Continuing medical education (CME) accreditation and compliance

All AO educational activities are aligned with local and regional CME accreditation requirements.

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UEMS

The AO Foundation is a trusted provider of the European Accreditation Council for Continuing Medical Education (EACCME®)

 

The EACCME® recognizes the outstanding quality of CME Live educational events organized by a number of providers over many years and trusts that such providers will continue to maintain a record of excellence in CME activities.

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Good CME practice group

The AO Foundation is a proud member of the Good CME Practice Group. The aim of the group is to guide European CME providers to contribute to improving health outcomes. It does this by:

  • Championing best practice in CME/CPD

  • Maintaining and improving standards

  • Mentoring and educating the provider community

  • Working in collaboration with critical stakeholders.

Continuing medical education (CME) mission

The CME mission of the AO Foundation is to provide comprehensive multidisciplinary needs-based education to surgeons, fellows, and residents in the specialties of orthopedics, hand, craniomaxillofacial, spine, neurosurgery, and veterinary surgery in the areas of trauma (ie, operative reduction and fixation), degenerative disorders, deformities, tumors, and reconstruction.
Expected results of the CME activities for surgeons, fellows, and residents are to:


  • Increase their knowledge base and surgical skill level.
  • Improve competence by applying advances of knowledge in patient care in the areas of
    trauma, degenerative disorders, deformities, tumors, and reconstructive surgical techniques.
  • Address practice performance gaps by improving the management of aspects of traumatic
    injuries and musculoskeletal disorders (ie, preoperative planning to postoperative care).
 

Core principles of AO educational activities:

1. Academic independence

Development of all curricula, design of scientific event programs, and selection of faculty are the sole responsibilities of volunteer surgeons from the AO network. All education is planned based on needs assessment data, designed and evaluated using concepts and evidence from the most current medical education research, and involving the expertise of the AO Education Institute.
Industry participation is not allowed during the entire curriculum development and planning process, to ensure academic independence and keep content free from bias.


2. Compliance to accreditation codes

Planning, organization, and execution of educational activities follow existing codes for accreditation of high-quality education:


3. Branding and advertising

No industry logos or advertising (with the exception of the AO Foundation and AO Clinical Division) are permitted in association with education and in the area where educational activities take place.
Industry staff are not allowed to interfere with the educational content or engage in educational activities during the events.
Sponsors providing financial or in-kind support are allowed to have a promotional booth or run activities outside the educational area.


4. Transparency

All relevant information is disclosed to the learners so that they fully understand how the content has been developed and presented.
This includes:

  • Conflicts of interest disclosures of faculty involved in the development and delivery of the scientific content
  • Financial or in-kind support received from sponsors.

5. Use of technologies and products in simulations

If case simulations are chosen as an educational method to develop skills, only technology approved by the AO Technical Commission (AO TC) will be used. AO TC is a large independent group of volunteer surgeons developing and peer-reviewing new technology. More information about AO TC, its development and approval process can be found on the here.


6. Compliance to industry codes

Events that receive direct or indirect unrestricted educational grants or in-kind support from industry follow the ethical codes of the medical industry, such as:

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Experienced, dedicated, and productive professionals.

Q&A for participants and learners

Identifying and resolving/mitigating any potential conflicts of interest based on  disclosure information ensures the academic independence of the AO Foundation educational activities.

Conflicts are created by ALL financial relationships within the last 36 months with an ineligible company and the opportunity to impact medical education content.

An ineligible company (sometimes called financial interest) is defined as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Individuals that refuse to provide disclosure information are disqualified from the planning and implementation of accredited continuing education. 

Every individual assigned as educational planner, faculty, course chairperson, and others who are in positions to control educational content must disclose all financial relationships to ineligible companies using their personal AO profile data. Current and past disclosures are stored for documentation purpose.

Disclosed conflicts are reviewed by an assigned mitigator who decides on the mitigation strategy and procedure. All disclosures (or their absence) and mitigation decisions are made public prior to the event on the respective events/activity website.

Event faculty members are mitigated by the event chairperson, chairpersons are mitigated by the respective chairperson of the education commission or the chairperson of the respective regional education commission. Educational staff and planners are mitigated by the chairperson of the respective international education commission.

All conflicts and mitigation decisions are made public on the events/activity website before the learners engage with the education.

We have four mitigation options:

1. Disclosure of conflicts and non-bias attestation 
The individual providing and/or delivering education signs an “attestation of non-bias” declaration confirming that the educational material provided is free of commercial influence and based on best evidence available.

2. Altering content assignment and non-bias attestation
The individual providing and/or delivering the education is asked to change the topic/content that was assigned to them. The newly assigned content, being unrelated to the disclosed financial relationship, carries a reduced risk of bias. Additionally, they are required to sign the “attestation of non-bias” declaration.
 
3. Peer-review / Independent content validation
The material provided is peer-reviewed by at least one individual.

4. Conflict unresolvable (exclusion from event)
Owners and employees of ineligible companies are not allowed to participate in any role in accredited clinical education and are excluded from participation.

Every contributor to an educational activity/event attests that she or he will adhere to best-practice in sound academic independence of medical education. With the attestation the faculty member confirms that

  • The content presented/planned will be evidence-based and commercially unbiased. 
  • Recommendations provided involving clinical medicine will be based on current science or evidence that is accepted within the profession as adequate justification for their indications and contraindications in the care of patients. 
  • If new and evolving topics are discussed for which there is a lower (or absent) evidence base these will be clearly identified as such.
  • The content presented will only use generic names of products, or if trade names appear, the use of these names will be justified (e.g. product is known more widely for the trade name, or the product does not have a generic name).
  • The content presented will be free of logos or other corporate identifiers of healthcare industry companies, specifically those whose primary business is producing, marketing, selling, or distributing healthcare products used by or on patients.
  • If research funded by an ineligible company is presented, the information will be based on generally accepted scientific principles and methods and does not promote the commercial interest of the funding company. 

All disclosures of potential conflicts can be found in the “Faculty” tab of the respective educational activity/event.

The information on the entire Faculty of an event can be displayed, downloaded and printed by clicking on the link at the end of the page. This is available for the respective faculty members but also for education commission members and educational planners.

 

Q&A for faculty, planners, and course chairpersons

It is the policy of AO Foundation to strictly follow the standards for integrity and independence in continuing education as defined by accreditation authorities for CME in Europe and North America (EACCME, ACCME) and other relevant regulatory bodies to avoid commercial bias in education. 

Identifying and mitigating any potential conflicts of interest based on your disclosure information ensures the academic independence of the AO Foundation educational activities.

A Conflict of Interest is created by ALL financial relationships of a faculty, chairpersons, planner of an educational activity/event within the last 36 months with an ineligible company and the opportunity to impact medical education content.

Any relationship in which the individual benefits by receiving a salary, research funding, royalties, intellectual property rights, consulting fees, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefits.

Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Examples include: Device manufacturers or distributors; manufacturers of health-related wearable products; pharmaceutical companies or distributors; bio-medical startups that have begun a governmental regulatory approval process; advertising, marketing, or communication firms whose clients are ineligible companies; compounding pharmacies that manufacture proprietary compounds; diagnostic labs that sell proprietary products; reagent manufacturers or sellers.

Your disclosures are stored in your AO profile on the AO Website. After login go to your Dashboard and select “My disclosures” under the “Profile” tag.

You can now add new disclosures or deactivate disclosures that are older than 36 months.

If you get a chairing or a teaching assignment in the invitation to an educational event you will be asked to update and confirm your list of disclosures. In addition, you will be asked that you confirm that you will stick to certain best-practice rules when presenting and discussing medical content. This includes your confirmation that you will take care that your content will be commercially unbiased and that your content is evidence-based, if evidence is published.

If the mitigation decision is

1. “Disclosure of conflicts and non-bias attestation”

You should add a slide in your presentation disclosing your potential Conflicts of Interest to the audience (use the standard disclosure template). You should also be aware that you have confirmed that your content will be commercially non-based and evidence-based.

2. “Altering content assignment and non-bias attestation”

The Chairperson of the educational event has assigned a different topic to you to avoid potential bias. Please disclose your potential conflicts to the audience by adding a slide in your presentation (use the standard disclosure template You should also be aware that you have confirmed that your content will be commercially non-based and evidence-based.

3. “Peer-review / Independent content validation”

You need to get your slides/content reviewed by the Chairperson or the Co-Chairperson of the event prior to presenting. This needs to be done before the event takes place, at the very latest during the Faculty precourse.

4. “Conflict unresolvable”

You cannot participate in the accredited educational event - for example because you are the owner of an ineligible company

You cannot teach in an accredited educational event without disclosing ALL financial relationships with ineligible companies you have or had in the past 36 months.

If you don’t have any potential conflicts you need to confirm their absence. 

 

Q&A for mitigators and reviewers

As a mitigator it is your responsibility to assess the disclosed potential Conflicts of Interest and decide on an appropriate strategy to mitigate the conflict, so content is not influenced by the disclosed financial relationship.

Faculty are mitigated by the Chairperson or the Co-Chairperson of the event. Chairpersons are mitigated by the respective Education Commission member. Education Commission Members are also subject to the disclosure process. All information on disclosures and m9tigation are published on the respective event website.

Based on the content you assigned to the respective Faculty or Chairperson you have to decide on the appropriate mitigation strategy that will prevent potential influence of the financial relationship disclosed on the content presented to learners.
All faculty have provided a “non-bias attestation” that they explicitly will avoid commercial bias in their content and that they will present evidence-based content, if evidence is available.
In addition, the mitigator can change the assignment so the conflict becomes unrelated to the content assigned. 
The mitigator can also request peer-review of the content prior to the educational activity.
Owners or employees of ineligible companies need to be excluded from participating as planners or faculty. 

Additional guidance: 

 

If peer-review is part of the mitigation strategy the respective Faculty member should submit the content prior to the event to the Chairperson or Co-Chairperson of the event for peer-review and feedback. At the latest the peer review should take place in the Faculty precourse of the respective event.