With an impetus from the Association of American Medical Colleges, led by Dave Davis, MD, Barbara Barnes, MD, and Carol Goddard, and preceded by a period of pilot testing, the American Medical Association Council on Medical Education has authorized academic CME providers to certify a new category of American Medical Association Physician’s Recognition Award (AMA PRA) Category 1 credit: Learning from Teaching for academic endeavors in both undergraduate medical education (UME) and graduate medical education (GME).
These new credits are only to be certified by academic teaching centers (i.e., medical school UME and GME and hospital centers that offer GME), and they are predicated on a collaborative process between the CME offices at those institutions and their UME/GME offices. Teacher-learners must complete an application for credit and/or special planning notes that document typical Accreditation Council for Continuing Medical Education planning criteria, and they must document the outcomes of their learning-through-teaching experience.
According to the AAMC, the purpose of Learning from Teaching initiatives is to “formally recognize and document the learning activity that occurs as a result of interacting with, teaching, and assessing the competence of students and residents.” The AAMC also points out that, due to the expansion of traditional teaching sites from the main campus to community-based venues, it has become necessary to rely onteachers as opposed to only full-time .
To be eligible to certify new Learning from Teaching in UME and GME credits, CME providers must meet the following requirements:
- They must be a national organization that is accredited by or by a state medical association recognized by ACCME.
- The institution must be Liaison Committee for Medical Education—and/or Accreditation Council for Graduate Medical Education—accredited.
- Applying faculty must be willing to document what they learned through teaching in UME and/or GME.
- The CME office must have adequate staff to manage and document this new type of learning in accordance with ACCME’s Criteria for Accreditation and the AMA PRA rules.
The Planning Process
According to the ACCME, Learning from Teaching activities are essentially “personal learning projects designed and implemented by the learner with facilitation from the accredited provider.” The ACCME reinforces that these activities are expected to be developed in compliance with all applicable ACCME Criteria for Accreditation and policies, and that they must facilitate practice-based learning and improvement. In the case of Learning from Teaching activities, “practice-based” can mean the teacher’s professional teaching practice.
Importantly, the teacher-learners must document the gap in knowledge, competence, or understanding that required research, updating, reflection, or the development of materials relative to the teaching assignment (Criterion 2). Relative to Criterion 3 (the intended results of the activity), the ACCME suggests that such outcomes could include:
- Improved teaching skills
- Improved patient management
- Better understanding of pathophysiology
- Other types of improvements in the teacher’s competence or performance as a teacher
Likewise for Criterion 6 (universal competencies), Learning from Teaching activities are particularly germane to the ACGME Competencies, including:
- Medical knowledge
- Clinical practice/patient care and procedural skills
- Systems-based practice
- Practice-based learning/improvement
- Communication skills
See Figure 1 below for an example of a planning document uniquely related to Learning from Teaching activities.
The AAMC suggests these categories of potential outcomes from Learning from Teaching activities:
- Preparing for a student/resident encounter or teaching session
- Literature searching: updating bibliographies, synthesizing literature
- Researching case materials related to presentations
- Case discussion prompting questions and information-seeking
- Researching clinical questions online or in journals and other text sources
- Reflection on teaching encounters and undertaking improvements, developing learning/teaching plans
- Developing educational materials related to case or clinical problems
Learners can’t reflect on these outcomes by merely by checking off a box. Rather, each learner requesting this credit should describe under each applicable category the improvement they made as they prepared to teach medical students and/or residents. See below for an example of an outcomes form for Learning from Teaching activities.
Validation of Approved Status
Learning from Teaching activity files must contain evidence that the individual is an approved teacher or member of the faculty and, if it is a GME-based teaching assignment, that the residency program in which the teacher is teaching is ACGME-approved. The sample planning document includes two sections in which the learner obtains signatures from bona fide authorities from the institution that verifies these two points. Figure 3 shows a suggested format for this documentation from the planning document.
Documentation of Credit Claimed
The second page of the sample Learning from Teaching planning document shows how a teacher-learner can document the time he or she spent in each potential applicable segment of a Learning from Teaching activity (as shown in Figure 4).
The credit worksheet shown in Figure 3 reiterates the seven potential categories of learning from this type of activity and asks the learner to indicate the number of minutes (rounded up or down to the nearest quarter-hour) spent in each category (or to check “NA”). Once the CME office receives the planning form, it adds the minutes together. This becomes the number of AMA PRA credits authorized for the learner.
Learning from Teaching and PARS
Learning from Teaching activities are reportable in the ACCME’s Program and Activity Reporting System, also known as PARS. While the ACCME allows providers to group Learning from Teaching activities into one activity for reporting purposes, this is only applicable when all learners are claiming the same number of credits (i.e., their total claimed credits add up to two, for example). In most cases, since this is an individual learning experience, the number of credits claimed by the learners will vary considerably, and therefore—practically speaking—each Learning from Teaching activity may be a separate reportable activity in PARS.
You can download the sample planning form and the outcomes form for a Learning from Teaching activity here: www.passinassociates.com/downloadmmm.
Steve Passin is president and CEO of Steve Passin & Associates, CME consultants and advisors based in Newtown Square, Pa. He can be contacted at firstname.lastname@example.org.