Two Themes Weave through the new Accreditation Council for CME criteria that relate to planning CME interventions. Those themes include a deeper understanding of learners' needs, environments, and gaps in knowledge. This requires a more sophisticated approach to needs assessment.

The new criteria require that providers design interventions that are “appropriate for the setting, objectives and desired results” of the activity. This means CME providers need to factor in not only what area of medicine they are addressing, but also how physicians in that arena best learn, what types of clinical services they need to provide the best care to their patients, and what gaps in knowledge or skills may be necessary to improve their performance. Assessing all these factors will allow the CME provider to choose the best educational design.

We have often said that a planning document is a very useful tool to provide links between the educational methodology, needs assessment process, learning objectives, desired results, and tools to identify barriers to implementation. This is not a linear process but one that is dynamic and interactive.

Increasing Your Competency

You need to design interventions that address the physicians' educational needs that underlie their performance or knowledge gaps. A Level 2 provider will skillfully design the intervention(s) in a way that fits within the scope of the practice and learning environments of the targeted learners. This requires a new level of staff competency for most providers. CME professionals will need to be able to assess gaps in performance as well as integrate the competencies required by the appropriate specialty board, the Institute of Medicine report, Accreditation Council for Graduate Medical Education criteria, applicable national and specialty society guidelines, and more.

For example, if participants need to improve their knowledge, a didactic format might be appropriate. But if they need to change their attitude, confidence level, or beliefs, casework and peer discussion might work better. To overcome system obstacles an effective format would include group discussion about best practices.

Improving Your Program

Level 2 criteria refer to a “link to competencies.” Remember, in your revised CME mission statement (which we discussed in the last issue) you are now addressing three areas, as applicable to your organization: physician competencies, performance-in-practice, and patient outcomes. Your mission for physician competence should focus on establishing criteria or metrics to achieve those expected results. In your self-study report, you will demonstrate that you have applied these metrics to your interventions and applied appropriate goals for improvements when necessary.

Level 2 providers should be able to demonstrate that they have the skills to assess the effectiveness of their overall CME program. You will need to identify areas for improvement and implement an improvement plan that links back to the CME mission. Where will these improvements come from? Your revised CME mission's metrics in the areas of physician competency, performance improvement, and patient outcomes will identify the goal, and improvements will be identified based on the analysis of your mission's goals compared to actual accomplishments. Remember, the new criteria don't stop at the identification of improvements, but rather with the implementation of improvements.

This is an exciting time in CME. Not only are you designing educational activities that enable physicians to perform at their best, but you are also affecting patient safety and improving the quality of healthcare for patients

For the first column in this series, “Your New Mission,” visit In the March/April issue, we will discuss the new criteria for Level 3 accreditation with commendation.

Steve Passin and Susan O'Brien are, respectively, the president and senior associate of Steve Passin & Associates, a CME consulting company headquartered in Newtown Square, Pa. Reach Passin at; and O'Brien at