Policy on the Recognition of Educational Activities
Background The Fédération des médecins omnipraticiens du Québec (FMOQ) has been certifying family physicians’ participation in educational activities since 1967. In 1981, the Collège des médecins du Québec (CMQ) accredited the FMOQ for the purpose of continuing medical education (CME). Certificates of attendance then qualified as education credits for the physicians receiving them. This accreditation has been successively renewed since then. In 2002, in addition to CME activities, eligibility was extended to professional topics concerning the organization and delivery of patient care and services. The term “Continuing Professional Development” (CPD) now encompasses Continuing Medical Education (CME) and professional development for physicians, leading to the eligibility of topics related to the CanMEDS framework.
Objectives of the Policy on the Recognition of Educational Activities
To establish the accreditation criteria for educational activities in accordance with the Structured Approach to CPD and the CQDPCM’s Code of Ethics. To specify the conditions for applying the Structured Approach to CPD. To determine the CPD obligations for the organizers within our education network.
Accredited Organizations The organizations accredited by the CMQ are the following: Collège québécois des médecins de famille (CQMF) Faculties of medicine of Québec universities (Laval, McGill, Montréal, Sherbrooke) Fédération des médecins omnipraticiens du Québec (FMOQ) Fédération des médecins spécialistes du Québec (FMSQ) Médecins francophones du Canada Given their accreditation by the CMQ, these organizations are qualified to accredit CPD activities. The Type 1 credits (Category 1, Mainpro‐M1, Section 1) awarded by these organizations are therefore equivalent.
Structured Approach to CPD Every educational intervention must comply with all the steps in the Structured Approach to CPD, namely: 1. Identifying the target audience 2. Determining the educational needs 3. Formulating the learning objectives 4. Choosing the type of educational activity 5. Identifying and choosing the human and material resources 6. Promoting the activity 7. Carrying out the activity 8. Evaluating the activity and the achievement of the learning objectives This activity must also comply with the CQDPCM’s Code of Ethics (www.cqdpcm.ca).
Structured Approach to CPD: Conditions of Application 1. Identifying the target audience The target audience must be clearly indicated in the program and its method of consultation must be specified; a representative from the target audience must take part in designing and developing the activity content, format and schedule. Professional development may be uniprofessional (family physicians), multiprofessional (family physicians and specialists, family physicians and nurses) or interprofessional (health professional teams). Although most CPD activities are intended for family physicians (uniprofessional activity), the target audiences are becoming increasingly varied, such as those participating in interprofessional education activities. The FMOQ developed a practice guide for developing continuing interprofessional development activities and published it in June 2013. 2. Determining the educational needs A needs analysis must be performed in order to meet the educational needs of the previously documented target audience (perceived, demonstrated, institutional and regulatory needs). The following are a few suggested methods: Meetings with colleagues (the use of this method is valid only for target clients within a clinic, an institution or a community) Needs surveys. For regional or provincial activities, sampling criteria must be respected (see Section 2.1, page 7) Case studies Nominal group technique Other (e.g., new standards, practice guides, recommendations from learned societies)
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3. Formulating the learning objectives Specific learning objectives must be defined according to the pre‐determined needs. The learning objectives to be achieved must be consistent with adult education standards and must be stated in the activity program. The use of action verbs is preferred over that of passive verbs such as “to know,” “to comprehend” and “to understand.” A specific objective is a precise statement written in terms of the learner’s observable behaviour by the end of the learning period. Criteria for a specific objective: • Expressed in relation to the learner • Uses an action verb • Refers to an observable behaviour • Specifies the conditions for achieving it • Defines a required performance level Qualities of a specific objective: • Relevant • Unambiguous • Realistic • Reproducible • Measurable 4. Choosing the type of educational activity The educational method must be chosen according to the type of activity most likely to achieve the learning objectives and to foster interaction. Conference Workshop Roundtable Case discussion Individual or group online training Other (e.g., simulation centre activity). 5. Identifying and choosing the human and material resources Resource persons must always be selected by the scientific committee designated by the activity organizer. The choice of resource materials may be delegated to a funding organization in accordance with the CQDPCM’s Code of Ethics.
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6. Promoting the activity The means used to promote the activity must be consistent with the elements generated by the electronic platform for applications for credits. The promotion of the activity must be directed toward the members of the identified target audience and must comply with the CQDPCM’s Code of Ethics. To that end, a standard invitation form can be printed once the application for credits is completed and approved. When the continuing education programs are intended for family physicians from several affiliated associations or when the educational sessions are to be held outside Québec, the responsible persons or bodies, which took steps to become associated with the FMOQ, may wish to obtain prior recognition from the FMOQ for the purposes of promoting these programs. Such recognition relates to compliance with the current policy and to the scientific merit of the proposed program, such merit implying, in particular, the credibility of the persons or organizations or both, and the relevance of the particular program for family physicians. The CPD Director is responsible for this evaluation; if necessary, the Director will consult the members of the CPD Committee or those responsible for continuing education in the affiliated associations or both. An activity targeted to clients from two or more associations is considered multiregional and the application for credits must be submitted for analysis to the CPD Director by a regional network education coordinator. Up to 10% of participants from another association is allowed before an activity is considered to be multiregional. The programs thus approved by the FMOQ may contain the following statement on the promotional brochure: “The Fédération des médecins omnipraticiens du Québec, a continuing education body fully accredited by the Collège des médecins du Québec, grants ____ hour(s) of Category 1 credits to the participants in this activity. The Code of Ethics of the Conseil québécois de dévelopment professionnel continu des médecins (CQDPCM) must be respected (www.cqdpcm.ca).” Similarly, a continuing education program intended for the members of an association and approved by a regional coordinator may contain the following statement on the promotional brochure: “The Association des médecins omnipraticiens de _____________ (association), under the umbrella accreditation of the FMOQ, grants ____ hour(s) of Category 1 credits to the participants in this activity. The Code of Ethics of the Conseil québécois de dévelopment professionnel continu des médecins (CQDPCM) must be respected (www.cqdpcm.ca).” However, a statement such as “An application for ___ Category 1 credits has been submitted to the FMOQ” or the equivalent in no way assumes any such accreditation and must not be used because it may mislead potential participants in the event that this accreditation application is refused.
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7. Carrying out the activity Face‐to‐face activities must last a minimum of one hour. A minimum length of 30 minutes is accepted for online education sessions or for webinars hosted on platforms that allow verification of the participants’ attendance. The time scheduled for breaks and meals is not credited. 8. Evaluating the activity and the achievement of the learning objectives The CPD activity or program must be evaluated by the organizers and the participants. Participant evaluation of the activity is compulsory. All face‐to‐face or real‐time activities must be evaluated by means of the evaluation form adopted by the FMOQ’s CPD Committee. However, after analysis and decision by the CPD Division, the use of a post‐test may replace that of the form (e.g., Le Médecin du Québec journal, online sessions.) Several key steps must be completed before physicians who participated in an education activity can be granted Category 1 credits. Category 1 credits will be granted after the activity has taken place and once the evaluation synthesis has been submitted to the FMOQ. As a result, Category 1 credits can be granted only after an activity has been held.
Criteria for Awarding Category 1 Credits 1. General procedure An application for Category 1 credits, provided on the extranet site reserved for credit claims, must be completed by a family physician acting as a local or regional CPD coordinator. Once submitted, this application will be reviewed by the regional coordinator of the association concerned who, where applicable, will make a recommendation for accreditation to the FMOQ’s CPD Director. All the steps of the Structured Approach to CPD must be respected to entitle applicants to Category 1 credits. Local CPD coordinators must submit applications for credits in accordance with the territorial framework assigned to them by their associations, or, failing this, upon agreement with the regional coordinator if the activity is intended for all family physicians of the region or the association. Consequently, all applications for credits for activities intended for multiregional clients (two or more associations) must be submitted by at least one regional CPD coordinator and ideally from all the regional coordinators concerned. When regional coordinators act alone as the applicants, they must notify all the regional coordinators concerned if they are not included as applicants.
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Furthermore, all applications for credits for activities intended for clients across the province must be transmitted to the CPD Division by a regional coordinator or by the head of an interest group. An interest group is defined as a limited group in which the physicians engage in a specialty or a particular field of expertise not shared by the majority of the physicians of an association (e.g., physician coroners, physicians working in youth protection centres, physicians performing abortions). Applications to accredit CPD activities submitted after the activity has been held will not be approved. Once the activity has been approved, all the forms related to it (attendance sheet, evaluation, certificate of attendance, invitation, etc.) will be made available on the credit claim website under the tab “Imprimer” for the activity. 2. Special situations for granting Category 1 credits 2.1 Turnkey programs A turnkey program is defined as follows: “Any program designed by a body not accredited in continuing education by the Collège des médecins du Québec and intended to be delivered face‐to‐face or online within the FMOQ network.” According to the policy adopted by the Office of the FMOQ, no turnkey education programs may be used as part of the CPD activities held under the auspices of the FMOQ unless they have been analyzed and validated as being in compliance with the Structured Approach to CPD. This analysis will be performed by a member of the CPD Division or by a person appointed by the CPD Division, the cost being assumed by the organization wishing to promote this program. Once the program has been validated, it will be added to the list of programs recognized by the FMOQ and posted on its website. If the program is designed by an accredited CPD organization in Québec, it is automatically recognized by our organization. The accredited organizations in Québec are the following: Collège québécois des médecins de famille (CQMF); faculties of medicine of Québec universities (Laval, McGill, Montréal, Sherbrooke); Fédération des médecins omnipraticiens du Québec (FMOQ); Fédération des médecins spécialistes du Québec (FMSQ); Médecins francophones du Canada. Note that the College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) are not accredited organizations in Québec. If a program is not designed by an accredited CPD organization in Québec, it must be evaluated by the CPD Division.
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The program must be developed in accordance with the Structured Approach to CPD. The criteria for approving an assessment of perceived needs are the following: o For a survey carried out in Québec alone, the minimum number of respondents must be 75 family physicians. o For a survey carried out in Canada, the minimum number of respondents must be 150 family physicians, including at least 30% from Québec. To meet the requirements of the Structured Approach to CPD, a representative from the target audience (family physician) must be a member of the scientific committee. This committee must include a general practitioner. Ideally, it will include a medical content expert from Québec and at least one physician from Québec. The concepts of scientific committee and organizing committee are defined in the CQDPCM’s Code of Ethics. Any use of an online turnkey program must meet the criteria for special situations described for web conferences, webcasts and online learning activities delivered on teaching platforms recognized by an organization accredited by the CMQ.
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2.1.1 CPD activities developed by health professionals for health professionals in their communities outside the framework of a CPD‐accredited organization The program must be developed in accordance with the CQDCM’s Structured Approach to CPD and Code of Ethics. The application for accreditation must be submitted to the local or regional CPD coordinator. A maximum of five face‐to‐face activities within the same program in one or more regions may be offered. Beyond these five activities, the program will be considered a turnkey program and the terms and conditions for turnkey programs shall apply. In such circumstances, the costs for validating this turnkey program shall be determined by the CPD Division taking into account the following aspects: o Existence of an educational grant from one or more sources o Type of health professional o Number of activities planned Web seminars – Webinars A web seminar is defined as follows: “Any CPD activity developed for FMOQ members in a region or in the province that is transmitted to participants in real‐time through the platform of a webinar.” In accordance with the ad placement policy in the CQDPCM Code of Ethics, the platform used may not be identified with a funding organization. The application for accreditation must be submitted: o by the regional coordinator if the activity is held solely in one or more locations in their region; o to the FMOQ’s CPD Division for all multiregional or provincial activities. 7
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A learning activity delivered as a web seminar more than twice in several regions or across the province will be considered a turnkey program and must be submitted for validation. Activity access modes o Individual access The platform used must make it possible to: identify the participants (names and medical licence numbers) and to transmit this list to the FMOQ for the purpose of credit compilation; use an electronic means to confirm each participant’s presence at the web seminar; offer each participant the opportunity to ask the webinar leader questions (written or oral); allow the participants to evaluate the activity using the FMOQ’s form. o Group access: The activity coordinator must designate a general practitioner, ideally a local or regional coordinator, on each site to: act as session chair; forward the signed attendance sheet to the FMOQ; distribute the FMOQ’s evaluation form and to transmit the synthesis of the collected evaluations to the FMOQ. Conditions for granting credits Once the attendance sheet and the evaluation synthesis are received, Category 1 credits will be granted to the participating physicians. Upon request and payment of an administrative fee, a certificate of attendance may be transmitted to other health professionals.
Webcasts A webcast is defined as follows: “The dissemination of audio or video content online. It may be streamed or downloaded.” The conditions for accessing and granting credits for streamed or downloaded activities are the same as those for web seminars (see Section 2.2 above). Online learning activities on the Caducée portal An online learning activity on the Caducée portal is defined as follows: “Any CPD activity developed for FMOQ members according to a specific educational path and transmitted asynchronously on the Caducée portal.”
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2.5
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Other types of learning activities 2.5.1 Presentations and lectures Physicians may earn Category 1 credits for the time spent preparing and giving a lecture as part of a CPD activity, which itself qualifies for Category 1 credits from an organization accredited by the CMQ (between 1 and 15 hours per lecture). Credits must be claimed by means of the appropriate form available on the FMOQ website at https://www.fmoq.org/formulaires/. This claim must be accompanied by all the required information. 2.5.2 Development of CPD activities Family physicians may earn Category 1 credits for the time spent developing a CPD activity accredited by an organization accredited by the CMQ (from 1 to 15 hours per activity). Credits must be claimed by means of the appropriate forms available on the FMOQ website at https://www.fmoq.org/formulaires/. This claim must be accompanied by all the required information. 2.5.3 Program design / Agents Credits may also be granted to physicians who collaborate with the FMOQ in developing an education program leading to Category 1 credits granted by the FMOQ (from 1 to 15 hours per program). General practitioners acting as agents for the FMOQ, for example, in the areas of online conferences or the education program validation process, may also earn Category 1 credits. Credits must be claimed by means of the appropriate form available on the FMOQ website at https://www.fmoq.org/formulaires/. This claim must be accompanied by all the required information. Reflective practice activities As part of the reflective approach promoted by the FMOQ, family physicians may earn Category 1 credits for reflective practice activities. This may involve an individual or a group reflective process. The reflective activity on the application of learning to their practice must target individual, group or organizational aspects related to their clinical practice. 9
The approach used must be structured and must focus on questions fostering reflection. For example, this may result from a reflection on specific findings regarding the evaluation of their practice, the application of treatments or future adjustments, or the treatment team’s modes of operation. 2.6.1 Individual reflective practice activities Appendix 13 of the FMOQ‐SCPDP
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Family physicians who have participated in an accredited activity and who have completed Appendix 13 of the FMOQ‐SCPDP (reflective approach) by identifying a change to be made to their practice may claim, at three or six months’ follow‐up, thirty minutes of Category 1 credits. The conditions for granting these credits, once the reflective process is completed, are under development. For the time being, we encourage our members to record them in their FMOQ‐SCPDP. Appendix 16 of the FMOQ‐SCPDP (available in 2016) Family physicians who have completed Appendix 16 of the FMOQ‐SCPDP (reflective approach) by identifying a change to be made to their practice may claim, at three or six months’ follow‐up, one hour of Category 1 credits. The conditions for granting these credits, once the reflective process is completed, are under development. For the time being, we encourage our members to record them in their FMOQ‐SCPDP. 2.6.2 Group reflective practice activities Appendix 16 of the FMOQ‐SCPDP (available in 2016) Family physicians may earn Category 1 credits for a group reflective practice activity. To do so, the physician acting as the group’s respondent must complete Appendix 16 of the FMOQ‐SCPDP (reflective approach) by identifying a change to be made to their group practice. Publications Family physicians may earn Category 1 credits for the work involved in preparing and actually writing an academic paper on a theme related to family medicine once it has been accepted for publication in a peer‐reviewed textbook or journal (1 to 15 hours per manuscript). Concerning the authors who produce articles for the Continuing Education Section of the Médecin du Québec, claims by medical specialists will also be considered.
Credits must be claimed by means of the appropriate form available on the FMOQ website at https://www.fmoq.org/formulaires/. This claim must be accompanied by all the required information.
Criteria for Granting Category 2 Credits
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Category 2 credits are granted when a given educational activity, usually carried out in a group, meets the criteria for granting Category 1 credits, except for participant evaluation.
Transcripts of Educational Activities As of August 2014, family physicians have been able to access their continuing education credit transcripts from the FMOQ through the web application mon.fmoq.org. Members may consult and print their personal continuing education activity transcripts by determining the start and end dates of the transcript.
Establishment of the FMOQ’s CPD Network Following the recommendation from the FMOQ’s CPD Committee, the FMOQ Council adopted the following resolution in March 2012: Within a maximum of two years, all CPD coordinators in the FMOQ network, both on a regional and on a local level, must be duly certified in this matter. To do so, they will need to have successfully completed the workshop on the structured and ethical approach to CPD, a 6‐hour workshop currently under development within the CPD Division, or its equivalent recognized by the CPD Division. This compulsory workshop, which will be available in the spring of 2012, will initially be offered to the regional coordinators. The local coordinators will then attend the same workshop given by a member of the CPD Division, assisted by the regional CPD coordinator. An experienced regional coordinator may also be mandated by the CPD Division to do so. Since offered in 2012–2013, this network education has been available periodically. However, a new local CPD coordinator, upon recommendation by a regional coordinator, may make this workshop available online and may subsequently submit credit claims. This coordinator must nevertheless commit to participating periodically in face‐to‐face workshops.
Umbrella Accreditation for Associations Given that the FMOQ is the organization accredited by the Collège des médecins du Québec, associations fall under its umbrella accreditation for their educational activities. As a result, the FMOQ’s Policy on the Recognition of Educational Activities takes precedence over any internal continuing education policy set by an association of the FMOQ. The FMOQ’s Policy on the Recognition of Educational Activities is available on the FMOQ website at https://www.fmoq.org/formation/politiques/. Updated: June 2017
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