Maintenance of Certification-The Value to Patients and Physicians

This Viewpoint discusses the ABIM’s continuing efforts to innovate and streamline maintenance of certification, including the recently launched Longitudinal Knowledge Assessment (LKA), to better accommodate physicians’ schedules and desires for flexibility.

Accreditation model of European Haemophilia Centres in the era of novel treatments and gene therapy

INTRODUCTION

The international certification of haemophilia centres in Europe is run by the European Association of Haemophilia and Allied Disorders (EAHAD) and European Haemophilia Consortium (EHC) since 2013. The centres are designated as European Haemophilia Comprehensive Care Centres (EHCCC) or European Haemophilia Treatment Centres (EHTC), based on the specific requirements which evaluate centres' ability to provide care for patients with haemophilia and allied disorders.

AIM

To establish the new protocol for accreditation of European Haemophilia Centres.

METHODS

EAHAD, in collaboration with EHC, established Accreditation Working Group with the aim to define necessary measures to safeguard quality and improvement of bleeding disorders care throughout Europe and to build a novel model for accreditation of European Haemophilia Centres.

RESULTS

The European guidelines for certification of haemophilia centres have been updated to guidelines for the accreditation and include all the requirements regarding facilities, laboratory and personnel needed for optimal management of novel treatment options, including the introduction of the hub-and-spoke model for delivery of gene therapy. A pilot project for the accreditation of haemophilia centres including on-site audit has been designed.

CONCLUSION

Implementation of the novel accreditation protocol of the haemophilia treatment and haemophilia gene therapy centres has been made to further improve the quality of care for patients with haemophilia and other inherited bleeding disorders.

2020 family medicine postgraduate examinations at The University of the West Indies: successes and challenges in the time of COVID-19 pandemic

Little has been published regarding postgraduate assessments during the COVID-19 pandemic. There is an urgent need to graduate well-trained specialists including family physicians who play a key role in patient care. The successes and challenges encountered in mounting qualifying 2020 Family Medicine examinations during the COVID-19 pandemic at the University of the West Indies are described in this paper. Human resource, planning, use of technology and virtual environments are discussed, which enabled successful examinations at this multicampus regional site.

The Importance of Professional Discourse for the Continual Advancement of Practice Standards: The RBT® as a Case in Point

The Behavior Analyst Certification Board (BACB®) created a third level of certification, the Registered Behavior Technician™ (RBT®) in 2014. The RBT® was created based upon the requests of stakeholders who wanted to credential those individuals who make direct contact with clients under the supervision of a Board Certified Behavior Analyst®. There has been tremendous growth in the number of RBTs® with over 60,000 individuals certified to date. The BACB® recently sent out a newsletter outlining changes to the RBT® certification, including the processes of training, supervising, and becoming an RBT®. These changes represent a number of potential concerns. The purpose of this paper is to highlight these concerns and to propose solutions to improve the RBT® certification.

Influence of the artificial turf certification on physical performance and muscle damage in football players (QUALTURF PROJECT)

This study aimed to analyse the influence of the FIFA Quality PRO certification of artificial turf pitches on the physical, physiological performance and muscle damage in soccer players. Fifteen healthy male players (21.2 ± 1.4 years; 178.2 ± 4.3 cm; 79.1 ± 8.3 kg) from a university football team were selected to participate in the research. Mechanical properties related to surface-player interaction were assessed on the two surfaces selected for this study. A randomized design was used and the players performed the Ball-sport Endurance and Sprint Test (BEAST90) on the different artificial turf fields. Average time of the 20 m sprints was longer on the FIFA Quality Pro surface than on the non-certified pitch (+ 0.13 s; p < 0.05; CI 95% - 0.01 to 0.27; ES: 0.305). The players' perceived effort was higher in the first (+ 2.64; p < 0.05; CI 95% 0.92 to 4.35; ES: 1.421) and the second half (+ 1.35; p < 0.05; CI 95% - 0.02 to 2.72; ES: 0.637) of the test on the FIFA Quality Pro field. Comparative analysis between surfaces showed no significant differences in the time spent in each of the heart rate zones and higher concentrations of CK (+ 196.58; p > 0.05; CI 95% 66.54 to 326.61; ES: 1.645) were evidenced in the non-certified pitch surface. In response to a simulated match protocol, markers of post-exercise muscle damage may be reduced on accredited artificial turf fields. These insights can provide the opportunity to maximize the efficiency of training sessions and reduce the risk of injury during the season.

Development of gastroenterological surgery over the last decade in Japan: analysis of the National Clinical Database

The National Clinical Database (NCD) of Japan was established in 2010 with the board certification system. A joint committee of 16 gastroenterological surgery database-affiliated organizations has been nurturing this nationwide database and utilizing its data for various analyses. Stepwise board certification systems have been validated by the NCD and are used to improve the surgical outcomes of patients. The use of risk calculators based on risk models can be particularly helpful for establishing appropriate and less invasive surgical treatments for individual patients. Data obtained from the NCD reflect current developments in the surgical approaches used in hospitals, which have progressed from open surgery to endoscopic and robot-assisted procedures. An investigation of the data acquired by the NCD could answer some relevant clinical questions and lead to better surgical management of patients. Furthermore, excellent surgical outcomes can be achieved through international comparisons of the national databases worldwide. This review examines what we have learned from the NCD of gastroenterological surgery and discusses what future developments we can expect.

Progressing toward specialty certification as the National Standard for Nursing

Nursing specialty certification is an objective measure that assures the public that nurses demonstrate the highest level of professional knowledge in their field. Many nurses do not seek specialty certification, as evidenced by low certification rates. In this creative controversy article, we build a case that progressing toward nursing specialty certification as a national standard will increase overall nursing professionalism while better preparing nurses to meet the needs of their specialty patient populations and the changing health care system.

Performance of the Ebel standard-setting method in spring 2019 Royal College of Physicians and Surgeons of Canada internal medicine certification examination consisted of multiple-choice questions

PURPOSE

It aimed to know the performance of the Ebel standard-setting method in in spring 2019 Royal College of Physicians and Surgeons of Canada internal medicine certification examination consisted of multiple-choice questions. Specifically followings were searched: the inter-rater agreement; the correlation between Ebel scores and item facility indices; raters' knowledge of correct answers' impact on the Ebel score; and affection of rater's specialty on theinter-rater agreement and Ebel scores.

METHODS

Data were drawn from a Royal College of Physicians and Surgeons of Canada certification exam. Ebel's method was applied to 203 MCQs by 49 raters. Facility indices came from 194 candidates. We computed Fleiss' kappa and the Pearson correlation between Ebel scores and item facility indices. We investigated differences in the Ebel score (correct answers provided or not) and differences between internists and other specialists with t-tests.

RESULTS

Kappa was below 0.15 for facility and relevance. The correlation between Ebel scores and facility indices was low when correct answers were provided and negligible when they were not. The Ebel score was the same, whether the correct answers were provided or not. Inter-rater agreement and Ebel scores was not differentbetween internists and other specialists.

CONCLUSION

Inter-rater agreement and correlations between item Ebel scores and facility indices wee consistently low; furthermore, raters' knowledge of correct answer and rater specialty had no effect on Ebel scores in the present setting.

A New Paradigm for Testing Clinical Competence in Chaplaincy Certification

This article describes the rationale, evolution, implementation, and evaluation of a process for testing clinical competence in health care chaplaincy certification. The process developed by the Spiritual Care Association uses Zoom technology, simulated patient actors, and evidence-based behaviors. Evaluation of the process by users has been very positive. The process seems to have acceptable validity, reliability, and usability and should be considered as an alternative to self-report clinical encounters as a test of clinical competence.

An Examination of Self-Reported Assessment Activities Documented by Specialist Physicians for Maintenance of Certification

INTRODUCTION

Specialists in a Maintenance of Certification program are required to participate in assessment activities, such as chart audit, simulation, knowledge assessment, and multisource feedback. This study examined data from five different specialties to identify variation in participation in assessment activities, examine differences in the learning stimulated by assessment, assess the frequency and type of planned changes, and assess the association between learning, discussion, and planned changes.

METHODS

E-portfolio data were categorized and analyzed descriptively. Chi-squared tests examined associations.

RESULTS

A total of 2854 anatomical pathologists, cardiologists, gastroenterologists, ophthalmologists, and orthopedic surgeons provided data about 6063 assessment activities. Although there were differences in the role that learning played by discipline and assessment type, the most common activities documented across all specialties were self-assessment programs (n = 2122), feedback on teaching (n = 1078), personal practice assessments which the physician did themselves (n = 751), annual reviews (n = 682), and reviews by third parties (n = 661). Learning occurred for 93% of the activities and was associated with change. For 2126 activities, there were planned changes. Activities in which there was a discussion with a peer or supervisor were more likely to result in a change.

CONCLUSIONS AND DISCUSSION

Although specialists engaged in many types of assessment activities to meet the Maintenance of Certification program requirements, there was variability in how assessment stimulated learning and planned changes. It seems that peer discussion may be an important component in fostering practice change and forming plans for improvement which bears further study.

Change of accreditation standards of medical schools by the Korean Institute of Medical Education and Evaluation from 2000 to 2019

It aimed to provide the change of accreditation standards of medical schools in Korea by the Korean Institute of Medical Education and Evaluation (KIMEE) from 2000 to 2019. Specifically, the following was explained: the development process, setting principle and direction, items of evaluation, characteristics of the standards, and validity test of 4 cycles. The first cycle of accreditation (2000-2005) was a process to secure the minimum requirement of the educational environment. The evaluation criteria emphasized the evaluation of the core elements of medical education, including facilities and human resources. The second cycle of accreditation (2007-2010) was a process in which the university emphasized its commitment to social accountability and the pursuit of excellence in medical education. It raised the importance of the qualitative standard for judging the contents and fidelity of education. In the post-2nd cycle of accreditation (2012-2018), the certification criteria were developed to standardize the educational environment and educational programs and to use them in the development of curriculum, to continually improve the quality of basic medical education. The ASK2019 accreditation aimed at qualitative evaluation following the World Federation of Medical Education's accreditation criteria to reach the international level of basic medical education, which stresses the student-centered curriculum, communication with the society, and evaluation through whole basic medical education course. KIMEE has developed the basic medical education evaluation and certification system step by step as above. Understanding the previous process will help to develop the accreditation criteria of medical school in Korea.

Development of a Professional Certification in Cancer Patient Education

Patient educators come into the field from diverse professional backgrounds and often lack training in how to teach and develop patient education resources since no formal patient education professional certification program exists. A professional certification program for patient educators would further define the professional scope of practice and reduce variability in performance. The purpose of this study was to (1) determine the level of interest among Canadian cancer patient educators in a patient education professional certification program and (2) determine the competencies to be included in the professional certification program. A 12-item survey was designed by executive members of the Canadian Chapter of the Cancer Patient Education Network. The survey included a list of competencies associated with patient education, and a 4-point Likert scale ranging from "slightly important" to "very important" was used to determine the rank of each competency. The survey was sent to 53 patient educators across Canada. Ninety-two percent of the patient educators are interested in a professional certification program. Patient educators indicated that competencies related to developing patient resources, collaboration, plain language expertise, and health literacy were of most importance. Patient educators support the development of a patient education professional certification program and endorsed the competencies proposed. This information provides the foundation for the creation of a professional certification program for cancer patient educators.

Current Data of Foreign-Educated Nurses in Italy and the Recognition of Their Professional Qualifications

Up-to-date data on foreign-educated nurses (FENs) in Italy and the recognition of their professional qualifications are pivotal to boost international discussion, and to improve the engagement and involvement of multistakeholders in the nursing profession. Currently, FENs in Italy represent roughly 6% of the total number of registered nurses. FENs are predominantly females between 35 and 54 years old. This article discusses FENs' paths to achieve their professional qualification to practice in Italy. It also offers insights for regulators and stakeholders, such as the need to enlarge the scope of practice for nurses.

Can Maintenance of Certification Work? Associations of MOC and Improvements in Physicians' Knowledge and Practice

PURPOSE

To summarize the findings of studies, conducted by individuals both internal and external to the American Board of Medical Specialties (ABMS) Member Boards, of the associations of Maintenance of Certification (MOC) and improvements in physicians' knowledge and patient care processes or outcomes.

METHOD

The authors conducted a narrative review of studies identified by searching PubMed and Web of Science for English-language articles from the United States published between 2000 and May 2017. To be included, articles had to examine the relationship of MOC to physician knowledge, clinical practice processes, or patient care outcomes. The initial search yielded 811 articles. After two rounds of review and excluding those articles that did not fit the study criteria, 39 articles were included for analysis.

RESULTS

The 39 included studies were conducted by or included diplomates of 12 ABMS Member Boards. Twenty-two studies examined MOC processes that were developed by an ABMS Board; 17 examined interventions that were developed by nonboard entities but accepted for MOC credit by an ABMS Board. Thirty-eight studies examined a single component of MOC; 24 studied the improvement in medical practice component. Thirty-seven studies reported at least one positive outcome.

CONCLUSIONS

Most of the studies included in this review highlighted circumstances in which MOC was associated with positive impacts on physician knowledge and patient care processes or outcomes. Future collaborative research is needed to improve the relevance, helpfulness, and generalizability of continuing certification to different physicians across specialties and practice settings.

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TOWARDS A NEW CERTIFICATION OF HEALTHCARE FACILITIES FOR 2020.: The accreditation process, now a certification process for healthcare facilities, has constantly evolved since 1999 in order to improve the quality and safety of care provided to patients. In order to meet demographic, epidemiological and social challenges, it needs to be revised again. The French National Health Authority board has fixed three main objectives for the 2020 version: to medicalise certification, simplify it and adapt it to hospital groups in the public and private sector.

[Not Available]

The certification visit by the French National Health Authority requires a high level of commitment and collaboration on the part of the teams of the healthcare facility concerned. Professionals from a hospital at home unit having obtained its Level A certification describe the process and explain how the approach helped to give meaning to collective action when caring for patients in their home.

[Not Available]

V2014 CERTIFICATION AND NURSING TEAMS.: V2014 certification focuses on the management of care-related risks. During the certification visit, the caregiver sometimes has to explain to the experts from the French National Health Authority their understanding of the approaches undertaken in their department, as well as their own contribution to their implementation. Users' representatives are also consulted. The next version of the certification, in 2020, will aim to give even more meaning to nursing practices through the analysis and the relevance of the care provided.

What Family Physicians Really Think of Maintenance of Certification Part II Activities

INTRODUCTION

This study examines how improving curricular content and technical interface issues could make maintenance of certification activities more meaningful to American Board of Family Medicine diplomates completing Maintenance of Certification for Family Physicians (MC-FP) Program self-assessment modules (SAMs).

METHODS

We used a sequential exploratory design to analyze quantitative and qualitative data from 320,500 surveys of family physicians who completed a SAM between January 2004 and April 2013. This included numeric rating scales and free text comments. Basic statistical rankings, template-based automated coding, and emergent coding were used to analyze SAM experience and identify thematic content.

RESULTS

Across SAMs, numeric ratings were universally high and positive free text comments outnumbered negative comments two to one. When comparing feedback on the knowledge assessment and clinical simulation (CS) activities, SAMs were rated less favorably when the frequency of ideas identified by participants as most prevalent in one activity mismatched those identified as most prevalent in the companion activity. Participants were also critical of navigation issues, technical issues, and a lack of realness in the CS activity.

DISCUSSION

Whether analyzed through quantitative data, qualitative data, or mixed methods, a large majority of participants rated their experience with SAMs highly. When individual SAMs were rated poorly, it seemed to be due to discordance in ideas emphasized between the knowledge assessment and CS components, or an opinion regarding the SAM topic that existed independent of the SAM process.

Conducting simulation studies for computerized adaptive testing using SimulCAT: an instructional piece

Computerized adaptive testing (CAT) technology is widely used in a variety of licensing and certification examinations administered to health professionals in the United States. Many more countries worldwide are expected to adopt CAT for their national licensing examinations for health professionals due to its reduced test time and more accurate estimation of a test-taker's performance ability. Continuous improvements to CAT algorithms promote the stability and reliability of the results of such examinations. For this reason, conducting simulation studies is a critically important component of evaluating the design of CAT programs and their implementation. This report introduces the principles of SimulCAT, a software program developed for conducting CAT simulation studies. The key evaluation criteria for CAT simulation studies are explained and some guidelines are offered for practitioners and test developers. A step-by-step tutorial example of a SimulCAT run is also presented. The SimulCAT program supports most of the methods used for the 3 key components of item selection in CAT: the item selection criterion, item exposure control, and content balancing. Methods for determining the test length (fixed or variable) and score estimation algorithms are also covered. The simulation studies presented include output files for the response string, item use, standard error of estimation, Newton-Raphson iteration information, theta estimation, the full response matrix, and the true standard error of estimation. In CAT simulations, one condition cannot be generalized to another; therefore, it is recommended that practitioners perform CAT simulation studies in each stage of CAT development.

Guidelines for training in cardiovascular magnetic resonance (CMR)

These "Guidelines for training in Cardiovascular Magnetic Resonance" were developed by the Certification Committee of the Society for Cardiovascular Magnetic Resonance (SCMR) and approved by the SCMR Board of Trustees.

Relationships Between the ACGME Resident and Faculty Surveys and Program Pass Rates on the ABIM Internal Medicine Certification Examination

PURPOSE

The Accreditation Council for Graduate Medical Education (ACGME) has surveyed residents since 2003, and faculty since 2012. Surveys are designed to assess program functioning and specify areas for improvement. The purpose of this study was to assess the association of the ACGME's resident and faculty surveys with residency-program-specific performance on the American Board of Internal Medicine (ABIM) certification exam.

METHOD

Data were available from residents and faculty in 375 U.S. ACGME-accredited internal medicine programs from the 2012-2013, 2013-2014, and 2014-2015 academic years. Analysis of variance and correlations were used to examine the relationship between noncompliance with ACGME program requirements as assessed by the resident and faculty surveys, and ABIM program pass rates.

RESULTS

Noncompliance reported on the resident and faculty surveys was highest for programs not meeting the ACGME program requirement of an 80% pass rate on the ABIM certification examination. This relationship was significant for overall noncompliance, both within the resident (P < .001) and faculty (P < .05) surveys, for many areas within the two surveys (correlations ranged between -.07 and -.25, and P values ranged between .20 and < .001), and for the highest levels of noncompliance across areas of the resident (P < .001) and faculty (P < .04) surveys.

CONCLUSIONS

ACGME resident and faculty surveys were significantly associated with ABIM program pass rates, supporting the importance of these surveys within the ACGME's Next Accreditation System.

Development and evaluation of an elective course that incorporates a standard medication therapy management certificate program

BACKGROUND AND PURPOSE

To describe the development and evaluation of a medication therapy management (MTM) elective that incorporates a nationally recognized certificate training program (CTP) by assessing changes in perceived abilities and values among student pharmacists, knowledge of course material, and performance conducting MTM services. Student satisfaction with course content and delivery model was also evaluated.

EDUCATIONAL ACTIVITY AND SETTING

University faculty developed a didactic elective course to provide third-professional year student pharmacists with the opportunity to meet the learning objectives of the American Pharmacists Association (APhA) "Delivering Medication Therapy Management Services" CTP. Additional learning activities developed by course faculty included supplemental didactic content, reinforcement exercises, simulated patient interactions, self-reflections, and detailed faculty assessment and feedback. Pre- and post-course surveys collected information about student perceptions and values. Course grades for quizzes, midterm, follow-up, and final comprehensive medication review (CMR) assessments were retrospectively analyzed to assess student performance. Student satisfaction with course content and delivery methods was assessed via a survey.

FINDINGS AND DISCUSSION

Student-reported perceived abilities improved across all survey items and there was high baseline agreement with MTM value statements. Quiz results suggested student achievement of course objectives. Student performance improved in most grading domains from the midterm to final assessment. A majority of students were satisfied with the course content and delivery methods.

SUMMARY

Evaluation of student perceived abilities and values, performance, and satisfaction support the successful incorporation of the MTM CTP along with faculty-developed supplemental content and activities into a longitudinal elective course in the pharmacy curriculum.

Simulation for competency assessment in vascular and cardiac ultrasound

Healthcare providers who use peripheral vascular and cardiac ultrasound require specialized training to develop the technical and interpretive skills necessary to perform accurate diagnostic tests. Assessment of competence is a critical component of training that documents a learner's progress and is a requirement for competency-based medical education (CBME) as well as specialty certification or credentialing. The use of simulation for CBME in diagnostic ultrasound is particularly appealing since it incorporates both the psychomotor and cognitive domains while eliminating dependency on the availability of live patients with a range of pathology. However, successful application of simulation in this setting requires realistic, full-featured simulators and appropriate standardized metrics for competency testing. The principal diagnostic parameter in peripheral vascular ultrasound is measurement of peak systolic velocity (PSV) on Doppler spectral waveforms, and simulation of Doppler flow detection presents unique challenges. The computer-based duplex ultrasound simulator developed at the University of Washington uses computational fluid dynamics modeling and presents real-time color-flow Doppler images and Doppler spectral waveforms along with the corresponding B-mode images. This simulator provides a realistic scanning experience that includes measuring PSV in various arterial segments and applying actual diagnostic criteria. Simulators for echocardiography have been available since the 1990s and are currently more advanced than those for peripheral vascular ultrasound. Echocardiography simulators are now offered for both transesophageal echo and transthoracic echo. These computer-based simulators have 3D graphic displays that provide feedback to the learner and metrics for assessment of technical skill that are based on transducer tracking data. Such metrics provide a motion-based or kinematic analysis of skill in performing cardiac ultrasound. The use of simulation in peripheral vascular and cardiac ultrasound can provide a standardized and readily available method for training and competency assessment.

Assessment and Change: An Exploration of Documented Assessment Activities and Outcomes by Canadian Psychiatrists

INTRODUCTION

Fellows of the Royal College of Physicians and Surgeons of Canada are required to participate in assessment activities for all new 5-year cycles beginning on or after January 2014 to meet the maintenance of certification program requirements. This study examined the assessment activities which psychiatrists reported in their maintenance of certification e-portfolios to determine the types and frequency of activities reported; the resultant learning, planned learning, and/or changes to the practice they planned or implemented; and the interrelationship between the types of assessment activities, learning that was affirmed or planned, and changes planned or implemented.

METHODS

A total of 5000 entries from 2195 psychiatrists were examined. A thematic analysis drawing on the framework analysis was undertaken of the 2016 entries.

RESULTS

There were 3841 entries for analysis; 1159 entries did not meet the criteria for assessment. The most commonly reported activities were self-assessment programs, feedback on teaching, regular performance reviews, and chart reviews. Less frequent were direct observation, peer supervision, and reviews by provincial medical regulatory authorities. In response to the data, psychiatrists affirmed that their practices were appropriate, identified gaps they intended to address, planned future learning, and/or planned or implemented changes. The assessment activities were internally or externally initiated and resulted in no or small changes (accommodations and adjustments) or redirections.

DISCUSSION

Psychiatrists reported participating in a variety of assessment activities that resulted in variable impact on learning and change. The study underscores the need to ensure that assessments being undertaken are purposeful, relevant, and designed to enable identification of outcomes that impact practice.

Virtually Certified: Development of an Online Oral Examination Phase for a National Advanced Practice Certification Model for Radiation Therapists in Canada

Following development of a framework to establish the scope of advanced practice for radiation therapists (APRTs), a Canadian certification process was built. This involved three independently-assessed phases: professional portfolio, case submission, and oral examination. The oral examination was to test the candidate's knowledge and capacity for decision-making. Development and piloting involved 3 elements: 1) content development, including relevant case selection, with accompanying high-fidelity imaging and resources; 2) harnessing of technology and ensuing logistics, given the desire to offer the examination online, maximizing accessibility and minimizing resources; and 3) examiner recruitment and preparation, involving a national call for interprofessional examiners, to assess across the spectrum of competencies. Each element was approached systematically, with modifications made iteratively. Three overarching challenges required ongoing attention and consideration: resource-intensiveness of building and validating cases, ensuring applicability and relevance of case content and "answers" across practice environments, and preparation of non-radiation therapist (oncologist and physicist) examiners regarding APRT standards. The resultant examination model is thought to be a robust assessment tool, well-regarded by candidates and examiners as fair and transparent, and complementary to the other certification phases. A consultatory pilot process supported establishment of a robust framework that is believed to be defensible and preliminarily valid.

Certification, Accreditation, and Credentialing for 503A Compounding Pharmacies

The terms certification, accreditation, and credentialing are often used interchangeably when they apply to compounding-pharmacy qualifications, but they are not synonymous. The reasons for obtaining each, the requirements for each, and the benefits of each differ. Achieving such distinctions can negatively or positively affect the status of a pharmacy among peers and prescribers as well as a pharmacy's relationships with third-party payors. Changes in the third-party payor industry evolve constantly and, we suggest, will continue to do so. Compounding pharmacists must be aware of those changes to help ensure success in a highly competitive marketplace. To our knowledge at the time of this writing, there is no certification program for compounding pharmacists, although pharmacy technicians can achieve certification and may be required to do so by the state in which they practice (a topic beyond the scope of this article). For that reason, we primarily address accreditation and credentialing for 503A compounding pharmacies. In this article, the evolution of the third-party payment system for compounds is reviewed; the definitions of certification, accreditation, and credentialing are examined; and the benefits and recognition of obtaining accredited or credentialed status are discussed. Suggestions for selecting an appropriate agency that offers accreditation or credentialing, preparing for and undergoing an onsite survey, responding to findings, and maintaining a pharmacy practice that enables a successful survey outcome are presented. The personal experience of author CK during accreditation and credentialing is discussed, as is the role of a consultant (author BJ) in helping compounders prepare for the survey process. A list of agencies that offer accreditation and credentialing for compounding pharmacies is included for easy reference.

Incorporating the American Pharmacists Association's Delivering Medication Therapy Management services certificate program into an accelerated pharmacy curriculum

BACKGROUND AND PURPOSE

To describe the incorporation of the American Pharmacists Association (APhA) Delivering Medication Therapy Management (MTM) Services program into a PharmD curriculum and to describe student perceptions of the program.

EDUCATIONAL ACTIVITY AND SETTING

The program was delivered over 12 months to students on two campuses via two didactic courses in the second professional year and during the first two advanced pharmacy practice experiences in the third professional year of an accelerated school of pharmacy program.

FINDINGS

Student perceptions were assessed by review of responses to the APhA MTM program evaluation survey.

DISCUSSION AND SUMMARY

Incorporation of the APhA MTM program into an accelerated PharmD program required careful planning and coordination amongst faculty and course coordinators. Students perceived that the program was valuable, met their educational needs, and incorporated effective learning experiences and cases. These perceptions were reinforced by the high percentage of students who completed the program.

[Continuing medical education in gastroenterology and recertification in Peru]

The field of action of gastroenterology has been expanded due to technological development and the advent of new sub-specialties, such as gastroenterology oncology. Currently, there is no standardization of medical training programs in gastroenterology in our country. The health system and education are changing, so medical practice and competency assessment for medical certification and recertification should reflect these changes. On the other hand, the quality of a specialized unit, service or medical department is directly related to the quality of human resources. Lifelong learning is reflected in continuing medical education (CME). The goal of CME should be to achieve changes in staff conduct, through continuous improvement in daily practice. This requires knowing the social, institutional and individual needs and developing new, more flexible and individualized CME programs. Recertification at fixed intervals should be abandoned in favor of a model that promotes continuous professional development based on health needs and with curricular materials that support competency assessments.

Practice simulated office orals as a predictor of Certification examination performance in family medicine

OBJECTIVE

To determine if performance on practice simulated office orals (SOOs) conducted during residency training could predict residents' performance on the SOO component of the College of Family Physicians of Canada's (CFPC's) final Certification examination.

DESIGN

Prospective cohort study.

SETTING

University of Ottawa in Ontario.

PARTICIPANTS

Family medicine residents enrolled in the University of Ottawa's Family Medicine Residency program between July 1, 2012, and June 30, 2014, who were eligible to write the CFPC Certification examination in the spring of 2014 and who had participated in all 4 practice SOO examination sessions; 23 residents met these criteria.

MAIN OUTCOME MEASURES

Scores on practice SOO sessions during fall 2012, spring 2013, fall 2013, and spring 2014; and the SOO component score on the spring 2014 administration of the CFPC Certification examination.

RESULTS

Weighted least squares regression analysis using the 4 practice SOO session scores significantly predicted the final Certification examination SOO score (P < .05), with an adjusted R² value of 0.29. Additional analysis revealed that the mean scores for the cohort generated at each time point were statistically different from each other (P < .001) and that the relationship over time could be represented by either a linear relationship or a quadratic relationship. A generalizability study generated a relative generalizability coefficient of 0.63.

CONCLUSION

Our results confirm the usefulness of practice SOOs as a progress test and demonstrate the feasibility of using them to predict final scores on the SOO component of the CFPC's Certification examination.

A global picture of pharmacy technician and other pharmacy support workforce cadres

INTRODUCTION

Understanding how pharmacy technicians and other pharmacy support workforce cadres assist pharmacists in the healthcare system will facilitate developing health systems with the ability to achieve universal health coverage as it is defined in different country contexts. The aim of this paper is to provide an overview of the present global variety in the technician and other pharmacy support workforce cadres considering; their scope, roles, supervision, education and legal framework.

MATERIAL AND METHODS

A structured online survey instrument was administered globally using the Survey Monkey platform, designed to address the following topic areas: roles, responsibilities, supervision, education and legislation. The survey was circulated to International Pharmaceutical Federation (FIP) member organisations and a variety of global list serves where pharmaceutical services are discussed.

RESULTS

193 entries from 67 countries and territories were included in the final analysis revealing a vast global variety with respect to the pharmacy support workforce.

ROLES AND COMPETENCY

From no pharmacy technicians or other pharmacy support workforce cadres in Japan, through a variety of cadre interactions with pharmacists, to the autonomous practice of pharmacy support workforce cadres in Malawi.

RESPONSIBILITIES

From strictly supervised practice with a focus on supply, through autonomous practice for a variety of responsibilities, to independent practice.

SUPERVISION

From complete supervision for all tasks, through geographical varied supervision, to independent practice.

EDUCATION

From on the job training, through certificate level vocational courses, to 3-4 year diploma programs.

LEGISLATION, REGULATION AND LIABILITY

From well-regulated and registered, through part regulation with weak implementation, to completely non-regulated contexts.

CONCLUSION

This paper documents wide differences in supervision requirements, education systems and supportive legislation for pharmacy support workforce cadres globally. A more detailed understanding of specific country practice settings is required if the use of pharmacy support workforce cadres is to be optimized.

Supporting children's nurses through Nursing and Midwifery Council revalidation

In April 2016 the Nursing and Midwifery Council introduced revalidation for all nurses and midwives. It was designed to demonstrate a registrant's ability to practise safely and effectively throughout their career and thereby improve patient and public protection. Children's nurses should be aware of their renewal (revalidation) date to prepare their portfolio in good time. The portfolio must include evidence of 450 hours of practice, 35 hours of continuing professional development, five examples of feedback on practice and five written reflective accounts. Revalidation was tested in 19 pilot sites across the UK including Aneurin Bevan University Health Board (ABUHB) - the overall experience of the children's nurses from ABUHB who participated in the pilot was positive. Children's nurses have been supported in revalidation through learning from shared examples of portfolio entries. Advice from ABUHB pilot participants to children's nurses includes getting organised, recording information regularly in their portfolio and the reassurance that revalidation is not difficult.

How to submit your revalidation application

Rationale and key points This is the final in a series of eight articles providing information about the Nursing and Midwifery Council revalidation process. This article focuses on submitting a revalidation application to the NMC. » Nurses and midwives must demonstrate that they have: completed 450 hours of practice, or 900 hours if revalidating as both a nurse and midwife; undertaken 35 hours of continuing professional development, 20 hours of which must be participatory; recorded five examples of feedback on their practice; written five reflective accounts; had a reflective discussion with an NMC registrant; and sought confirmation that they have met these requirements. » Nurses and midwives who fail to submit their revalidation application by the stated date will put the renewal of their registration at risk. Reflective activity 'How to' revalidate articles can help to update your practice and provide information about the revalidation process, including how you can submit your revalidation application. Reflect on and write a short account of: 1. The professional accountability associated with declaring that you have met the revalidation requirements. 2. How you could use this article to educate your colleagues. Subscribers can upload their reflective accounts at: rcni.com/portfolio .

How to engage in a reflective discussion for revalidation

Rationale and key points This is the sixth in a series of eight articles providing information about the Nursing and Midwifery Council (NMC) revalidation process. This article focuses on the requirement for nurses and midwives to engage in a reflective discussion with an NMC registrant. The purpose of the reflective discussion is to encourage a culture of sharing information to support professional development and improve practice. » The reflective discussion must be undertaken with an NMC registrant. » The reflective discussion should cover the five written reflective accounts required to renew registration. Reflective activity 'How to' revalidate articles can help to update your practice and provide information about the revalidation process, including how you can engage in a reflective discussion. Reflect on and write a short account of: 1. How engaging in a reflective discussion with an NMC registrant helps you to view a situation from another person's perspective. 2. How you could use this article to educate your colleagues. Subscribers can upload their reflective accounts at: rcni.com/portfolio.

How to record and evidence continuing professional development for revalidation

Rationale and key points This is the third in a series of eight articles providing information about the Nursing and Midwifery Council (NMC) revalidation process. This article focuses on recording and providing evidence of continuing professional development (CPD). Nurses and midwives must have undertaken 35 hours of CPD, of which at least 20 hours must have included participatory learning, relevant to their scope of practice, in the 3-year period since their registration was last renewed or they joined the register. » CPD enables nurses and midwives to ensure their knowledge and skills are up to date. » The participatory component of CPD encourages engagement and communication with others, thus challenging professional isolation. Reflective activity 'How to' revalidate articles can help to update your practice and provide information about the revalidation process, including how you can record and evidence CPD for revalidation. Reflect on and write a short account of: 1. How recording and evidencing CPD will demonstrate the skills, knowledge and experience you have gained in practice. 2. How you could use this article to educate your colleagues. Subscribers can update their reflective accounts at: rcni.com/portfolio.

How to prepare for revalidation

Rationale and key points This is the first in a series of eight articles providing information about the Nursing and Midwifery Council (NMC) revalidation process, which was introduced in April 2016. This article focuses on setting up an online NMC account, preparing for revalidation and understanding revalidation requirements. » Revalidation is a mandatory process for nurses and midwives, enabling them to demonstrate their ability to practise safely and effectively. » Registered nurses and midwives are required to revalidate with the NMC every 3 years. » Revalidation encourages nurses and midwives to stay up to date in their professional practice. Reflective activity How to revalidate articles can help to update your practice and provide information about the revalidation process, including how you can successfully submit your revalidation request to the NMC. Reflect on and write a short account of: 1. The strengths of revalidation compared to post-registration education and practice requirements. 2. The revalidation requirements and how these can be met. Subscribers can upload their reflective accounts at: rcni.com/portfolio .