Guidelines by the European Federation of Neurological Societies (EFNS) subcommittee for Continuing Medical Education (CME) – modification 2003

Abstract

Education in all fields [pre-medical, postgraduate, continuing medical education (CME)] is a major task of the European Federation of Neurological Societies (EFNS). In the past, the EFNS task force for CME carried out surveys and found that despite considerable differences in education in neurology in Europe, clinical neurologists have a common need for CME. This need is enhanced by globalization, rapid turnover of scientific findings and a staggering accumulation of new knowledge, which can be directly or indirectly applied in clinical practice. In addition, there is rapid clinical application of new scientific knowledge in clinical practice. The problem we are still facing is the transfer of knowledge, practice and ‘state-of-the-art’ developments to the practising neurologist. This activity, now an obligation in most countries, is known as CME. Continuing Medical Education can be obtained in Europe mainly through attending congresses and meetings and, in the future, by making local visits to hospitals and specialized laboratories. Furthermore, there is a growing tendency in the industry to conduct CME-like meetings, which, while often presenting exquisite scientific content, ultimately aim at the promotion of a product. This kind of activity should be recognized as not preserving the necessary analytical distance and objectivity of the physician. As CME and CME activities of EFNS grew in importance and frequency, the former EFNS task force for CME, which had published and distributed the first version of the EFNS guidelines for EFNS approval of CME (Grisold, 1999), was made the standing committee of the EFNS: during the Third EFNS Congress in Seville, Spain, 19–25 September 1998, the EFNS Subcommittee on Continuing Medical Education (CME) was established to serve as the official body for the evaluation and approval of meeting approval applications. The EFNS Subcommittee on CME is within the structure and responsibility of the Education Committee, to which it reports and from which at least one member is represented on the subcommittee. However, it is an independent subcommittee in the sense that it has obvious freedom to judge on CME events. It consists of one chairperson, four members from EFNS member countries as well as one member with a consulting function from the USA. The involvement of a non-European member is helpful for finding solutions in cases of doubt or uncertainty among committee members or in cases where there is no agreement on whether or not to grant EFNS co-sponsorship. Members of this committee are required to be easily reachable via e-mail or fax, have a declared interest in education in neurology and they must process applications within the deadlines given. The following committee members were appointed. The chairman of the Subcommittee on CME is David B. Vodusek, Ljubljana, Slovenia. David B. Vodusek is Medical Director of the Division of Neurology at the University Medical Centre in Ljubljana and Professor of Neurology at the Medical Faculty of the University of Ljubljana. He is active both in graduate and postgraduate teaching and his main interests are clinical neurophysiology, uroneurology and behavioural neurology. He also is the first CME Editor of the European Journal of Neurology. The four European committee members are Guido Cavaletti, Monza, Italy; Nils E. Gilhus, Bergen, Norway; Marianne De Visser, Amsterdam, The Netherlands; Wolfgang Grisold, Vienna, Austria. Guido Cavaletti's interests lie in the field of light and electron microscopy with particular regard to the peripheral nervous system. He is in charge of the neuropathological section of the neuromuscular unit at the Institute “S. Gerardo” for Biomedical Sciences in Monza. Nils E. Gilhus works in the Department of Neurology at the University of Bergen. He is presently chairing the EFNS Scientist Panel on Neuroimmunology and also has a great interest in neurorehabilitation, headache and movement disorders. Marianne De Visser works in the Department of Neurology of the Academic Medical Centre of the University of Amsterdam and has great interest in neuromuscular disorders. Wolfgang Grisold has served as chairman of the EFNS task force for CME and set up the rules for EFNS approval of meetings. He is the head of the neurological department of the Kaiser-Franz-Josef Hospital in Vienna. He is very much involved in all fields of education in neurology and is the current chair of the EFNS Education Committee. He is also particularly interested in neurooncology. Eva L. Feldman from the University of Michigan in Ann Arbor, USA, is a consulting member of the EFNS Subcommittee on CME. E. L. Feldman is active in a variety of teaching activities at Michigan University. She is very much involved in the fields of amyotrophic lateral sclerosis, diabetes and polyneuropathies. Following the EFNS congress in Helsinki, 30 August to 2 September 2003, the CME guidelines (Grisold, 1999) were revised and the following is the first revised CME guideline version. This revised and updated handout is applicable throughout Europe. It serves to publicize high-quality CME events (approved by the EFNS) and to guarantee the unbiased nature of meetings, and ensure that the scientific and educational programmes are free of any influence from the industry. A CME event approved by the EFNS thus applies to any activity which conforms to the EFNS guidelines for approval of meetings. The idea behind these rules and the approval standards is to offer a platform for any involved, competent European neurologist with particular interest in science and education, who wishes to undertake CME, either by organizing an EFNS-approved CME meeting or by participating in an EFNS-approved meeting – the approval of which guarantees its unbiased nature and high quality. The subcommittee on CME is entrusted with reviewing submitted applications within 5 weeks of receipt. The members may abstain from voting in cases where doubt or uncertainty about a programme is felt. In addition to approval of a meeting, a committee member may act as monitor of a co-sponsored meeting or may suggest a monitor for such event. The EFNS is very pleased to offer this service and it is hoped that in the course of time a steadily increasing number of meeting organizers will make use of it. As a means of supporting and encouraging quality CME for neurologists, the EFNS has developed a system for publicly recognizing CME that meets the basic standards of quality. This way, institutions and organizations will strive to achieve or maintain standards of quality programming based on commonly accepted principles of continuing adult education. Moreover, neurologists will be able to note in advance those CME programmes that have successfully passed through the quality control process of the EFNS. The EFNS believes that it should promote quality CME on an intra-European basis. A quality programme developed in one European country may well be of benefit to physicians in other parts of Europe. European neurologists should be encouraged to participate in quality CME that meets their individual educational needs no matter where it takes place. EFNS approval facilitates this greater educational co-operation and sharing of resources throughout Europe. Some national groups have developed CME requirements (credit requirements) that specialists are expected to fulfill in order to remain in good standing. The EFNS believes that its approval system will satisfy these groups’ requirements so that specialists attending EFNS-approved programmes will be able to gain CME credits through their national groups. The EFNS is willing to consider live group programmes such as meetings, conferences, workshops and symposia for CME approval. Such educational events organized by independent organizers represent the main focus of EFNS support. The EFNS will also review other CME formats such as videotapes, computer-assisted instruction, internet education, home-study courses or printed materials for approval. Medical institutions and organizations involved in medical education, medical service, and professional associations may submit their CME programmes for review and approval. These organizations must have the respect of the local medical community for their integrity and commitment to quality education or service. The person responsible for the educational programme must be a neurologist or neuroscientist. The programme should have the recommendation of the national neurological society. If not included in the application, the EFNS reserves the right to ask the concerned national neurological society for a letter of recommendation. The programme being submitted to the EFNS for review must be in English. EFNS is also willing to approve high-quality educational events organized by industry-related institutions if they fulfill the strict criteria and have an open access. These institutions have to be funded by non-restricted educational grants; within the co-sponsored event there should be no product promoting activities. In addition to the usual application for the EFNS CME approval, a disclosure of financing of the industry-related institution is required in the form of a declaration of independence from the industry, obtained along with bylaws of the institution which performs the CME event. The bylaws or the status of the organization must be delivered in English. If it is an official bylaw, the translation into English must be legally confirmed. Additionally, it is mandatory that these industry-sponsored CME events are organized by an independent scientific person/committee. A declaration of independence – financial dependence of the said person(s) from industry with a complete financial disclosure is mandatory and needs to be added to the application. Granting CME approval to such education events will allow the organizers to add to their programmes a specially formulated co-sponsorship declaration, which is different from the declaration for events organized by independent organizers. A checklist for industry-sponsored events containing the above-mentioned details will be available for applicants. Approval by the EFNS means that in the best judgement of the EFNS, the CME programme satisfactorily meets its standards of quality programming and administration. EFNS approval pertains only to the educational programme that is under the direct responsibility of the institution or organization. Approval does not extend to industry-presented education (frequently called ‘satellite’ programmes). The EFNS retains the right to take the final decision as to whether a programme meets the EFNS standards. The authors are grateful to Lisa Müller for active involvement in development of the ideas and text. Educational and administrative standards Institutions and organizations that wish to apply for EFNS review and approval of their CME programme should request an application form. The completed application form should be sent to the EFNS with the information requested: EFNS Head Office, University Campus, Courtyard 1, Alser Strasse 4, A-1090 Vienna, Austria Tel.: +43 1 889 05 03; Fax: +43 1 889 05 03 13; E-mail: [email protected] Checklist for applications of industry-sponsored events: Applications must be sent at least 5 months prior to the CME meeting. The fee for review is €200. Applicants from European countries in transition may apply for a reduced review fee. A part of this fee may be used to cover travel expenses for EFNS representatives who monitor and evaluate approved meetings on site. A response will be made within 5 weeks of receiving the application. Questions concerning the process and application requirements should be addressed to: David B. Vodusek, c/o EFNS Head Office Vienna (see address details above). The EFNS will establish a complaint procedure. Participants of EFNS-approved programmes will be informed that they may file a complaint with the EFNS relating to approval standards or practices that are inappropriate for professional CME. The EFNS will normally appoint an official representative to monitor and evaluate the meeting. However, as it will not be possible to have a representative at every approved meeting, participation of representatives will be decided through random selection. If a representative has been appointed for a given meeting, the on-site expenses of this representative will be borne by the applicant organization, i.e. the applicant organization must provide free access to the programme (i.e. waive the registration and other fees pertaining to accommodation, if necessary, and meals, according to faculty standards, etc.). Approved programmes may include the following statement in promotional materials, brochures, printed programmes: This (meeting) has been reviewed and approved by the European Federation of Neurological Societies. The wording of our approval declaration to industry-related events: ‘EFNS acknowledges the educational value of the ………(event)………, (co-) organized by the ………(industry−relatedorganizer)………, and grants CME approval for the full programme because the contents are free of product information in any form, the education material is not accompanied by any product information and all the activities are organized on the basis of an unrestricted educational grant’. When a CME meeting is approved by the EFNS, the organizers may use the EFNS logo in connection with the EFNS approval statement. The logo may be obtained through the Head Office in Vienna. EFNS approval is proof of the high standard of the event. EFNS approval strongly increases the likelihood that the event will be accepted as CME activity by all national health authorities. A brief description/announcement of the event may be published in the European Journal of Neurology. The abstracts and/or proceedings of the meeting may be published in a supplement to the European Journal of Neurology at the cost of the organizer. EFNS-approved meetings will be listed in the calendar of events of the EFNS Newsletter as ‘approved (co-sponsored) by the EFNS’.