The ASSH enduring materials policy is applied to Internet CME, Journal CME and Manuscript Review CME.
The Policy on Enduring Materials exists to provide guidance for staff, faculty and committee members on the requirement to produce enduring materials.
The ACCME defines CME enduring materials as printed, recorded, or computer-assisted instructional materials that may be used over time at various locations and which constitute a planned activity of continuing medical education. Examples of such materials for independent learning by physicians include: programmed texts, audio tapes, videotapes, Internet CME, and other computer-assisted instructional materials which are used alone or in combination with written materials. Not included are “reference materials” such as books, journals, or manuals. Enduring materials are similarly defined by the AMA and the American Academy of Family Physicians (AAFP).
- Enduring materials are planned just like any other CME activity, except that certain addition special requirements must be included.
- Enduring materials may contain advertisements as long as they are not product specific and do not appear within the pages of the CME content. The ads may appear on the preceding pages and following the activity material, but cannot be imbedded in the content.
- Enduring materials shall not reference trade-named products specifically, although discussions of generic use of products in treatments may be made as long as they are fair, balanced, and reference studies that are scientifically-objective.
- Acknowledgement of the receipt of commercial support for the enduring material must be made, and that acknowledgement must be made at the beginning of the enduring material.
- General CME information – including the accreditation statement, credit designation statement, target audience, all special enduring material statements (see “Implementation”), and disclosure of both financial relationships and discussion of unlabeled or unapproved uses – must be made at the beginning of the enduring material.
Because there is no direct interaction between the provider and/or faculty and the learner, the provider must communicate the following information to participants so that they are aware of this information prior to starting the educational activity:
- Principal faculty and their credentials;
- Medium or combination of media used;
- Method of physician participation in the learning process;
- Estimated time to complete the educational activity (same as number of designated credit hours);
- Dates of original release and most recent review or update; and
- Termination date (date after which enduring material is no longer certified for credit).
- Providers that produce enduring materials must review each enduring material at least once every three years or more frequently if indicated by new scientific developments. So, while providers can review and re-release an enduring material every three years (or more frequently), the enduring material cannot be offered as an accredited activity for more than three years without some review on the part of the provider to ensure that the content is still up-to-date and accurate. That review date must be included on the enduring material, along with the original release date and a termination date.
- Sometimes providers will create an enduring material from a live CME activity. When this occurs, ACCME considers the provider to have created two separate activities – one live activity and one enduring material activity. Both activities must comply with all ACCME requirements, and the enduring material activity must comply additionally with all ACCME policies that relate specifically to enduring materials.
This policy describes ACCME requirements with regard to the ACCME-defined activity type, enduring materials.
The ACCME defines enduring materials as CME activities that are printed, recorded, or accessible online and do not have a specific time or location designated for participation. Rather, the participant determines where and when to complete the activity. Examples: online interactive educational module, recorded presentation, podcast.
For CME activities in which the learner participates electronically (e.g., via the Internet), all required information specified in the ACCME’s Enduring Materials: Definition and Requirements Policy and the Internet CME Policy must be made accessible to the learner prior to the learner beginning the CME activity. Providers may use tabs, links, "click here" buttons, rollover text, or other electronic means to make this information accessible.
The required information specified in the ACCME Standards for Commercial Support must be transmitted, not only made accessible, to the learner prior to the learner engaging in the CME activity. The learner should be made to pass through this information prior to engaging in the CME activity. The use of tabs, links, or other electronic means that allow learners to go directly to the CME content and bypass the information are not acceptable methods for complying with Standard for Commercial Support 6.
The following statement should be used in both promotional materials and in the enduring material itself for a directly-sponsored enduring material:
“The American Society for Surgery of the Hand is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.”
In a jointly sponsored enduring material, the following statement should be utilized in lieu of the one above:
“This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Society for Surgery of the Hand and < name of non-accredited sponsor>. The American Society for Surgery of the Hand is accredited by the ACCME to provide continuing medical education for physicians.”
Credit Designation Statement
The following statement should appear in both promotional materials and in the enduring material itself:
“The American Society for Surgery of the Hand designates this educational activity for a maximum of <number of credits> AMA PRA Category 1 Credit(s)™ .
Physicians should claim only the credit commensurate with the extent of their participation in the activity”
Statement of Need:
The need determined by the planning committee should be indicated in both the promotional materials and the course materials.
Target Audience and Prerequisites (if any):
Both the promotional materials and course materials should clearly indicate the audience for which the enduring material has been developed. If there are special requirements for participants in the enduring material (prerequisites), those prerequisites should be stated in this section.
Topics and Faculty and Committee Member Credentials:
Information about the topic(s) of the enduring material, the faculty and their credentials must be included in both the materials announcing the educational activity and in the enduring material itself.
Acknowledgment of Commercial Support:
The following statement should appear in both promotional materials and the actual enduring material: “This educational activity is supported by an educational grant(s) from <list individual company names>.”
NOTE: No other company messages, product advertisements, or product inserts are to appear or be included in or be distributed with these materials.
Sponsor and Faculty Financial Relationships Disclosure
The following language must appear in printed and electronic materials, and/or on video/audio tapes:
“As a provider accredited by the ACCME, it is the policy of the American Society for Surgery of the Hand to require the disclosure of the existence of any significant financial interest or any other relationship the sponsor or faculty members and their spouse/partner have with the manufacturer(s) of any commercial product(s) discussed in an educational presentation.
The presenting faculty reported the following: <insert disclosures, including all faculty disclosure statements as well as those who have no disclosure to report.>"
Faculty Discussions of Unlabeled or Unapproved Uses
Staff will include all disclosure information received from faculty – concerning their discussion of unlabeled or unapproved uses of drugs or devices in their presentations. This will be disclosed to the learners prior to the beginning of the activity and include the name of the product or device for which discussion are not labeled.
Release Date, Review Date, Expiration Date, Estimated Time to Complete the Activity
The following information should be listed in the enduring material:
Original Release Date: <insert month/day/year>
Review Date: <insert month/day/year> (use only if applicable)
Expiration Date: <insert month/day/year (no longer than 3 years from most recent review date)>
Estimated Time to Complete This Educational Activity: <number of hours and/or credits (same as credit designation statement)>
Evaluation and Post-Test
A set of test questions will be developed that address the material presented. These questions should be developed with the activity objectives as a guide. In addition, an evaluation instrument will be included with each enduring material. The post-test will be set up online using the ASSH learning management system. A minimum passing score will be set for each online test given. Answers will be provided after the test is completed. CME will only be awarded if the minimum passing score is met.
Instructions for Participating in the Activity and Securing CME Credit
Clear instructions describing how participants can participate in the activity and receive CME credit, including completion of test questions and methods to returning them for scoring will be included in the enduring materials. A certificate will be posted to the participant’s online transcript within thirty (30) days of receipt. Participants must achieve a passing grade (70% or higher) to receive credit.
All Internet CME activities sponsored by the American Society for Surgery of the Hand will comply with the following requirements:
- Activity Location: ACCME-accredited providers may not place their CME activities on a Web site owned or controlled by a commercial interest.
- Links to Product Web sites: With clear notification that the learner is leaving the educational Web site, links from the Web site of an ACCME accredited provider to pharmaceutical and device manufacturers’ product Web sites are permitted before or after the educational content of a CME activity, but shall not be embedded in the educational content of a CME activity.
- Transmission of information: For CME activities in which the learner participates electronically (e.g., via Internet, CD-ROM, satellite broadcasts), all required ACCME information must be communicated to the learner prior to the learner beginning the CME activity.
- Advertising: Advertising of any type is prohibited within the educational content of CME activities on the Internet including, but not limited to, banner ads, subliminal ads, and pop-up window ads. For computer based CME activities, advertisements and promotional materials may not be visible on the screen at the same time as the CME content and not interleafed between computer windows or screens of the CME content.
- Hardware/Software Requirements: The accredited provider must indicate, at the start of each Internet CME activity, the hardware and software required for the learner to participate.
- Provider Contact Information: The accredited provider must have a mechanism in place for the learner to be able to contact the provider if there are questions about the Internet CME activity.
- Policy on Privacy and Confidentiality: The accredited provider must have, adhere to, and inform the learner about its policy on privacy and confidentiality that relates to the CME activities it provides on the Internet.
- Copyright: The accredited provider must be able to document that it owns the copyright for, or has received permissions for use of, or is otherwise permitted to use copyrighted materials within a CME activity on the Internet.
In addition, activities that are provided electronically, whether they have live or enduring activities, must comply with all accreditation requirements.
Journal CME: Definition and Requirements
A journal-based CME activity includes the reading of an article (or adapted formats for special needs), a provider stipulated/learner directed phase (that may include reflection, discussion, or debate about the material contained in the article(s), and a requirement for the completion by the learner of a pre-determined set of questions or tasks relating to the content of the material as part of the learning process.
The ACCME considers information required to be communicated before an activity (e.g., disclosure information, disclosure of commercial support, objectives), CME content (e.g., articles, lectures, handouts, and slide copies), content-specific post-tests, and education evaluation all to be elements of a journal-based CME activity.
The educational content of journal CME must be within the ACCME's Definition of CME. Journal CME activities must comply with all ACCME accreditation requirements. Because of the nature of the activity, there are two additional requirements that journal CME must meet:
- The ACCME does not consider a journal-based CME activity to have been completed until the learner documents participation in that activity to the provider.
- None of the elements of journal-based CME can contain any advertising or product group messages of commercial interests. Disclosure information cannot contain trade names. The learner must not encounter advertising within the pages of the article or within the pages of the related questions or evaluation materials.
Manuscript Review CME
Manuscript review activities describe a learning process in which physicians, under the collaborative direction of a journal editor and an accredited provider, critically review assigned journal manuscripts. Additionally:
- The texts to be reviewed must be original contributions to the medical literature that require multiple reviewers, e.g., not book reviews.
- All articles reviewed by the Associate Editors are original contributions to the medical literature that require multiple reviewers. Book reviews, review articles, etc. are not included.
- The journal editor, working with the accredited provider, will need to educate reviewers about the CME process: establish objectives and criteria for content review, and provide all needed instructions.
- All Associate Editors receive “Guidelines for Reviewing Scientific Manuscripts” at the time they become members of the Editorial Board.
- Associate Editors are required to attend the instructional course on “Reviewing Manuscripts for the JHS” at the ASSH Annual Meeting (if available) or review the recorded session on the ASSH/JHS website.
- Manuscript review assignments must be at a depth and scope that require a review of the literature and a knowledge of the evidence base for the manuscripts reviewed. To the extent possible, this review of the evidence base should be documented.
- All Associate Editors are chosen for membership on the Editorial Board based on the quality of their reviews as Consultant Reviewer over an extended period of time. AE are qualified hand surgeons who have expertise in various subspecialties of hand surgery. Articles are assigned to specific reviewers based on the subject of the article and the specific areas of hand surgery expertise of the reviewers.
- The accredited provider, working with the journal editor, should have an oversight mechanism to evaluate the quality of reviews submitted. This process should assure that physicians who submit substandard reviews do not continue to participate or receive credit for subsequent activities.
- A grade is assigned to each review. At the end of the year, Associate Editors will receive a compilation of the quality of their reviews during the year.
- A reviewer with substandard reviews is taken off the Editorial Board.
CME Credit Guidelines for Manuscript Reviewers
Needs Assessment Statement
The American Society for Surgery of the Hand (ASSH) has a responsibility to maintain an ongoing knowledge and understanding of the most current issues in hand and upper extremity surgery, thus ensuring physicians are providing the highest standards of patient care. One method of maintaining that standard is through the manuscript review process. Review of manuscripts being considered for publication in the Journal of Hand Surgery (JHS) provides a platform for reviewers to refine their skills in performing critical analysis of the literature. Such review ultimately increases the quality of the published science by ensuring assessment based on expert perspectives from practice and via a mechanism free from conflict of interest.
Scientific Associate Editors are eligible for JHS manuscript CME.
Upon completion of this CME activity, participants will be able to:
- Demonstrate skills in performing critical analyses of the medical literature and knowledge of current issues and developments in hand and upper extremity surgery.
- Conduct an appropriate review of the literature related to the proposed manuscript and, when available, a review of the evidence-based clinical data related to the proposed manuscript.
- Prepare a confidential review without conflict of interest.
- Produce a standardized, concise, constructive and timely evaluation that is balanced and objective avoiding any personal comments.
- Synthesize the review of literature with a thorough review of the proposed manuscript thereby identifying its strengths and areas needing improvement prior to publication.
The American Society for Surgery of the Hand is accredited by the Accreditation Council on Continuing Medical Education to provide continuing medical education for physicians.
The ASSH designates this educational activity for a maximum of 3.0 AMA PRA Category 1 Credits™ with a maximum of 15 AMA PRA Category 1 Credits™ claimed per year. Physicians should only claim credit commensurate with the extent of their participation in the activity.
To claim CME credit, you must first review the disclosure information for the appropriate journal's Editor in Chief and Associate Editors: Disclosure Review search here
Then complete the CME Self-Assessment and Evaluation Questions for Reviewers when completing your review online.