANA Code of Ethics for Nurses with Interpretive Statements (2008) all establish the foundation for the standards. The U.S. federal government and its agencies have recently recognized the value of accreditation standards and continuing education in the Affordable Care Act, Physician Sunshine Payment Act legislature, and the Food and Drug Administration's Risk Evaluation and Mitigation Strategies program. Through recognition, the federal government has identified accrediting bodies as developing and enforcing accreditation criteria that promote high-quality educational activities (42 C.F.R. § 403.904, 2013).

Health care professionals today can participate in a wide variety of educational activities in different formats including live (i.e., face-to-face) and Web-based learning opportunities. CE providers are using an expanded variety of methods beyond traditional didactic lectures, conferences, and courses. CE providers are blending multiple educational methodologies such as interactive and experiential learning with techniques including questioning, discussion, coaching, and role-play, whether offered live or online.

The IOM (2010) report highlights the increasingly popular use of e-learning as a method to provide CE among health care disciplines, and stated: “E-learning modalities include programs delivered via electronic asynchronous or real-time communication without the constraints of place and often time” (p. 33). Webinars are instructional presentations that are an increasingly utilized format of e-learning. According to the IOM (2010), “While some professionals prefer traditional learning formats that include face-to-face contact, e-learning has the advantage of supporting healthcare professionals to set their own learning pace, review content when needed and personalize learning experiences” (p. 33). Benefits from the perspective of the CE provider may include the ability to reach more participants, increase interprofessional educational opportunities for learners, and reduce development costs. According to the IOM (2010):

Ultimately, e-learning may be equal to or better than more traditional learning methods for individual health professionals, as measured by learner satisfaction and acquisition of knowledge and skills.

Purpose

The purpose of this pilot study was to assess whether a measurable difference existed in the quality between those activities designed utilizing accreditation criteria compared with those that do not, as perceived by a learner when participating in 1-hour Web-based educational activities.

Method

A 15-item matrix identifying measurable characteristics of educational activities that reflected 2013 ANCC Primary Accreditation standards and quality was created to score each learning activity. Ten webinars, available online and 60 minutes in length each, were randomly selected and then scored using the matrix. Five activities were developed by organizations using ANCC accreditation standards and five were developed by organizations that did not use ANCC accreditation standards. Those organizations that used ANCC accreditation standards were also multiply accredited by other organizations, including the Accreditation Council for Continuing Medical Education and the Accreditation Council for Pharmacy Education. Data were analyzed to assess whether a measurable difference existed in the quality of an education program developed by organizations using ANCC accreditation criteria, compared with those not using ANCC accreditation criteria.

Search Strategy

All 10 webinars were independently and randomly selected using Google as the search engine, along with the following search terms: accredited, approved, free, on-line, one hour, nursing, webinar, CE credit, CNE, 1 hr., and CEU.

This search strategy resulted in a list of organizations advertising webinars. Lists were screened for webinars related to nursing. After the nursing webinars were determined, the primary reviewer linked into the Web site of the organization advertising the activity.

The primary reviewer then analyzed content on the organization's Web site to determine the following:

  • Accreditation status of the organization providing the activity.
  • One-hour free webinars that awarded CE credit.

When webinars meeting inclusion criteria were identified, the primary reviewer selected content that reflected a variety of different areas in nursing practice, including clinical and nonclinical topics. Only one webinar per organization was chosen. The primary reviewer purposefully selected three webinars that were provided by commercial interest organizations and that advertised they awarded CE credit.

Instrument

Evaluation of quality was documented using the 15-item matrix (Table), which identified measurable characteristics of education activities based upon 2013 ANCC Primary Accreditation standards. A pilot study was conducted between the primary reviewer and an ANCC credentialing expert to validate whether evaluation data were consistent between matrix users, whether novice or expert in the credentialing field. The pilot demonstrated consistency between users when one random, free, online webinar was evaluated individually and evaluation results were compared. After matrix consistency was established, the primary reviewer randomly selected 10 separate 1-hour (free) webinars to compare—five developed by organizations using ANCC accreditation standards and five from organizations that did not. The primary reviewer evaluated each CNE activity (or webinar) using the matrix to rate adherence to accreditation standards. Data were analyzed using the applied matrix to evaluate whether a measurable difference existed in the quality of an educational program as perceived by the learner between programs developed by organizations using accreditation standards and those that did not.


            15-Item Matrix Identifying Measurable Characteristics of Educational Activities Based on American Nurses Credentialing Center Accreditation Standards
            15-Item Matrix Identifying Measurable Characteristics of Educational Activities Based on American Nurses Credentialing Center Accreditation Standards

Table:

15-Item Matrix Identifying Measurable Characteristics of Educational Activities Based on American Nurses Credentialing Center Accreditation Standards

Although the matrix was based on 2013 ANCC accreditation criteria, it is important to note that the major U.S. health care accreditors in nursing, medicine, and pharmacy have continued to align their individual accreditation standards, in particular to further collaboration in IPCE. Therefore, the accreditation principles evaluated in this pilot study may be generalizable across professions.

Results

The primary reviewer scored each webinar using the matrix. Values were aggregated to determine overall themes.

The matrix identified 15 specific and measurable characteristics to evaluate educational activities. Eleven items were rated using a 3-point Likert scale, where 1 = unable to determine, 2 = partially able to determine, and 3 = clearly able to determine. Four items were rated using a yes-or-no response indicating the presence or absence of the characteristic.

It is important to note that although the author based the development of the matrix on the 2013 ANCC accreditation criteria, two items were added to the matrix that, although not identified as essential to share with the learner, are important principles in planning and developing CNE activities when using accreditation standards. The primary reviewer added these two characteristics to the matrix to evaluate whether a learner-perceived impact on quality existed. The two identified characteristics included whether the target audience is clear to the learner and whether the learner can easily identify who planned an activity, including that individual's qualifications. Both characteristics could potentially promote trust to a learner when identifying an appropriate CNE activity to participate in.

CNE Activities Developed by Organizations Using ANCC Accreditation Criteria

The primary reviewer found that the majority of items scored using the matrix were clearly able to be determined.

In all five activities evaluated, six criteria were scored as clearly able to determine. These included:

  • Learner was informed of whether the educational activity received funding from another organization.
  • Learner was informed whether the organization was accredited.
  • Objectives were communicated, clear, and measurable.
  • Content of the educational activity was congruent with purpose and objectives.
  • Content of the educational activity was based on the most current and available evidence and documentation cited supported the quality.
  • The learner understood clearly what was required in order to obtain contact hours for the educational activity.

In four of five activities, four criteria were scored as clearly able to determine:

  • Target audience was clear to the learner.
  • Learner was informed whether any individual who was in a position to control content had a conflict of interest.
  • Purpose of the educational activity was clear to the learner.
  • Instructional methods were appropriate to achieve the purpose of the activity.

In two activities, the primary reviewer was partially able to determine who planned the activity, including that individual's qualifications. No characteristic was scored as unable to determine for any of the five programs reviewed.

For matrix characteristics scored as yes or no, the primary reviewer was able to determine whether the number of contact hours seemed appropriate for the educational activity, based on the standard metric of 1 contact hour equals 1 hour of participation in activity, and was able to participate in evaluating the educational activity in all activities reviewed. In addition, no commercial bias was perceived, and no activity appeared to promote a product or service in any of the five webinars using the 2013 ANCC accreditation program criteria.

CNE Programs Developed by Organizations Not Using ANCC Accreditation Standards

For the five programs developed by organizations not using accreditation standards, no criteria were scored as clearly able to determine consistently.

In four of the five activities, the primary reviewer was clearly able to determine (a score 3 of 5) and partially able to determine (a score of 1 of 5) the purpose of the educational activity and whether the content of educational activity was congruent with the purpose and objectives.

In the educational activities, the primary reviewer was clearly able to determine (a score of 3 of 5) or partially able to determine (a score of 2 of 5) the intended target audience and that the objectives were clear and measurable.

There was a noted inconsistency in activities regarding whether the learner was informed if the educational activity received funding from another organization (i.e., commercial support). In three of the five activities, the primary reviewer was clearly able to determine this. In two of the five programs, the primary reviewer was partially able or unable to determine this.

One criterion was scored as clearly able to determine in three of five programs and unable to determine in the remaining two programs regarding whether the learner was informed if the organization was accredited or not at beginning of webinar.

For the criterion addressing whether the learner could easily identify planner and qualifications, content of educational activity was based on the most currently available evidence and documentation supported the quality; as well as instructional methods were appropriate to achieving stated purpose, one of the five programs was scored as clearly able to determine and four of the five programs were scored as partially able to determine.

The criterion identifying whether any individual who was in a position to control content or had a conflict of interest was scored as clearly able to determine in one of the five programs, partially able to determine in two of the five programs, and unable to determine in two of the five programs.

The criterion identifying whether the learner understood what must be done to earn contact hours rated as clearly able to determine in one of the five programs, partially able to determine in one of five programs, and unable to determine in three of the five programs.

For matrix characteristics scored as yes or no, the reviewer was able to determine that the number of contact hours that seemed to be appropriate for the educational activity in three of the five programs reviewed. In two of the five programs reviewed, the learner was able to participate in evaluating the educational activity.

For the remaining two characteristics scored as yes or no, the reviewer perceived commercial bias, and the activity seemed to promote a product or service in two of the five programs. Both activities were provided by commercial interest organizations.

Discussion

Of the CNE programs developed by organizations using the 2013 ANCC primary accreditation standards, all clearly communicated accreditation status to the learner and whether the program received external funding. All programs demonstrated well-defined and focused content with well cited, supporting references, and four of the five programs engaged the learner in the educational experience. Although not technically an accreditation criteria requirement to disclose to learners, understanding the individuals who planned and presented the education program is an opportunity for improvement as the reviewer was unable to clearly determine in two of the five programs reviewed. The number of CE credits awarded for all programs was clearly stated prior to starting sessions. All programs demonstrated a consistent sense of quality along with user-friendly characteristics that included easily searchable terms, ability to participate, and opportunity to evaluate.

The five programs developed by organizations not using ANCC accreditation standards failed to provide as satisfying an educational experience for the learner. The primary reviewer had difficulty locating and starting several of them or understanding what was required to earn CE credit. Two programs did not award CE credit on completion of the activity, although advertising implied that credit would be awarded. Again, although not technically a requirement to disclose to learners, the majority of programs failed to communicate who had planned the activity, as well as planner or presenter qualifications. Several programs included citations for older references (1998–2009), one cited references on slides that were difficult to read, and one based its content solely on the presenter's individual work. Two activities were based exclusively on the supporting organizations' work. Objectives in two of five webinars were not initially clear to the primary reviewer and required reassessment. In addition, the objectives were presenter focused, as opposed to learner focused. The target audience was unclear in two of the five webinars, and the primary reviewer again returned to the CNE activity or Web site to evaluate whether the program was appropriate for an RN. The evaluation process was not consistent among the five chosen educational activities because three did not require an evaluation. Of the activities that did require an evaluation, the evaluation was a quick rating process, with three to five questions and little emphasis on learner feedback. Commercial support was apparent in two of the five programs, and each included promotion of a product or commercial organization. Overall, these five CNE experiences did not leave the primary reviewer with a sense of gaining clear, organized, important information with which to improve practice. Participation in several of the webinars proved frustrating and received no CE credit for successful completion.

Conclusion

Accreditation is one criterion that can be used to evaluate the quality of an educational activity. Darla Coffey, in the IOM workshop summary Assessing Health Professional Education (2014), addressed the “value of measuring what is valued, as over time what is measured will be valued, because that is where the supportive data will be” (p. 69). It is through the effective design and use of technology that can empower health care communities to further improve CE, but it must be ensured that what is offered online relies on consistently strong standards when providing educational training. Accreditation is a strategy to help guide organizations in the design, implementation, and evaluation of CNE activities, which results in high-quality and effective learning experiences. Evaluation of this small sample of online CNE webinars demonstrates that the learner is able to perceive a measurable difference between 1-hour, Web-based CNE activities developed in compliance with ANCC accreditation criteria compared with learning activities that did not comply with ANCC accreditation criteria. This pilot study, although small, is the beginning of an important conversation in evaluating effective CNE activities that engage the learner, ensure independence from the influence of commercial interest organizations, and positively influence the practice of nursing.

Limitations

Although findings suggest a perceptible difference to the learner when evaluating webinars developed by organizations utilizing ANCC accreditation criteria compared with those that did not, there are significant limitations. Because it was a pilot study with a small convenience sample, the findings are not generalizable. Although an attempt to ensure consistency between reviewers was implemented, only one reviewer scored each webinar; therefore, no interrater reliability was established. Only one type of educational format was assessed (i.e., webinar), and there are elements of evaluation that may not be apparent to a learner in this format. Future evaluation should encompass learner perceptions of educational activities involving different educational delivery formats and of different lengths. In addition, it is recommended that multiple reviewers assess the activities so interrater reliability can be calculated.

References

  • American Nurses Association. (2008). Code of ethics for nurses with interpretative statements. Silver Spring, MD: Author.
  • American Nurses Credentialing Center. (2013). 2013 ANCC primary accreditation application manual: For providers and approvers (3rd ed.). Silver Spring, MD: Author.
  • American Nurses Credentialing Center. (2013). American Nurses Credentialing Center's content integrity standards for industry support in continuing nursing educational activities. Retrieved from http://www.nursecredentialing.org/Accreditation/ResourcesServices/Accreditation-CEContentIntegrity
  • American Nurses Credentialing Center. (2015). 2015 ANCC primary accreditation application manual: For providers and approvers. Silver Spring, MD: Author.
  • American Nurses Credentialing Center's Commission on Accreditation. (2012). The value of accreditation for continuing nursing education: Quality education contributing to quality outcomes. Silver Spring, MD: American Nurses Credentialing Center. Retrieved from http://www.nursecredentialing.org/Accreditation/ResourcesServices/Accreditation-WhitePaper2012.pdf
  • American Nurses Credentialing Center's Commission on Accreditation. (2014). The importance of evaluating the impact of continuing nursing education on outcomes: Professional nursing practice and patient care. Retrieved from http://www.nursecredentialing.org/Accreditation/ResourcesServices/Evaluating-the-Impact-CNE-Outcomes.pdf
  • Cervero, R.M. & Gaines, J.K. (2014). Effectiveness of continuing medical education: Updated synthesis of systematic reviews. Retrieved from http://www.accme.org/sites/default/files/2014_Effectiveness_of_Continuing_Medical_Education_Cervero_and_Gaines_0.pdf
  • Dickerson, P. & Chappell, K. (2015). Content integrity, conflict of interest and commercial support: Defining and operationalizing the terms. Journal for Nurses in Professional Development, 31, 225–230. doi:10.1097/NND.0000000000000182 [CrossRef]
  • Donabedian, A. (1966). Evaluating the quality of medical care. The Milbank Quarterly, 83, 691–729. doi:10.1111/j.1468-0009.2005.00397.x [CrossRef]
  • Harper, M. & Maloney, P. (Eds). (2016). Nursing professional development: Scope & standards of practice (3rd ed.). Chicago, IL: Association for Nursing Professional Development.
  • Institute of Medicine. (2010). Redesigning continuing education in the health professions. Washington, DC: The National Academies Press.
  • Institute of Medicine. (2014). Assessing health professional education: Workshop summary. Washington, DC: The National Academies Press.
  • McMahon, G.T. (2016). What do I need to learn today? The evolution of continuing medical education. New England Journal of Medicine, 374, 1403–1406. doi:10.1056/NEJMp1515202 [CrossRef]
  • Moore, D., Green, J. & Gallis, H. (2009). Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. Journal of Continuing Education in the Health Professions, 29, 1–15. doi:10.1002/chp.20001 [CrossRef]
  • Reports of Payments or Other Transfers of Value to Covered Recipients, 42 C.F.R. § 403.904 (2013).

15-Item Matrix Identifying Measurable Characteristics of Educational Activities Based on American Nurses Credentialing Center Accreditation Standards

Criterion 1 = Unable to Determine 2 = Partially Able to Determine 3 = Clearly Able to Determine



Accredited Unaccredited Accredited Unaccredited Accredited Unaccredited
1. Target audience is clear to the learner (e.g., I know if this educational activity is appropriate for me). n = 1 n = 2 n = 4 n = 3
2. I can tell who planned this activity, including their qualifications. n = 2 n = 4 n = 3 n = 1
3. I am aware whether any individual in a position to control content had a conflict of interest. n = 2 n = 1 n = 2 n = 4 n = 1
4. I was informed whether the educational activity received funding from another organization such as a commercial interest organization (commercial support).a n = 1 n = 1 n = 5 n = 3
5. I was informed whether the organization was accredited. n = 2 n = 5 n = 3
6. The purpose of the educational activity is clear to me as a learner. n = 1 n = 1 n = 4 n = 4
7. Objectives are communicated, clear, and measurable. n = 2 n = 5 n = 3
8. The content of the educational activity is congruent with the purpose and objectives. n = 1 n = 5 n = 4
9. The content for the educational activity is based on most currently available evidence and documentation cited supports the quality (e.g., reference provided in presentation or similar). n = 4 n = 5 n = 1
10. The instructional methods are appropriate to achieve the purpose and objectives of the activity (e.g., I felt engaged as a learner). n = 1 n = 4 n = 4 n = 1
11. I understand what I must do to earn contact hours for the educational activity. Criteria for successful completion are identified and communicated prior to the start of the activity. Whether/when partial completion will receive partial credit is noted. n = 3 n = 1 n = 5 n = 1
Criterion Yes No


Accredited Unaccredited Accredited Unaccredited
12. The number of contact hours I received for the educational activity seemed to be appropriate. n = 5 n = 3 n = 2
13. I am able to participate in evaluating the educational activity as a learner. n = 5 n = 2 n = 3
14. I perceived commercial bias (i.e., commercial interest organization).a n = 2 n = 5 n = 3
15. The activity seemed to promote a product or service (i.e., noncommercial interest organization). n = 2 n = 5 n = 3
Authors

Ms. Novakovich is Research Nurse Specialist, Vasculitis Translational Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland.

This research was supported in part by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health.

The author has disclosed no potential conflicts of interest, financial or otherwise.

The author thanks Kathy Chappell, PhD, RN, FNAP, FAAN, Senior Vice President, Certification/Measurement, Accreditation, and Institute for Credentialing Research, American Nurses Credentialing Center, for her direction and mentoring throughout this project.

Address correspondence to Elaine M. Novakovich, MS, BSN, RN, Research Nurse Specialist, Vasculitis Translational Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bldg. 10/6N226, 9000 Rockville Pike, Bethesda, MD 20892; e-mail: enovakovich@mail.nih.gov.

Received: July 28, 2016
Accepted: October 27, 2016

10.3928/00220124-20170321-05

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