Disclosure Policy (Conflict of Interest) - Geisinger Health System

Professional 

Development 

Policy & 

Procedure 

Manual 

2006 

Revised 03/16/06 

© Professional Development P&P Manual 2005 1


Table of Contents 

Page 

ESSENTIAL 1 - PURPOSE AND MISSION 

Mission Statement 7 

CME Essentials 9 

CME Committee Membership 11 

Executive Committee 12 

Grievance Process 13 

ORGANIZATION 

CME Office Historical Perspectives 15 

Organizational Chart 16 

Organizational Chart of the Internal Structure 17 

Personnel Directory 18 

Job Descriptions 19 

Responsibilities of the CME Office 34 

Roles and Responsibilities of the CME Activity Director 36 

Policy for Non-Compliance with CME Requirements 38 

Roles and Responsibilities of the CME Associate 40 

Role Description of the CMEC Member 41 

ESSENTIAL 2 - EDUCATIONAL PLANNING AND EVALUATION 

Introduction to Educational Planning and Evaluation 43 

Definition of Category 1 46 

Definition of Category 2 46 

Needs Assessment 

Definition 47 

Establishing Needs Assessment 48 

Examples of Methods 50 

Planning 

Planning Minutes 55 

Facility Information – ACPE 56 

Objectives 

Definition of Objectives 58 

Vocabulary 59 

References for Objective Writing 60 

Policy for Single Day Activity 60 

Policy for Recurring Activities 60 


Approval Process 

Process 61 

Application 62 

Requirement 64 

Check List 65 

Evaluation 

Definition 69 

Policy 69 

Summary 69 

Who Receives Summaries 69 

Samples 70 

ESSENTIAL 3 - RESOURCES/JOINT SPONSORSHIP/ENDURING 

MATERIALS/COMMERCIAL SUPPORT - 

Policies for Various Types of Activities 

Self-directed 79 

Mini-fellowships 85 

Enduring Materials 91 

On-Line 93 

Joint Sponsorship 95 

Team CME Policy 98 

Commercial Support 

Standards 104 

Disclosure Policy 109 

Management of Conflicts of Interest Policy 110 

Disclosure Form 112 

Faculty Attestation Form 113 

Written Agreement 114 

VARIOUS CME POLICIES & SAMPLES 

Activity cancellation 116 

Activity Refunds 116 

Confirmation Letters 116 

Attendance Record Samples 118 

Certificates of Attendance 119 

BROCHURE DESIGN 

Policy 125 

Required Statements 125 

Deadlines 126 

Proofreading 126 

Sample 126 


FISCAL 

No Fee CME Policy 125 

Honoraria Policy 125 

Disposition of Surplus 126 

Office Budget 127 

MISCELLANEOUS 

Facilities Policy 130 

Faculty Check List 131 

Budget Check List 132 

CME Office Activity Request Policy 133 

CME Office Activity Request Form 134 

CME Office Activity Request Confirmation 135 


Essential 1 

Purpose And Mission 


Mission Statement 

Geisinger Health System 

Continuing Medical Education/Continuous Professional Development 

(CME/CPD) 

The Continuing Medical Education/Continuous Professional Development 

Program of the Geisinger Health System serves the educational needs of the 

integrated health care delivery system. The Geisinger Health System includes a 

Geisinger Medical Center (teaching hospital), Danville; Geisinger Wyoming Valley 

(community hospital), Wilkes Barre; Marworth (alcohol and chemical dependency 

treatment center), Waverly; Sigfried & Janet Weis Center for Research, Danville; 

all owned clinic sites in the health system; Center for Health Research & Rural 

Advocacy, the Geisinger Health Plan; affiliated hospitals and community 

physicians and other healthcare providers. 

1. Goals: 

• The dissemination evidence-based medical knowledge and clinical skills in 

the healing arts to improve the safety and quality of the health care 

provided to patients. 

• Support of Geisinger and community physicians and other health care 

providers (see Addendum) in their professional roles by providing 

opportunities for enhancement of communication, teaching and 

management skills. 

• Professional development for physicians and health care providers. 

2. The major focus of the Geisinger CME/CPD is enhancement of patient care. 

Programs are developed to support providers in primary care, medicine, 

pediatrics, surgery, psychiatry, pathology, women’s health and radiology. 

3. Potential participants include all Geisinger Health System employees, 

Community and Affiliated physicians, mid-level providers and other 

appropriate health care providers. 

4. CME/CPD designs seminars, workshops, enduring materials, Intranet and 

Internet materials and provides conferences and jointly sponsored activities. 

Outcomes of these activities are to be measured by assessing: use of disease 

management protocols, improvement in quality indicators, improved patient 

and employee satisfaction, improved patient care team function and 

successful career development. Outcomes measurements will be completed 

by survey methods. 

Devised 3/17/00 




Approved by System Leadership Council: 

Bruce H. Hamory, M.D. 

Executive Vice President & Chief Medical Officer 

Date 


ADDENDUM 

Geisinger Health System Continuing Medical Education/Continuous Professional 

Development provides educational support to registered nurses, pharmacists, 

physician assistants, physical therapists, occupational therapists, radiation 

technologists, nurse practitioners, psychologists, professional coders, clinical 

research coordinators, lawyers, osteopaths, licensed practical nurses, nurse 

anesthetists, respiratory therapists, athletic trainers, religious leaders, dietitians, 

health care chaplains, social workers, students, counselors, certified therapists, 

childbirth educators, nursing home administrators and nurse midwives. 


CME Essentials 

Pennsylvania Medical Society System Of Accreditation 

Essential Areas, Their Elements And Criteria 

Essential Area #1: Purpose And Mission (Elements) 

The provider must: 

1.1 Have a written statement of its CME mission, which includes the CME 

purpose, content areas, target audience, type of activities provided and 

expected outcomes of the program. 

1.2 Demonstrate how the CME mission is congruent with and supported by 

the CME mission of the parent organization, if the CME parent 

organization exists. 

Essential Area #2: Educational Planning And Evaluation (Elements) 


2.1 Use a planning process(es) that links identified educational needs with a 

desired outcome in its provision of all CME activities 

• Consider design, audience, and type (format) of activity 

• Demonstrate that evaluation data are used in planning CME 

activities 

2.2 Use needs assessment data to plan CME activities 

2.3 Communicate learning/behavioral objectives of the activity so the learner 

is informed before participating in the activity 

2.4 Evaluate the effectiveness of its CME activities in meeting identified 

educational needs. Show that these evaluations assess: 

• Extent to which educational objectives are being met 

• Quality of the instructional process 

• Participants perception of enhanced professional effectiveness 

• Designated outcomes 

2.5 Evaluate the effectiveness of its overall CME program, make 

improvements to the program, demonstrate that evaluation data are used 

in planning future CME activities, and relate this to Essential Area 1 


Essential Area #3: Administration/Disclosure & Commercial 

Support/Enduring Materials/Journal-Based CME/Joint Sponsorship 

(Elements) 


3.1 Have an organizational framework for the CME unit that provides the 

necessary resources to support its mission including support by the parent 

organization, if a patient organization exists. 

• Document an organizational structure for CME and its 

administration, designating an entity responsible for CME and 

delineating its authority 

• Identify responsible individuals who will maintain continuity of 

leadership 

3.2 Operate the business and management policies and procedures of its CME 

program (as they related to human resources, financial affairs, legal 

obligations, record keeping, faculty and facilities), so that its obligations 

and commitments are met. 

• Provide a budget for the overall CME program and its major 

components 

• Utilize competent faculty 

• Provider appropriate facilities for CME activities 

• Have mechanisms to record and, when authorized by the 

participating physician, to verify participation 

3.3 Present CME activities in compliance with the Pennsylvania Medical 

Society’s policies for disclosure and commercial support 


Society’s policies for enduring materials 


Society’s policies for Journal-Based CME 


Society’s policies for joint sponsorship 


CME Committee Membership 

The Geisinger Health System CME Committee is made up of professionals who 

have insight into our continuing medical educational needs. The Associate Chief 

Medical Officer for Academic Affairs and Continuing Medical Education appoints 

members for a term of 2 or 3 years (staggered to allow for continuity). 

Reappointment is at the discretion of the CME Committee. 

The committee will consist of physicians from Community Practice representing 

State College and Wilkes-Barre areas, Manager, Office of Continuing Medical 

Education, Associate Chief Medical Officer for Academic Affairs, Director of 

Academic Information, Director of Faculty Development, a Physician Assistant, a 

Nurse Practitioner, Continuing Nursing Education Coordinator, a system leader in 

Practice Improvement, and ACPE administrator. The committee is charged with 

providing oversight and direction for the CME activities sponsored by the health 

system for physicians, nurses, pharmacists and other healthcare professionals. 

The committee objectives will include: 

1. Planning the overall scope and emphasis of the CME program; emphasizing 

needs assessment and outcomes measurement. 

2. Effectively manage CME to enhance the overall academic environment at 

Geisinger and in the community. 

3. Monitor the quality of the overall and individual programs. 

4. Maintain appropriate accreditation. 

The CME Committee will meet twice a year. Sessions will be devoted to short 

and long range planning including review of the policy and procedure manual 

and mission statement, reviewing needs assessments, analyzing program 

outcomes and providing feedback and evaluation of the CME planning and 

execution functions of the CME Office. 

The CME Committee will also be available to the CME Manager and the Associate 

Chief Medical Officer for Academic Affairs for consultation on an ongoing basis 

including course review. Each Associate Chief Medical Officer (ACMO) is 

appointed as an Ad Hoc Member. Programs with notable content or relevance 

are reviewed with the ACMO most closely tied to the activity. 


Executive Committee 

The Executive Committee of the CME Committee is made up of the Manager, 

Office of Continuing Medical Education, the Associate Chief Medical Officer of 

Academic Affairs and one regular or Ad Hoc member of the CME Committee. 

The Executive Committee is charged with reviewing and approving CME activities 

available for the Fast Track process*. This Committee will meet on an as needed 

basis. 

*The Fast Track process is an approval process of any activity that follows a 

previously accredited and established format. All programs approved by this 

method will come before the full CME Committee at their next scheduled 

meeting. 


Grievance Process 

A. Each CME requester must have a process for taking disciplinary action 

against the CME Office and a process for adjucating complaints or 

grievance relevant to the office. 

B. The CME requester is encouraged to seek resolution of grievances relating 

to his activity. "Grievances" means any difference between the CME 

requester and the CME Office with respect to his/her CME Application for 

approval of an activity. 

C. The procedure is as follows: 

• CME requester with a grievance is urged to first discuss it with the CME 

Manager. Issues can best be resolved at this stage and every effort 

should be made to affect a mutually agreeable solution. 

• If, after discussion with the CME Manager, the grievance is not resolved 

to the satisfaction of the CME requester, the requester has the option to 

present the grievance in writing to the Associate Chief Medical Officer of 

Academic Affairs and CME. In situations when the concern relates to 

the CME Manager, and the requester believes that it cannot be 

presented to the CME Manager, the requester may present the 

grievance directly to the Associate Chief Medical Officer of Academic 

Affairs and CME for guidance. 

• Upon failure to satisfactorily resolve the concern with the Associate 

Chief Medical Officer of Academic Affairs and CME, the requester may 

request that the concern be brought before the full CME Committee. At 

which time an ad hoc meeting of the full CME Committee, chaired by a 

member previously selected as the Chairman of the CME Committee 

Grievance Committee will investigate the concern(s) by appropriate 

methods and reach a decision by simple majority vote. The decision of 

the CME Committee/Grievance Committee shall be reached within a 

reasonable time period, and be final and binding upon the parties and 

documented. 


Organization 


CME Office Historical Perspective 

The Office of Continuing Medical Education was organized in 1973 as a branch of 

the executive offices. Geisinger received its initial accreditation from the 

Pennsylvania Medical Society to sponsor Category 1 programming in 1974 and 

has remained fully accredited until the merger in 1997. 

In 1975, the Office of Continuing Medical Education became an arm of the 

Geisinger Institute for Medical Education and Research. 

In 1983, with the reorganization of the Geisinger System, the Office of 

Continuing Medical Education relocated to the Geisinger Clinic, the physician 

group practice. 

In 1993, with further refinements to the System, the Office of Continuing Medical 

Education fell within the Education Division and reported corporately to the 

Executive Associate Chief Medical Officer for Clinical Programs and Process 

Improvement and the Clinical Practice Committee. 

In 1997, the Geisinger Medical Center and the Penn State College of Medicine 

announced a merger and formed the Penn State Geisinger Health System. While 

the Office of Continuing Medical Education remained at the Geisinger Medical 

Center, the Penn State College of Medicine became responsible for all its 

activities and the Office of CME reported directly to Associate Dean of Medical 

Education at the Penn State College of Medicine. 

In 1999, the Geisinger Health System and Penn State College of Medicine 

announced plans to unwind the merger effective June 30, 2000. Effective July 1, 

2000 the Office of Continuing Medical Education again fell within the Education 

Division and will report directly to the Chief Executive Officer of the Geisinger 

Health System. 

In 2000, the Office of Continuing Medical Education returned to the Geisinger 

Health System and became part of Academic Affairs which reports corporately to 

the Executive Vice President and Chief Medical Officer of the Geisinger Health 

System. 


Organizational Chart 

Organizational chart showing the relationship between the parent organization 

and the Continuing Medical Education Unit. 

Geisinger Foundation 

Glenn Steele, M.D., Ph.D. 

President and CEO 

Bruce Hamory, M.D. 

CMO 

Steven Pierdon, M.D. 

Community Practice 

Mark Selna, M.D. 

Clinical 

Effectiveness 

Michael Ryan, D.O. 

Pediatrics 

Linda Famiglio, M.D. 

ACMO 

Chair, CMEC 

William Strodel, M.D. 

Surgery 

Dennis Torretti, M.D. 

Medicine 

Joseph Bisordi, M.D. 

Geisinger Medical 

Center 

Sharon Hanley, RMP, CEP 

Manager, Office of Continuing 

Medical Education 


Organizational Chart of the Internal Structure of the 

Continuing Medical Education Unit 

Executive Vice President, 

Chief Medical Officer 

Bruce Hamory, M.D. 

System Leadership Council 

IT Product Analyst 

.1 FTE 

Michael Seibert 

Information Technologist 

.2 FTE 

Jason Brent 

Vice President for Curriculum 

TBA 

Associate Chief Medical Officer 

for Academic Affairs and CME 

Linda Famiglio, M.D. 

Administrative Assistant 

June Leffler 

Accountant 

.2 FTE 

Yvonne Knight 

CME Committee/ 

Professional Development 

Marketing/PR 

Representative 

.1 FTE 

Cathryn Connolley 

PSNA 

Teri Bickert, RN 

ACPE 

Dean Parry, RPh. 

Grievance 

Committee 

Manager, Office of Continuing 


Sharon Hanley 

Director of 

Faculty Development 

Timothy McConnell, 

Ph.D. 

Continuing Medical 

Education Specialists 

Barbara Barrick – 1.0 FTE 

Lenore Knarr – 1.0 FTE 


Education Specialist Assistant 

Andrea Ignaszewski – 1.0 FTE 


Education Clerk 

Lorie Derrick 

– 1.0 FTE 


Personnel Directory 

President and Chief Executive Officer 

Executive Vice President, Chief Medical Officer 

Dr. Glenn Steele, Jr. 

Foss Home, 16168 

Dr. Bruce Hamory 

Foss Home, 17092 

Associate Chief Medical Officer, Academic Affairs Dr. Linda Famiglio 

& Continuing Medical Education Hospital 4, 16114 

Director, Faculty Development 

Administrator, ACPE 

Manager, Office of Continuing Medical Education 

Continuing Medical Education Specialist 


Continuing Medical Education Specialist Assistant 

Continuing Medical Education Clerk 

Continuing Medical Education Accountant 

Timothy McConnell, Ph.D. 

Hospital 4, 16114 

Dean Parry, RPh. 


Sharon Hanley 


Barbara Barrick 


Lenore Hanley 


Andrea Ignaszewski 


Lorie Derrick 


Yvonne Knight 

Weis Center, 54494 

Continuing Medical Education 

Jason Brent 

Information Tech Hospital 4, 49434 


Job Descriptions 

Associate Chief Medical Officer 

Academic Affairs 

Position Description 

Title: Associate Chief Medical Officer, Academic Affairs: Continuing Medical 

Education 

General Responsibility: 

• Responsible for the quality, content and scientific integrity of all accredited 

continuing medical education programs sponsored by the Geisinger Health 

System 

• Responsible for maintaining accreditation 

Specific Responsibilities: 

• Chair the Continuing Medical Education Committee 

• Coordinate the planning and evaluation of accredited continuing medical 

education activities for physicians throughout the Geisinger Health System 

• Establish and administer the policies and procedures of the CME Office 

• Assure compliance with the essentials of continuing medical education to 

maintain accreditation 

• Develop and maintain effective relationships with other educational 

organizations and accreditation bodies interested in continuing medical 

education 

• Member of the Senior Leadership Council, Central Region Operations 

Committee, and the Medical, Research and Academic Affairs 

Subcommittee of the Board of Directors 


Director of Faculty Development 



Department: Academic Affairs 

FLSA: Exempt 

Reports to: Associate Chief Medical Officer of Academic Affairs and Continuing 


Purpose: To provide support and programs to meet the faculty development 

needs of clinical providers. 

Nature and Scope: Responsible for faculty development by organizing and 

promoting programs and other initiatives designed to enhance scholarly 

performance of the clinical faculty throughout the Geisinger Health System. 

Major duties and responsibilities: 

1. Continuing Medical Education 

• Create and provide CME programs related to faculty development 

topics. 

• System liaison for issues involving faculty development 

• Promote processes that assist in the promotion and appropriate credit 

for teaching efforts. 

• Serve as a resource for Activity Directors in the development of CME 

programs. 

2. Graduate Medical Education 

• Serve as a mentor and coach for residency programs 

• Provide expertise and guidance in research methods, process and 

procedure. 

• Provide lectures and workshops on educational theory and methods. 

3. Assist in grant writing opportunities and grant funding administration. 

4. Work with other system committees with a common mission of faculty 

performance and, ultimately, improved service. 

Duties 1,2,3 are considered essential. 

Skills and Abilities: 

Ability to organize and direct educational programs. Working knowledge of 

learning theory. Computer skills including PowerPoint. 

Education and/or experience: 

Physician or educational professional with a minimum of a master level degree is 

required. 

Working Conditions/Physical Demands: 

Work is performed in an office environment. 


ACPE Administrator 


Director of Pharmacy Utilization Management 


Title: Director of Pharmacy Utilization Management 

FLSA Status: Exempt Region: NC - Danville 

Dept: System Therapeutics 

Job Summary: 

Under the direction of the System Therapeutics Leadership, the scope and breath 

of responsibility for the Director of Pharmacy Utilization Management (DPUM) will 

accept responsibility for the planning, development, implementation and 

supervision of comprehensive drug management programs for the Geisinger 

Health System. This will include the provision of pharmaceutical care, staff 

development, data analysis and employment of pharmacoeconomics and 

pharmacoepidemiologic principles to the measurement of outcomes associated 

with such programs. The DPUM must possess excellent consultation, 

communication and interpersonal skills including, empathy and the ability to 

educate patients and providers. The DPUM must have the ability to work with 

others in a team-based environment and teach and reinforce communication 

skills and patient education skills. The DPUM should constantly seek to identify 

and take advantage of opportunities to improve the health and wellness of the 

patients served by the Geisinger Health System in conjunction with the overall 

goals and objectives of the System. Performs duties to provide the highest level 

of patient care and maximize patient satisfaction. 

Duties and Responsibilities: 

The Director of Pharmacy Utilization Management will demonstrate in more 

specific terms: 

• Utilization Management 

- Identify changes in utilization and costs occurring within a program 

or specialty. 

- Identify factors driving utilization and cost trends. 

- Identify therapeutic classes most cost-effective to target and 

identify appropriate outcomes for such classes. 

- Identify problematic drug classes. 

- Predict the effect of managed care benefit design changes on 

utilization. 

- Work in conjunction with the physician/administrative partner to 

develop programs to address identified issues. 

- Make recommendations for utilization of new biotechnologic entities 

introduced to the market. 


- Develop evidence-based, cost-effective protocols and drug 

therapies. 

- Work in conjunction with other pharmacy entities and physician 

providers to develop policies related to drug utilization. 

- Work in partnership with other hospital areas involved in outcomes 

management. 

- Develop and evaluate tools for data analysis, outcomes criteria to 

monitor established programs. 

- Collaborate with other system entities on disease management and 

ambulatory practice issues to establish a continuum of care. 

- Identify and implement protocols, which appropriately match 

therapy to patient's conditions (i.e. step therapy). 

• Staff Development 

- Provide direction and guidance to pharmacy personnel for the 

development and implementation of optimum standards of 

pharmaceutical care. 

- Develop and oversee pharmacist staff development and 

competency programs. 

- Emphasize, support and develop the pharmacist provider as an 

integral part of the health care team. 

- Utilize technology to provide comprehensive, up-to-date and easily 

accessible education to all department members. 

- Coordinate education activities with other disciplines as needed. 

- Maintains relationships with the pharmaceutical industry to ensure 

appropriate product detailing and education. 

- ACPE administrator 

• Performance Parameters/Continuous Quality Improvement 

- Enhance the ability of the pharmacy staff to provide quality 

pharmaceutical care by establishing monitoring parameters and 

develop divisional standards for the skills and education necessary 

to meet system performance standards. 

- Deliver feedback on performance; develop plans to address issues. 

- Participate on institutional quality outcomes committees. 

- Integrate data links to provide feedback on physician and 

pharmacist performance. 

- Develop outcomes-oriented, continuous improvement standards for 

performance measurement. 

• Financial Performance 

- Provide data analysis and program suggestions that will facilitate 

the ability of the system to achieve it’s goals related to 

pharmaceutical budget management and system performance. 

- Develop methodologies to track and project changes in 

pharmaceutical performance and analyze deviations from budget 

projections. 


• Employee Management 

- Motivate, energize, direct and support the staff in the provision of 

pharmaceutical care. 

- Provides overall operational management of the Drug Information 

Office. 

• Patient/Customer Satisfaction 

- Implements standards, measures performance and takes action to 

promote a customer service oriented culture. 

• Student/Intern Educational Programs 

- Coordinates the development and implementation of educational 

programs that balance both the needs of the students and the 

System Therapeutics staff. 

- Develops and facilitates the relationship between schools of 

pharmacy and the Geisinger Health System. 

- Oversees the staff involvement in the preceptorship of the 

student/intern education programs 

• Performs other duties as required or assigned by emergency or other 

operational reasons for which the employee is qualified to perform. 

Education: 

Requires a Bachelor of Science degree in pharmacy from an accredited college 

and current licensure or eligibility for licensure by the Pennsylvania State 

Board of Pharmacy. 

Experience: 

Requires at least five years of experience as a pharmacist, including at least 

three years of experience in a clinical practice setting and at least three years 

in a project management role. Effective communication, computer based analysis 

and coordination skills are necessary. 


Manager 

Office of Continuing Medical Education 


JOB SUMMARY: 

Designs, implements, markets and evaluates continuing medical education 

programs in accordance with accreditation standards. Ensures that 

continuing education needs are met through analysis of potential programs 

and target audiences/disciplines. Manages all aspects of continuing medical 

education programs including marketing, registration, financial and 

program record keeping and travel arrangements. Responsible for the 

efficient management of the Continuing Medical Education office. 

Performs duties to support the goals and objectives of the Geisinger Health 

System in its efforts to provide quality patient care and patient satisfaction. 

Reports to the Associate Chief Medical Officer, Academic Affairs. 

MAJOR DUTIES AND RESPONSIBILITIES: 

*1. Program Planning: Develop, analyze, approve and market 1500 

programs that require substantial travel. Ensures programs are in 

compliance with accreditation standards; prepares analysis of potential 

program success; determines financial feasibility and ProForma; 

determines target audience and discipline; determines most appropriate 

advertising vehicles; prepares budgets; schedules facilities and equipment; 

prepares course materials; tabulates evaluations; maintains master files; 

and coordinates schedules and transportation as necessary. 

*2. Program Advertising: Designs brochure formats; coordinates mailing 

schedules; orders necessary supplies; prepares and submits copy for all 

advertisements in journals and news releases; carries out multiple studies 

of impact of alternative marketing and advertising styles; prepares and 

monitors budgets. 

*3. Program registrations: Maintains and confirms registration forms; 

prepares credit verifications; acts as registrar; prepares program materials; 

coordinate schedules; coordinates the completion of appropriate forms. 

*4. Record Keeping: Ensures that all necessary records are maintained and 

retained appropriately. Prepares application forms for accreditation to 

various societies/organizations for each program; collects and summarizes 

evaluation forms; maintains databases; arranges for pharmaceutical 

support for various programs. 


*5. Fiscal Responsibility: Responsible for developing and managing a $1 

million annual departmental budget, as well as, provide leadership and 

accountability for the development and integration of short and long-term 

operational planning. Also, assigns account numbers; deposits money into 

appropriate accounts; approves payments of invoices and other expenses; 

prepares contracts for jointly sponsored and accredited continuing 

education programs; and prepares and monitors program budgets. 

*6. Off-site Meetings: Negotiates and contracts with airlines/hotels for off 

site meeting transportation and facilities; maintains master accounts; 

arranges for registrants arrivals and departures; attends all meetings to 

handle registration and assure quality of service. Independent decision 

making at off-site locations for immediate problem solving. 

*7. Manages Daily Operations: Prepares quarterly and annual reports; 

oversees mailings, correspondence and filing; ensures special 

arrangements as necessary; tracks teaching time of Geisinger Health 

System personnel; prepares annual calendar of events and internal 

schedule of deadlines; conducts yearly studies of demographic 

characteristics of attendees and potential attendees; develop and maintain 

the CME Policy and Procedure Manual to meet all regulatory agency 

requirements and also assure compliance with the essentials of CME to 

maintain accreditation ; solicits various pharmaceutical companies for 

support; arranges for Geisinger staff to speak at area hospitals and county 

medical societies. Manages the CME Website and CME Calendar on the 

Geisinger Infoweb. Responsible for the selection, growth and development 

of the CME staff to ensure adherence accreditation and service standards. 

Conduct weekly QI of the office to meet all applicable regulatory 

standards, as well as, staff meetings. 

*8. ATLS Coordinator: Arranges five courses per year; prepares 

applications to conduct courses; makes all necessary arrangements and 

prepares all materials; and processes necessary paperwork. 

*9. PALS, FCCS, BLS and ACLS Co-Coordinator: Oversees 40 courses per 

year, maintains all course materials, finances and makes all necessary 

arrangements. 

*10. GWV CPSL Planner: Arranges weekly lectures, invite speakers, print 

posters, maintain schedules, send reminders, prepare handouts and make 

all necessary arrangements for meeting room, food and audiovisuals. 

Develop and maintain professional cme contacts at other hospitals that 

promote GHS physician speakers at their institutions. 


*11. CME Committee Secretary: Serves on the Continuing Medical 

Education Committee, arranges two meetings per year, distributes all 

course materials to be discussed/approved and records the minutes. 

*12. Nursing Education Planning Committee: Member of the nursing 

education planning committee that meets twice a year to plan future 

programming. Responsible for room and/or hotel scheduling, brochure 

design and tracking of trauma credits. 

*13. Room Scheduling: Currently oversees five meeting rooms within the 

Medical Center. Responsible for scheduling, AV equipment and 

maintenance. 

*14. New Physician Orientation Committee: Serves on the NPO 

Committee, arranges two meetings per year for new physicians, prepares 

the schedule, invites the faculty and new physicians, arranges for their 

overnight accommodations, plans social activities, helps conduct the day 

and a half day meeting and makes all other necessary arrangements. 

*15 Data Manager: Responsible to control and supervise specific data and 

to authorize access by users. 

*16. Attend the Pennsylvania Medical Society and the Alliance for 

Continuing Medical Education Meetings and other appropriate continuing 

education programs. 

17. Performs duties as required or assigned by emergency or other 


*Denotes essential job duties. 

SKILLS AND ABILITIES: 

Requires proven ability to work effectively with, through and for a variety 

of people at all levels within and external to the organization. Requires selfmotivation 

and leadership skills. 

Requires good organizational skills and attention to detail; basic computer 

skill, including spreadsheet and word processing; mathematical ability and 

basic financial skills and ability to maintain budgets. 

EDUCATION AND/OR EXPERIENCE: 

High school diploma with a commercial or business administration 

concentration or equivalent post-secondary education or experience 


equired. Masters level preferred. 

BS/BA required or at least 15 years experience in a CME Office with 

accreditation knowledge, project management, supervisory management, 

team processes and administrative experience. 

WORKING CONDITIONS/PHYSICAL DEMANDS: 

Work is typically performed in an office environment. 

The specific statements shown in each section of this description are not 

intended to be all-inclusive. They represent typical elements considered 

necessary to successfully perform the job. 





JOB SUMMARY: 

Provides clerical and administrative support for the Continuing Medical 

Education office. Supports the daily operational functions of the Continuing 

Medical Education office in a professional and efficient manner. Responsible 

for a variety of clerical and administrative activities including general office 

support, financial and program record keeping, activity registrations, 

managing nursing programs, and handling all the pharmaceutical support 

paperwork. 

Reports to the Manager, Continuing Medical Education. 

Performs duties to support the goals and objectives of the Geisinger Health 

System in its efforts to provide quality patient care and patient satisfaction. 


*1. Provides support for financial processes and transactions, including 

maintaining CME accounts; processing credit cards; recording check and 

cash deposits, uploads to the general ledger, invoicing, intercompany billing 

and maintaining computerized income and expense reports. 

*2. Handles administrative functions and logistical details for educational 

activities, which may involve maintaining mailing lists; sending out program 

information; tabulating responses; generating confirmation letters; preparing 

and distributing program materials; maintaining all required forms and 

processing necessary evaluations and reports. 

*3. Maintains and confirms all registration forms and depositing of all fees. 

*4. Responsible for maintaining and updating cme transcripts on the 

Infoweb. 

*5. Responsible for all on-line pharmaceutical grant applications and 

disbursement of funds. 

*6. Responsible for special projects, grant awards and administrative 

functions of PALS, ACLS, ATLS and BLS Courses. 

*7. Provides support for maintaining the CME calendar and CME webpage 

on the Geisinger Infoweb, as well as, all CME databases. 


*8. Responsible for maintaining and scheduling the Clinical Skills Lab. 

*9. Maintains all pharmaceutical grant records to assure all paperwork is 

received, check deposited and all bills paid. 

*10. Ensures nursing programs are in compliance with accreditation 

standards, provides Nursing Program support including serving as registrar 

and hostess for meetings; preparing and distributing conference materials; 

distributing and collecting evaluations; preparing meeting room; maintains 

attendee list; operating audio-visual equipment as needed; working with 

hotel personnel to coordinate facility set-up and services; and assuring that 

the needs of registrants are met. 

*11. Assists with scheduling of five meeting rooms and works with Learning 

Resources for "bridge" hook-up for meetings. 

*12. Oversees preparation of all conference materials. 

*13 Attends the annual Pennsylvania Medical Society meeting and 

appropriate continuing education programs. 

*14. Provides general clerical assistance, including: triaging phone calls, 

providing assistance and resolving issues when appropriate; distributing 

mail; generating correspondence; maintaining appropriate files and records 

for programs; and maintaining schedules for meeting rooms. 

*15. Performs duties as required or assigned by emergency or other 


*Denotes essential job duties. 


Requires proven ability to work effectively with, through, and for a variety of 

people at all levels within and external to the organization. 

Requires good organizational skills and attention to detail; advanced 

computer skills, including spreadsheet and word processing; mathematical 

ability; and experience or knowledge of basic financial record keeping. 


Requires a high school education with a commercial or business 

administration concentration or equivalent post-secondary education or 

experience. B.S. preferred 


Minimum one-year of administrative experience with CME Accreditation 

Documentation. 







Continuing Medical Education Specialist Assistant 



JOB SUMMARY: 

Responsible for front line clerical support for the department. Coordinates 

and prepares activities in an efficient and effective manner for the 

department. 

Directly accountable to the Manager. 


A. Accreditation and CME Credentialing 

• Oversees and maintains up-to-date filing system of all CME activities 

• Receives communications concerning CME transcripts and prepares 

transcripts from Peopleware on request 

• Tabulates and creates summary reports for CME activities 

evaluations and maintains confidentiality 

• Monitors evaluations for commercial bias and inappropriate 

promotion or marketing of any pharmaceuticals 

• Prepares and distributes educational/registration conference 

materials using Peopleware software 

• Monitors completeness of recurring meeting credit materials and 

communicates documentation deficiencies to activity directors and 

CME committee 

• Attend the annual Pennsylvania Medical Society, CME Associates 

meetings and any other applicable meetings. 

B. CME Activity Support Functions 

• Responsible for the administrative functions of all PALS, ACLS & BLS 

Courses 

• Develops, validates, and prepares all contact mailings for the 

physician liaison program 

• Types and distributes all first class flyers for the physician liaison 

activities 

• Oversees the answering of room scheduling phones 

• Responsible for scheduling of five meeting rooms 

• Maintains room scheduling recurring events 

• Types and distributes special project mailings 

• Tracks invoices in program, specific budget worksheets 

• Serve as registrar or “hostess” for activities as needed 


C. Office Operations 

• Responsible for organizing and ordering educational supplies 

• Develops and implements all mass mailings for CME brochures 

• Oversees the distribution of departmental mail 

• Oversees all photocopying responsibilities 

• Maintains and orders departmental supplies 

• Assists in answering all internal and external calls to the 

department. 

• Properly triages the calls and directs the call to the appropriate 

people 

• Responsible to auto attendant messages management 

• Performs other duties as assigned 


Demonstrates advanced skills in CME Accreditation Documentation and 

general office support. Performs duties to provide highest level of support 

for and during CME activities. 

Demonstrate competence in written, oral and electronic communication 

skills 

(interpersonal/communication and technological effectiveness 

competencies). 

Demonstrate ability to work independently, set priorities, multi-task and 

help provide problem resolution. 


Requires a high school diploma or equivalent required. AS Preferred 

Minimum one-year education office support experience required. 

Demonstrate customer service to all health care providers and colleagues. 







Clerical Assistant 



JOB SUMMARY: 

Responsible for providing clerical support to the department. Ensures 

clerical 

efficiency and organization to the department. 

Directly accountable to the Manager. 


1. Performs basic office functions such as filing, photocopying, mail sorting 

and distribution, data entry, and word processing. 

2. Responsible for office reception duties such as answering telephone, 

message taking and appropriate referral of calls. 

3. Responsible for preparing all first class mailings for program marketing. 

4. Will be required to assist with room scheduling and assignments. 

5. Will be required to assist with maintaining mailing lists. 


Demonstrate basic skills in general office support such as preparing routine 

correspondence, scheduling, data entry and word processing. 

Demonstrate competence in written, oral and electronic communication 

skills 

(interpersonal/communication and technological effectiveness 

competencies). 

Demonstrate ability to work independently. 


High School diploma or equivalent required. 

Minimum 6 months to one-year office support experience required. 







Responsibilities Of The CME Office 

1. Planning Functions (with Activity Directors) 

a. Compliance with accreditation standards, with direct oversight of 

the quality, content and scientific integrity of all CME activities 

b. Analysis of activity expectations and projected outcomes 

c. Maintain control of funds 

d. Define target audience(s) and disciplines 

e. Advertising vehicles 

2. Brochure Production and Mailing/Advertising 

a. Brochure design and format (final proof-reading and approval 

responsibility of the program director) 

b. Procures mailing labels in proper format for the job 

c. Assigns dates when materials are due and scheduled mail dates 

d. Coordinates work times with mailroom and print shop 

e. Orders paper stock as needed 

f. Types all ads for journals and submits as needed (final proofreading 

and approval responsibility of the Activity Director) 

3. Program Functions 

a. Arranges for coffee breaks, luncheons and other special functions 

b. Schedules all rooms 

c. Notifies housekeeping and others as needed 

d. Arranges for A.V. Personnel 

e. Requests necessary audio-visual equipment 

f. Serve as hostess to increase the happiness index and to meet 

peoples' needs 

g. Collects syllabus materials, collates in proper order, sends to print 

shop and has ready by program date 

h. Collects evaluation forms and tabulates data 

i. Maintains master file for each activity 

j. Sends activity director reminders of their deadlines 

4. Registration Functions 

a. Receives registration forms and enters in computer 

b. Prepares list of registrants 

c. Concurrently coordinates registrants with hotel for off-site 

programs 

d. Prepares name tags 

e. Prepares credit verification forms and receipts 

f. Sends confirmation letters 

g. Acts as registrar day of the meeting 

h. Provides syllabus/notebooks/paper/pens 


i. Has internal people sign in on appropriate form 

j. Has faculty sign faculty disclosure forms 

5. Maintenance of Records 

a. Types, collects and summarizes evaluation forms for activity and 

activity directors 

b. Types application forms for accreditation to various 

societies/organizations for each activity 

c. Retains list of attendees to verify their attendance 

d. Maintains mailing lists 

6. Fiscal Functions 

a. Assigns activity account numbers 

b. Receives all monies related to the activity 

c. Records and deposits money into proper accounts with accountant 

d. Pays all bills out of proper accounts 

e. Prepares monthly transfer sheets for employee attendance 

f. Arranges for checks for travel, honoraria and other expenses 

g. Reviews master accounts with hotels 

h. Deposits all checks from drug/instrument companies 

i. Assure compliance with Standards for Commercial Support 

7. Hotel Negotiations 

a. Makes all contacts with hotels for off-site meetings and all 

arrangements are made for the meeting by the CME Office 

b. Determines for brochure production the reservation form and hotel 

information what will be included 

c. Checks and cross-checks registration and room reservation lists 

d. Opens and maintains master account to maintain fiscal 

responsibility. Only the CME Manager can sign for items or give 

approval for changes to the master account. 

e. Responsible for signing agreements/contracts with hotels 

f. CME Manager attends all meetings (expenses are built into the 

budget) 

g. CME Manager handles the registration desk and see that quality of 

services at hotel are appropriate 


Roles and Responsibilities of CME Activity Director 

Strategy: 

• Meet with the Associate Chief Medical Officer for Academic Affairs and/or 

the CME Manager at least six months prior to developing a CME Activity. 

A conference call or site visit for Activity Directors not on the Danville 

Campus can be arranged. 

• Understand the Pennsylvania Medical Society, ACPE, PSNA, AAPA, and 

AAFP essentials and standards for commercial support. 

• Review needs assessment and documentation, propose goals and 

objectives, propose activity content, target audience, speakers and plan 

outcome measures. 

• Participate in a financial feasibility study and course feasibility study with 

the CME Office. 

• If approved, help determine course date by advising on competition, and 

the likes and dislikes of the target audience. 

• Deadlines are important to assure that your program will be successful. If 

prescribed dates are not met, the CME Office has the right to cancel the 

activity. 

• Commercial Funding: The FDA requires that the CME Office must handle 

all funds for your activities. 

• Discuss and develop outcome measures with the CME Office. 

Operations: 

• Contact speakers for commitment of time and topic: copy to be sent to 

the CME Office for documentation. Be aware of any conflict of 

interest/disclosure issues for each speaker. CV’s are required for all 

outside speakers. 

• Assist in obtaining commercial support as required from financial feasibility 

study for outside speakers, internal speakers and extras. Provide copy of 

all correspondence for activity file. 

• Provide content for the brochure four months prior to your activities. 

• Assist with procuring mailing lists that the CME Office may not have on 

file. 

• Coordinate syllabus production with speakers and provide it three weeks 

prior to your activity. If deadline is not met, you will be responsible to 

provide your own handouts. Handouts will be reviewed for 

appropriateness. 

• Monitor quality and scientific integrity of each activity and ensure proper 

disclosure. 

• Develop evaluation tools with CME Office. Feedback from your activity will 

come to you, the Activity Director as well as the entire faculty. 


Checklist for each program: 

Strategic Planning 

- Handbook provided 

Meeting details 

- Application 

(needs assessment and objective) 

- Printing 

- Commercial Support 

Budgets 

LMF/TM 

SKH 

SKH/LMF 


Policy for Non-Compliance with CME Requirements 

The GHS CME Committee has established the following policy and procedures for 

activities that do not comply with the CME Policy. 

Definitions 

Accredited Provider – the institution or organization accredited by the ACCME 

or a State Medical Society to award Category 1 credit to a continuing medical 

education activity. In this case the Pennsylvania Medical Society is the 

Accredited Provider. 

Activity Director – the activity director must take responsibility for his/her CME 

activity and must adhere to all FDA and AMA regulations. 

Procedure 

1. All current and potential Activity Directors are provided access to the 

CME Committee’s Policies. In addition, all new and potential Activity 

Directors are required to meet with CME staff to review the process for 

applying for and awarding AMA PRA Category 1 Credit for an 

educational activity. 

2. If at any time following the approval of an award of AMA PRA Category 

1 Credit and prior to the educational activity, an Activity Director 

refuses to adhere to CME policies and procedures, the CME staff 

should report this to the CME Committee members immediately and 

provide them with a mechanism to vote on whether or not to reverse 

the award of AMA PRA Category 1 Credit. 

3. If the Activity Director fails to provide any required documentation to 

the CME Office within 90 days of the educational activity, staff will 

follow-up with a request in writing from the CME Committee. This 

letter will advise the Activity Director that the CME Committee will not 

go forward with any future applications for Category 1 credit until all 

documentation from prior programs is submitted and this will affect all 

other activities. 


4. If after feedback and guidance from the CME Executive Committee, an 

Activity Director fails to meet for a third time in an accreditation year, 

responsibilities as delineated in the "Responsibilities of the Activity 

Director" policy , the activity will not be eligible for the fast-track 

approval process. The CME Executive Committee will report the noncompliance 

to the CME Committee at their next meeting. The CME 

Committee will then decide on an appropriate course of action. 

Possible actions may include, but are not limited to: 

a. Assess additional management and administrative fees over a 

specified period of time (i.e. 1 year) or until the Activity Director 

successfully submits all required documentation for a specific 

number of activities. 

b. Denial of all future requests for AMA PRA Category 1 Credit. 


Roles and Responsibilities of the CME Associate 

Strategy: 

• Meet with the CME Office staff at least twice a year to discuss CME 

processes. 

• Review needs assessment and documentation. 

• Deadlines are important to assure that meetings will be recorded and 

credit issued in a timely manner. 

• Commercial Funding: The FDA requires that the CME Office must handle 

all funds for guest speakers. 

Operations: 

• Contact speakers for commitment of time and topic: copy to be sent to 

the CME Office for documentation. Be aware of any conflict of 

interest/disclosure issues for each speaker. CV’s and disclosure forms are 

required for all outside speakers. If payment is required, a W-9 form is 

necessary. 

• Coordinate syllabus production with speakers and provide it three weeks 

prior to your program. If deadline is not met, you will be responsible to 

provide your own department’s and/or speaker handouts. 

• Develop evaluation tools with CME Office. It is your responsibility to send 

the information to the CME Office. 


Role Description of the CMEC Member 

Responsibilities: 

• Engage in planning the overall scope and emphasis of the CME activity. 

• Monitor the quality of the overall activity through CMEC meetings. 

• Monitor the quality of individual activities including grand rounds or 

full/half day activities whenever attending these events (specific 

evaluation form). 

• Review online courses as assigned. 

• Facilitate self-directed projects as requested. 

• Attend two meetings/year for a two-year term. 

Benefits: 

• All GHS sponsored CME activities will be tuition free during the term of 

their membership. 


Essential 2 

Educational Planning 

and Evaluation 


Introduction to Educational Planning and Evaluation 

Educational Planning 

Planning is a vital component to any type of education that is being created. 

Before delivering the actual instruction, there are steps that should be followed 

to ensure that the instruction is of the highest quality and instructionally sound. 

Instructional Design 

Instructional design is a process that works towards a defined educational goal. 

This process defines what will be learned, plans how the learning will occur, and 

ensures that objectives will be met. 

The instructional design model that is utilized is the ADDIE model (see figure 

below). This is a generic instructional design model that allows an organized 

method of preparing and delivering instruction. 

Analysis 

Design 

Development 

Implementation 

Evaluation 

The analysis phase involves the majority of the planning. During this phase, the 

need for instruction will be identified as well determining the task, content and 

goal. 

The design and development phases go hand in hand. Often these phases take 

place simultaneously. Instructional strategies are identified and the actual 

instructional materials are created. 

The implementation phase is the actual delivery of the instruction followed 

immediately by the evaluation phase. The evaluation phase is critical to find out 

the impact of the instruction on the audience. 


Procedure for Commencement of Activity Development 

Before any of these phases can commence, the first step is to disclose your 

intent to develop a CME activity to the CME Office. You can do this in several 

ways. 

1. You can complete the “Intent to Develop a CME Credited Course Form.” 

This form can be found on the CME web page or obtained from the CME 

Office. It can be submitted through interoffice mail to 13-50 or faxed to 

(570)271-5850. 

2. The information on the form can also be submitted to the CME Office via 

email at cme@geisinger.edu 

3. Simply stated verbally to the CME staff by calling (570)271-6692. 

Once the CME staff is aware of the activity director’s intent to develop an 

activity, the staff will work with him/her to complete an application for credit and 

proceed through the other necessary steps of planning and development. 


Intent to Develop a CME Credited Activity 

I would like to develop an activity on____________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

CME Strategic Goal(s): 

Does this activity: 

support our professionals’ development? 

enhance relationships in our system, region, and nation? 

enhance our clinical or academic reputation? 

Type of mailing lists: _______________________________________________ 

_________________________________________________________________ 

I would like the activity to be: 

Online 

½ day 

Full day 

Other __________________________ 

I think the activity director should be: 

Me __________________________ 

Other __________________________ 

Date I would like to do this _______________________________ 

Please contact me at __________________ or ___________________________ 

phone 

email 

Please return this form to the CME Office by mailing to internal zip 

13-50, faxing it to (570)271-5850 or emailing it to CME@geisinger.edu. 


Definition of CME Category 1 

Category 1 Credit 

Accredited Sponsorship 

A continuing medical education activity sponsored or jointly sponsored by an 

organization accredited for continuing medical education by the state medical 

associations or by the Accreditation Council for Continuing Medical Education 

(ACCME), and designated as Category 1 education by that organization. 

The activities designated for credit must comply with the Essentials of Continuing 

Medical Education. 

Definition of CME Category 2 

Category 2 Credit 

All Other Categories 

Activities that do not meet all of the Essentials for Category I but conform to the 

definition of continuing medical education: teaching; self-instruction – such as 

videotapes, audiotapes, etc., programmed medical educational materials, 

teaching devices such as computers and medical publications; consultation; 

patient care review; and self-assessment examination. 



Definition 

In CME, needs assessment can be defined as: an interactive, continuous process, 

using multiple information sources and data collection techniques, to identify 

needs as a basis for planning educational activities. 

Educational needs refer to any knowledge, skill or attitude that physicians, 

pharmacists, nurses and other allied health professionals want to (or should) 

acquire, develop or reinforce. 

The purpose of needs assessment in CME is to identify topics and problems for 

which CME activities can be developed that also fulfill two other criteria: 1) 

learners will be likely to participate in the activities and 2) the activities have the 

potential of improving health care. 

The needs assessment should document the processes used to identify CME 

needs, including data sources which go beyond the sponsor’s own perception of 

needs, as well as, state the overall needs identified by the above processes and 

indicate how this assessment is used in planning educational activities. 


Establishing Needs Assessment 

Information Flow for Analysis of Needs 

Departmental Committees 

CME Committee 

Conversations with Staff 

Staff Consultation 

Staff Questionnaires 

Needs Analysis 

Advances in Medical Knowledge 

Staff Interviews 

Audit Systems 

Patient Records 

House Staff Rounds 

Speaker’s Suggestions 

Laboratory, X-Ray and Special Procedures 

Source: from Bergin, JJ and GC Holmes, Continuing Medical Education in the Community Hospital. Port Washington, NY. 

Romaine Pierson Publishers, 1979. Reprinted with permission. 



The CME Office conducts a formal "learner perception style" needs assessment in 

May or June of each year. By surveying the Geisinger Health System and 

regional physicians, we obtain information regarding CME topics, formats, dates, 

etc. 

Every evaluation form has areas for learners to identify CME topics or formats 

they would like to see used in future programming. 

The Chair of the Quality Improvement Committee is a member of the Continuing 

Medical Education Committee. Data from and problems identified by this 

Committee serves as a basis for Continuing Medical Education activities and 

educational intervention. 


Examples Of Methods 

General Methods of Needs Assessment 

Method 1: 

Advantages: 

Limitations: 

Do's & Don'ts: 

Interview 

Revels feelings, causes, and possible solutions of problems 

as well as facts. Affords maximum opportunity for free 

expression of opinion and giving of suggestions. 

Is time-consuming, so can reach relatively few people. 

Results may be difficult to quantify. Can make subject feel 

"on the spot". 

Pretest and revise interview questions as needed. Be sure 

interviewer can and does listen, doesn't judge responses. 

Do not use to interpret, sell, or educate. 

Method 2: 

Advantages: 

Limitations: 


Questionnaire 

Can reach many people on a short time. Is relatively 

inexpensive. Gives opportunity of expression without fear or 

embarrassment. Yields data easily summarized and 

reported. 

Little provision for free expression of unanticipated 

responses. May be difficult to construct. Has limited 

effectiveness in getting at the causes of problems and 

possible solutions. 

Pretest and revise questions and form as needed. Offer and 

safeguard anonymity. Use only if prepared to (1) report 

findings, both favorable and unfavorable, and (2) do 

something about them. 

Method 3: 

Advantages: 

Limitations: 


Tests 

Are useful as diagnostic tools to identify specific areas of 

deficiencies. Helpful in selecting from potential trainees 

those who can most profitable be trained. Results are easy 

to compare and report. 

Tests validated for many specific situations often not 

available; tests validated elsewhere may prove invalid in new 

situation. Results give clues, are not conclusive; tests are 

second-best evidence in relation to job performance. 

Know what test measures; be sure it is worth measuring 

here; apply results only to factors for which test is good. 

Don't use tests to take blame for difficult or unpopular 

decisions which management should take. 


Method 4: 

Advantages: 

Limitations: 


Group Problem Analysis 

Same as for interview, plus; synthesis of different 

viewpoints; promotes general understanding and 

agreement; builds support for needed training; and is in 

itself good training. 

Is time-consuming and initially expensive. Supervisors and 

executives may feel too busy to participate, want work done 

for them. The results may be difficult to quantify. 

Do not promise or expect quick results. Start with problem 

known to be of concern to group. Identify all problems of 

significant concern to group. Let group make own analysis, 

set own priorities. 

Method 5: 

Advantages: 

Limitations: 


Job Analysis and Performance Review 

Produces specific and precise information about jobs, 

performance. Is directly tied to actual jobs and to on-job 

performance. Breaks a job into segments manageable both 

for training and for appraisal purposes. 

Time-consuming. Difficult for people not specifically trained 

in job analysis techniques. Supervisors often dislike 

reviewing employees' inadequacies with them personally. 

Reveals training needs of individuals but not those based on 

needs of organization. 

Brush up on job analysis techniques; arrange special training 

for those who are to do it. Be sure analysis is of current job, 

and current performance. Review with employee both: (1) 

analysis of job, and (2) appraisal of performance. 

Method 6: 

Advantages: 

Limitations: 


Records and Reports Study 

Provide excellent clues to trouble spots. Provide best 

objective evidence of results of problems. Are usually of 

concern to and easily understood by operating officials. 

Do not show causes of problems, or possible solutions. May 

not provide enough case materials (e.g., grievances) to be 

meaningful. May not reflect current situation, recent 

changes. 

Use as checks and clues, in combination 


2003-2004 Needs Assessment 

1. In which of the following month(s) do you generally attend continuing medical 

education (CME) programs? 

Jan _____ Feb _____ Mar _____ Apr _____ 

May _____ June _____ July _____ Aug _____ 

Sept _____ Oct _____ Nov _____ Dec _____ 

2. Which day of the week is best for you? 

Mon_____ Tues_____ Wed_____ Thurs_____ 

Fri_____ Sat______ Sun_____ 

3. Where do you prefer to attend CME meetings? 

Hometown_____ Cities_____ GMC_____ Resorts_____ 

4. What length of program do you prefer? 

½ day_____ Full day_____ 2 days_____ 3 or more_____ 

5. Which of the following CME methods do you prefer? 

30 minutes lectures_____ Panel discussions_____ 

Workshops_____ Case presentations_____ 

Grand Rounds_____ 3-5 minutes clinical pearls _____ 

Other__________________________________________________________ 

6. Which of the following formats are of interest to you? 

Review courses_____ 

Updates in medicine in general_____ 

Updates in your field of expertise_____ 

Other__________________________________________________________ 

7. What is your type of practice? 

Primary Care______ Pediatrics______ Surgery______ 

Other__________________________________________________________ 

8. Specific medical topic(s) (adult or pediatric)you would like to see 

included in an upcoming CME program:_______________________________ 

_______________________________________________________________ 

_______________________________________________________________ 

_______________________________________________________________ 

_______________________________________________________________ 

Please return to the CME Office at 13-50 or 

FAX to 570-271-5850 by ______. 


MEMORANDUM 

TO: 

RE: 

MESSAGE: 

BENEFITS TO YOU: 

INCENTIVE: 

All physicians who like to participate in designing their 

own continuing medical education 

An opportunity to tell us what you need 

Please fill out the enclosed questionnaire and return it 

in the stamped, self-address enclosed envelope 

- local programs designed to meet your needs 

- less time and cost out of your office 

All returned questionnaires will be placed in a drawing 

for free tuition to two one-day activities sponsored by 

the Geisinger Health System. Minimum value 

$130.00. 

From: 

CME Office 

13-50 


Continuing Education Needs Assessment 

1. Best day of the week? __________________________________ 

2. Best time of the year? __________________________________ 

3. How many hours do you prefer? __________________________ 

4. How many days do you prefer? ___________________________ 

5. Do you want weekend courses? ___________________________ 

6. Do you want family activities? _____________________________ 

7. I am interested in: (Yes or No) 

ACLS Courses________ BLS Courses________ 

ATLS Courses________ FCCS Courses ________ PALS Courses________ 

8. Favorite Format: 30 minute_____ Cases_____ Workshops_____ Role 

Playing_____ Other________ 

9. Do you want courses in vacation areas? _____________________ 

10. Do you want courses in Pennsylvania? ______________________ 

11. Do you want courses in other states? _______________________ 

12. Do you want courses with hunting or fishing? ________________ 

13. Do you want courses with sports activities? __________________ 

14. Topics I need: 

_____________________________________________________ 

_____________________________________________________ 

_____________________________________________________ 

15. Suggestions for improvement: 

_____________________________________________________ 

_____________________________________________________ 

Name (Please print)________________________________________ 


Planning 

Planning Minutes 

All CME Activity Directors are asked to keep minutes of their planning sessions 

for continuing medical education activities. The minutes need to be attached to 

the CME application. When the CME Manager and/or The Associate Chief 

Medical Officer of Academic Affairs and Continuing Medical Education meet with 

anyone concerning an activity offering credit, they also keep notes. The notes 

are kept in each individual activity file. 


Facility Information - ACPE 

Active Learning Principles 

The Geisinger Health System CME Office strongly encourages the use of “Active 

Learning” principles in the development of continuing education activities for 

pharmacists. These principles encourage the participants to become actively 

involved in the educational session, rather than remain passive listeners to the 

lecture. It has been shown that utilizing Active Learning techniques will enhance 

the participant’s interest and attention throughout the learning activity and help 

to tailor the educational activity to the audiences needs. 

Below are listed some examples of techniques which can be utilized to promote 

active participation and therefore active learning. This is not intended to be an 

all-encompassing list, but to act as a guide in helping you to develop your 

educational activity. If you have questions or need assistance with the process 

of incorporating active learning techniques into your educational activity you may 

contact the CME Office. 

1. Request input from the participants as to the type of information that they 

would like you to address during the lecture. This information can then 

be used to guide the talk to meet the needs of the participants. This can 

be done at the beginning of the program, during the presentation or at 

the end, followed by a tailored summary. 

2. Use question or solicit comments during your lecture. This allows the 

audience to participate and allows the presenter to check up on the level 

of comprehension and attention of the participants. 

3. Allow the audience to share similar cases examples or related experiences 

that may enhance the content of the presentation and lead to further 

questions or issues that the presenter can address. 

4. Prepare cases or questions, which can be discussed in small group format 

and then the conclusions, or questions that arise from those small groups 

can be shared with all of the program participants. 

5. Provide an opportunity for communication after the lecture, where 

participants can follow up with questions or clarifications that they need 

with regard to the material presented. This can be done through 

providing contact information to the participants or creating a forum 

where participants can share ideas or questions in an ongoing fashion 

(chat room, e-mail list, etc.). 


6. Utilize active learning exercises as a part of the presentation. These 

exercises must be tailored to the type of information being presented. 

Tools that can be utilized to create active learning exercises are such as; 

Pro and Con Grid to evaluate treatment options or therapeutic 

plans 

Requesting feedback on the least clear or most confusion point of 

the presentation 

Feature matrix, having participants compare and contrast important 

defining features of a concept of idea. 

Request feedback, written or oral on the most important point of a 

presentation, section or subject. 

Having the participants identify problems or issues from short 

case/situation presentations. 

Requesting from the participants, written or oral paraphrasing of 

information that has been presented. 

The purpose of providing continuing education activities, is not only the provision 

of accurate, up to date, appropriate information related to the goals of the 

particular activity but to tailor those educational sessions to facilitate learning 

and meet the needs of the activity participants. Activity design and appropriate 

teaching methods can help to enhance the learning environment. 


Objectives 

Definition Of Objectives 

An objective is defined as something toward which effort is directed, an aim or 

end of action. 

This concept can be broken down into two parts. The word goal is used as being 

somewhat more abstract, distant, and general; it is an umbrella statement, 

under which specific objectives – which are relatively concrete, short range, and 

usually measurable – can be clustered. 

Both goals and objectives should be realistic and obtainable, and both should 

define intended audience. 

There are three commonly used modifiers: 

1. Learner objectives reflect what the student should know or be able 

to do at the end of a learning period. 

2. Instructional objectives reflect what the instructor intends to accomplish. 

3. Behavioral objectives reflect what the learner might be expected to 

do differently (behavior change) as a result of what has been 

learned. 

Educational objectives for a planned CME activity should be based on clearly 

identified CME needs and should identify the target group. Where group or 

individual CME needs cannot be based on a private profile, peer review, selfassessment, 

case audits, or individually identified CME needs or interests, new 

medical knowledge can be used as a basis for developing the educational 

objectives that are specific for a knowledge level or performance capability. 

An objective should be stated in such a way that both the prospective learner 

and the teacher should ideally be able to answer three questions about the 

expectations: 

1. What should the learner be able to do? 

2. Under what conditions? 

3. How well (e.g., speed, accuracy)? 

Program objectives should be written after: 

1. The need is assessed. 

2. The target audience is determined. 

Program objectives should be written before: 

1. Teaching methods are determined. 

2. The kind of evaluation technique is decided. 


Vocabulary 

The following verbs have been found to be effective in formulating educational 

objectives: 

1. Those that communicate knowledge 

Information 

Cite Identify Quote Relate Tell Tabulate 

Count Indicate Read Repeat Trace Record 

Define List Recite Select Write Point 

Describe Name Recognize State Draw 

Comprehension 

Associate Describe Explain Locate Translate Review 

Classify Differentiate Express Predict Compare Interpret 

Discuss Extrapolate Report Compute Distinguish Estimate 

Interpolate Restate Contrast 

Application 

Apply Employ Locate Relate Sketch Dramatize 

Calculate Examine Operate Report Solve Interpret 

Complete Illustrate Order Restate Translate Predict 

Demonstrate Interpolate Practice Review Use Schedule 

Utilize 

Analysis 

Analyze Debate Distinguish Inventory Appraise Summarize 

Detect Experiment Question Contract Diagram Inspect 

Infer Separate Criticize Differentiate 

Synthesis 

Arrange Construct Formulate Organize Produce Prescribe 

Assemble Create Generalize Plan Propose Manage 

Collect Design Integrate Prepare Specify Detect 

Compose 

Evaluation 

Appraise Determine Judge Recommend Test Select 

Assess Estimate Measure Revise Choose Rate 

Evaluate Rank Score Critique Grade 

2. Those that impart skills 

Diagnose Integrate Measure Percuss Empathize Pass 

Internalize Palpate Project Hold Massage Visualize 

3. Those that convey attitudes 

Acquire Exemplify Realize Reflect 


References For Objective Writing 

Mager, R. Preparing Instructional Objectives. 2 nd ed. Belmont, CA: Fearon. (An 

easy-to-read introduction to objectives writing aimed at those in general 

education, but easily applied to CME.) 

Bunnel, K., Ed. Continuing Medical Educators Handbook. Colorado Medical 

Society, P.O. Box 17550, Denver, CO 80217. 1980. (A handbook designed for 

the community-based physician who has responsibilities for CME, but who may 

have little or no training in educational processes.) 

Bergin, J.J., G.C. Holmes. Continuing Medical Education in the Community 

Hospital. Port Washington, NY: Romaine Pierson, 1979. (A guide to designing, 

organizing, and conducting Category I programs.) 

Objective Policy For Single Activity 

It is the CME Office policy to assure that properly written objectives are prepared 

for all activities and appear on activity brochures, which reach participants six to 

eight weeks prior to the activity date. 

CME Activity Directors are required to meet with the CME Executive Committee, 

and after reviewing needs assessment data, design learner oriented objectives 

based on the expected target audience are written. Input from content experts 

and potential faculty is also obtained. 

If the objectives are not learner oriented or are not written with appropriate 

language, the CME Manager will renegotiate these with the speakers and/or 

Activity Directors. The CME Manager or Associate Chief Medical Officer for 

Academic Affairs and Continuing Medical Education has the ultimate 

responsibility for the objectives. 

Objective Policy For Recurring Activities 

Objectives for weekly or monthly conferences are written yearly at the time of 

application for continuing medical education credit. Once the application is approved, 

objectives are written for each individual weekly conference. 

If the objectives are not learner oriented or are not written with appropriate 

language, the CME Manager will renegotiate these with the speakers and/or CME 

Activity Directors. The CME Manager or Associate Chief Medical Officer for 

Academic Affairs and Continuing Medical Education has the ultimate 

responsibility for the objectives. 


Approval Process 

TO: Potential CME Applicants 

RE: Credit Application 

• Programs that follow previously accredited and established formats can 

be considered for credit up to 7 business days prior to the activity. 

Urgent needs should be discussed with the CME Manager. 

• Application for credit for novel and/or unique activities should be 

received 6-8 weeks prior to event for full CME Committee approval 

• You will be notified within 7-10 days of approval or denial of your 

activity 

• A fact sheet with all the essentials will be sent if the activity is 

approved 

• Evaluations and sign-in sheets will be available from the CME Office if 

you wish to use the standard forms 

• If your activity is denied, you have the option to meet with members 

of the CME Committee to revise your proposal so it meets the 

"standards." 

• If you have any questions in filling out this form, please feel free to call 

the CME Office at (570)271-6692. 


The Geisinger Health System Continuing Medical Education Office 

Application For Category 1 Credit 

I submit the following course_____, monthly conference____, weekly 

conference_____, joint-sponsored_____, enduring/on-line material_____, and 

other__________________, for the following credit(s): AMA credit _____, 

PSNA _____, AAPA _____, ACPE _____ or other_____________________. 

Title______________________________________________________ 

__________________________________________________________ 

Date S)_________________Time______________Total Hours_______ 

Location_______________________City_____________State_______ 

CME Activity Director_______________________Phone ____________ 

Mailing Address_____________________________________________ 

E-Mail Address_____________________________________________ 

• Needs Assessment - how have you identified the educational needs of your 

target audience? Please check the methods you used and a copy of the 

minutes must accompany application: 

_____ survey of target audience 

_____ peer review 

_____ M&M statistics 

_____ consensus of experts 

_____ faculty perception 

_____ self assessment 

_____ patient care audit 

_____ other_____________ 

• Behavioral Objectives - must have at least one objective for each 

activity/lecture 

At the completion of this conference, the participant should be able to: 

A)_______________________________________________________ 

B)_______________________________________________________ 

C)_______________________________________________________ 

• Subject Matter - attach outline of program ___________________ 

_________________________________________________________ 


• Educational design - what presentation method do you intend to use? 

_____ lecture(s) only _____ workshop(s) 

_____ case presentations _____ other_________________ 

_____ on-line course 

• Target audience_______________________________________________ 

_______________________________________________________________ 

• Teaching Staff - please list with appropriate titles. A CV for any outside 

speaker must accompany application. 

___________________________________________________________________________ 

___________________________________________________________________________ 

• How do you propose to cover costs associated with this activity? 

_____ Pharmaceutical Support ______ Foundation Grant 

_____ System Grant 

______ Tuition Fees 

_____ Don’t Know 

______ Other____________ 

• Do you anticipate any special expenses? 

__Honorarium $_______ ___ Special Services $_______ 

__Special Meals $_______ ___ Other $__________________ 

• How will this activity be evaluated to see that it meets your instructional 

objective(s)____________________________________ 

___________________________________________________________ 

Please submit summary of evaluations after the activity. 

FOR CME OFFICE USE: 

_____Fast Track Approval 

Signature________________________________________ Date_____________ 



CME Committee Action_____________________________ Date_____________ 


Requirement For Approval Of Continuing Education Activities 

Recurring activities and annual activities are reviewed at the Continuing Medical 

Education Committee bi-annual meeting and approval considered for the next 

cycle. 

The Associate Chief Medical Officer of Academic Affairs and Continuing Medical 

Education with the CME Manager reviews new applications and fast track needs 

in consultation with the CME Committee. 

If approved, review of the evaluation and outcomes as well as improvement 

projects will be reviewed at the next bi-annual meeting of the CME Committee. 


Check List for CME Activity Planning 

1. Name of activity______________________________________________________ 

2. Activity date(s)_______________________________________________________ 

3. CME Activity Director __________________________________________________ 

4. CME Application(s) complete: Yes No _______________Date____________ 

Intent date __________________Needs Assessment: Yes No ___________ 

Objectives: Yes No ____________________________________________ 

Target Audience _____________________________________________________ 

Other credits: 

 

AMA Application submitted: Yes No Date_________________ 

Received approval date: _________________ Approved credit hours: _________ 

 

AAPA Application submitted: Yes No Date_________________ 


 

NATA Application submitted: Yes No Date_________________ 


 

Social Worker Application submitted: Yes No Date_______________ 

Received approval date: __________________Approved credit hours: _________ 

 

AART Application submitted: Yes No Date_________________ 

Received approval date: __________________Approved credit hours:_________ 

 

NBCC Application submitted: Yes No Date_________________ 

Received approval date: __________________Approved credit hours: ________ 

 

AAFP Application submitted: Yes No Date_________________ 


 

Optom Application submitted: Yes No Date_________________ 

Received approval date: __________________ Approved credit hours: ________ 

 

AOA Application submitted: Yes No Date_________________ 



PSNA Application submitted: Yes No Date_________________ 


 

ASRT Application submitted: Yes No Date_________________ 


 

CDR Application submitted: Yes No Date_________________ 

Received approval date: ________________ Approved credit hours: __________ 

 

ACPE Application submitted: Yes No Date_________________ 

Received approval date: _________________Approved credit hours: _________ 

 

NATP Application submitted: Yes No Date_________________ 


 

APA Application submitted: Yes No Date_________________ 


 

Other Application submitted: Yes No Date_________________ 


5. Hotel Contract Yes No N/A Room deadline_______________________ 

Special Arrangements Needed: Yes No _____________________________ 

___________________________________________________________________ 

6. Audio-Visual Needs: Yes No N/A ________________________________ 

7. Faculty Letters Sent Yes No N/A Deadline given ____________________ 

8. Brochures 

Date Saver: Yes No N/A On Web Site Yes No N/A 

Date sent to Print Shop _______ Number of mailings ______ Mailing date(s)____ 

9. Exhibitor Letters sent: Yes No Date: ______________ 

Number of exhibits allowed ____________ 

Companies Letter Sent Date Received Date/Amount 

1. ________________________ ________________ ___________ 

2. ________________________ ________________ ___________ 

3. ________________________ ________________ ___________ 


4. ________________________ ________________ ___________ 

5. ________________________ ________________ ___________ 

6. ________________________ ________________ ___________ 

7. ________________________ ________________ ___________ 

8. ________________________ ________________ ___________ 

9. ________________________ ________________ ___________ 

10. _______________________ ________________ ___________ 

10. Handouts 

Due Date ___________ Date Rec’d ___________ Date sent to Print Shop_______ 

Date Due Back ____________ 

11. Faculty Travel 

Speaker Airline Hotel Conf # Limo 

_______________________ __________________ _______________________ _____ 

_______________________ __________________ _______________________ _____ 

_______________________ __________________ _______________________ _____ 

_______________________ __________________ _______________________ _____ 

12. Evaluation 

Copy prepared: Yes No Printed: Yes No 

Distributed and how: Yes No ______________________________________ 

Tabulated and on file in CME Office: Yes No __________________________ 

Copies sent on _________________ and to: 

13. Budget 

__Dr. Famiglio ____________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

Pre: Yes No N/A Post: Yes No N/A 

Activity Billed: Yes No N/A 

Date Amount N/A 

CME Adm. Fee ____________ ____________ ____________ 


CME Certificates ____________ ____________ ____________ 

CME App. Fee ____________ ____________ ____________ 

CME Other ____________ ____________ ____________ 

LOA/CME Fee ____________ ____________ ____________ 

14. Activity Director feedback 

Survey Completed: Yes No 

N/A 

15. Thank you letters sent on _____________________ and to: 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 

________________________ 


Evaluation 

Definition 

Evaluation involves quantifying the value and quality of a CME activity. The 

effect on participant's knowledge base, competence and performance of 

practicing health professionals served by our institution is evaluated. 

Policy 

Every activity, recurring activity, lecture, etc. receives an evaluation form from 

the Continuing Medical Education (CME) Office. It is the CME Activity Director’s 

responsibility to distribute and collect them at the end of every lecture/meeting. 

The evaluation forms are then sent to the CME Office to be entered into the 

computer. The computer then tabulates the results. 

A copy of the results is put in the activity file. Also, copies are sent to the 

Activity Director, the speakers, CME Manager and Associate Chief Medical Officer 

of Academic Affairs and Continuing Medical Education. 

The activity’s written objectives should be copied onto the evaluation forms and 

the question: Were the stated objectives for the program met? 

Objectives YES NO 

1. 

2. 

3. 

Every evaluation should give the participant the opportunity to evaluate the 

faculty and if the talk(s) were free of bias or commercial support. 

Future programming needs should also be assessed on the evaluation forms. 

Evaluation Summary 

An evaluation form is used at every CME lecture/activity and summarized to 

determine if the educational activities are accomplishing what they were 

designed to do and that no bias or commercialism was noted. 

Policy On Who Receives Copies Of Evaluation Summaries 

The summary of the evaluation forms will be sent to the CME Activity Director, 

CME Manager, Associate Chief Medical Officer of Academic Affairs and Continuing 

Medical Education, and the speakers. The originals will be kept in the respective 

activity file in the CME Office. 


TITLE OF EVENT 

DATE, 2005 - Evaluation Form 

Please indicate your degree(circle): MD DO CRNP PA-C RN Other________________ 

Geisinger Employee: Yes______ No______ 

Evaluate each Presentation 

SCALE: 5 = Excellent 4 = Very Good 3 = Good 2 = Fair 1 = Poor 

Using the above scale, please circle the following: 

PUT SPEAKER NAME HERE 

Amount & 

Depth of 

Material 

Relevance of 

Topic 

Organization 

& 

Effectiveness 

of Presenter 

Free of Bias 

Presenting 

Balanced 

View 

5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 Yes No 

PUT SPEAKER NAME HERE 

5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 Yes No 

If bias, please note________________________________________________________ 

Evaluate the Overall Event 

1. The content of this educational activity met my 

expectations. 

2. Objectives for this educational activity were met. 

3. Activity format enhanced achievement of program 

objectives. 

4. Level of material was appropriate for me. 

5. There was adequate time for questions/audience 

interaction. 

6. Information presented will be useful in my practice. 

Strongly 

Agree 

Agree 

Strongly 

Disagree 

5 4 3 2 1 

5 4 3 2 1 

5 4 3 2 1 

5 4 3 2 1 

5 4 3 2 1 

5 4 3 2 1 

7. Handouts and/or books were useful. 

8. Change in my knowledge as a result of this program. 

9. Facility was conducive to learning. 

5 4 3 2 1 

5 4 3 2 1 

5 4 3 2 1 

As a result of this activity, the primary thing I will do differently in my practice is:______________________________ 

________________________________________________________________________________________________ 

The best way to improve this activity is_______________________________________________________________ 

Suggestions for future topics:_________________________________________________________________________ 

Comments:________________ __________________ _________________________________________________ 


Continuing Medical Education Activity Evaluation 

Program Title: Medical Grand Rounds 

Date Of Activity: 

Location: Geisinger Medical Center, Danville, PA 

Was the speaker engaging? [no] Poor Fair Good VG Excellent [yes, indeed] 

1. ________________ ___ ___ ___ ___ ___ 

2. ________________ ___ ___ ___ ___ ___ 

AV Aids (slides etc) [unreadable] Poor Fair Good VG Excellent [very helpful] 

1. _________________ ___ ___ ___ ___ ___ 

2. _________________ ___ ___ ___ ___ ___ 

Clarity/organization [disorganized] Poor Fair Good VG Excellent [clear points] 

1. _________________ ___ ___ ___ ___ ___ 

2. _________________ ___ ___ ___ ___ ___ 

Appropriate for audience [no] Poor Fair Good VG Excellent [great choice] 

1. ________________ ___ ___ ___ ___ ___ 

2. ________________ ___ ___ ___ ___ ___ 

Poor Fair Good Excellent 

Were activity objectives clearly stated? ___ ___ ___ ___ 

Did the activity accomplish its objectives? ___ ___ ___ ___ 

Overall quality of activity? ___ ___ ___ ___ 

Change in knowledge as a result of this presentation? 

Yes ___ No ___ 

As a result of this activity, the primary thing I will do differently in my practice is: 

_________________________________________________________________ 

The best way to improve this conference is ______________________________ 

My general comments about this presentation are _________________________ 

_________________________________________________________________ 

Do you feel there was commercial bias in any of this presentation? Yes___ No ___ 


ACPE Program Evaluation Form 

Program Number: ________________________________ Date: ____________ 

Program Title: _____________________________ Location: _______________ 

1. How would you rate the Overall Quality of this educational program? 

____ Excellent ____ Very Good ____ Good ____ Fair ____ Poor 

2. How well did this program meet the stated educational objectives? 

Objective 1: ____ Very Well ____ Well ____ Somewhat ____ Not at All 





3. How well did this program improve your knowledge of the subject matter? 

____ Very Well ____ Well ____ Somewhat ____ Not at All 

4. Will the information from this program be applicable in your current practice 

environment? 

____ Very Applicable 

____ Somewhat Applicable 

____ Applicable 

____ Not Applicable 

5. How likely are you to share this information with your colleges? 

____ Very Likely ____ Somewhat Likely ____ Not Likely 

6. Facility Evaluation 

Evaluate the Speakers Effectiveness 

____ Very Effective ____ Somewhat Effective ____ Not Effective 


Evaluate the Speakers Organization 

____ Very Organized ____ Somewhat Organized ____Not Organized 

Evaluate the Speakers Knowledge on the Subject Matter 

____ Very Knowledgeable 

____ Not Knowledgeable 

____ Somewhat Knowledgeable 

7. Were active learning strategies (active participation) utilized during this 

program? 

____ Yes ____ No ____ Unsure 

8. If active learning strategies were utilized, did they help you to achieve the 

objectives? 

____ Very Helpful ____ Somewhat Helpful ____ Not Helpful 

9. What new information did you gain from this program? 

10. What questions still remain for you after this program? 

11. Were the facilities conducive to learning? 

____ Very Conducive ____ Somewhat Conducive ____ Not Conducive 

12. Do you feel that this program was free of commercial bias? 

____ Yes (it was free of Bias) 

____ No (there was commercial bias) 

13. Please provide suggestions of topics for future ACPE programs. 


Evaluation of Promotional Materials 

Program A Program B Program C 

Please list the Universal Program Number 

A. Educational goals and specific learning 

objectives 

B. Target audience 

C. Faculty members and their credentials 

(degree and position) 

D. Fees/Refund information (including no fee 

when applicable) 

E. Schedule of educational activities 

F. Amount of credit (contact hours or CEUs) 

G. ACPE logo, including trademark, and 

Provider Statement 

H. Universal Program Number 

I. Full description of requirements for credit, 

i.e. sign in sheet, evaluation form, etc. 

J. Acknowledgment of financial support (if 

applicable) 

K. Initial release date (ongoing programs) 

L. Educational activities distinguished from 

non-educational activities 

M. Statement of where and how a statement of 

credit will be issued 


EXAMPLE: Materials Checklist: 

This form may be used to evaluate the Provider’s record keeping 

activities. These forms may be duplicated as needed. 

Please list the Universal Program 

Number 

Program Description Form 


Cosponsorship agreement (if applicable) 

Program announcement materials 

Documentation of amount of credit assigned to 

program 

Documentation that participants have/have not 

met requirement for receiving credit 

Copy of one or more completed statements of 

credit from the program 

Proposed budget 

Actual budget 

Guidance provided to faculty 

Educational needs assessment and results 

utilized to develop offering 

Completed conflict of interest forms from 

faculty 

Documentation of conflict of interest 

information provided to participants (if any) 

Learning objectives 

Instructional materials (including paper copy of 

slides, handout materials, etc.) 

Documentation of active participation in 

learning 

Learning assessment instrument (s) 

Program evaluation instrument and summary 

results 


Additional materials required for Certificate Program 


Number 

CPN 


Certificate Program Plan 

Formative and summative evaluation 

instruments 

Evaluation of program effectiveness over time 

Documentation that participants have/have not 

met the pre-determined level of performance 

Documentation of successful completion of 

certificate program 


Provider Self-Evaluation of Statements of Credit 

Directions: Please evaluate each statement of credit for each of the selected 

programs using the checklist below. 


Number 


A. Participant name 

B. Title of Program 

C. Date of live program or date participant 

completed (mailed, stated completion of) the 

home study offering 

D. Accredited Provider sponsoring or 

cosponsoring the program, if applicable 

E. Official ACPE logo and trademark symbol 

F. Amount of credit awarded (contact hours or 

CEUs) 

G. Universal Program Number 

H. Continuing education administrator’s 

signature 

I. Date that the administrator signed the 

statement 


Essential 3 

Resources/ 

Joint Sponsorship/ 

Enduring Materials/ 



Policies For Various Types Of Activities 

Self Directed CME Projects 


Geisinger Health System’s (GHS) Continuing Medical Education (CME) Committee 

recognizes that physicians have unique educational needs. The CME Committee 

encourages physicians to take an active, self-directed role in satisfying their own 

educational needs. The CME Committee approves the following procedure by 

which physicians can obtain Category 1 credit for their participation in a 

structured self-directed educational activity. 

Procedure 

Upon the recognition of an educational need, the physician completes an 

application form. This form contains the educational objectives, which are 

reviewed, revised if necessary, and approved by the project facilitator, a member 

of the CME Committee. The physician then proceeds with identifying information 

resources, reading relevant citations, and writing a report, which contains at 

least four references. The physician systematically records the amount of time 

spent completing the project. Upon project completion, the physician submits 

the following to the project facilitator: 

1. Project report 

2. Total time report 

3. Attestation regarding total time accuracy and non duplication of CME 

credit 

4. Project evaluation form 

The project facilitator reviews, approves, and forwards the materials to the CME 

Committee for final assignation of Category 1 Credit. The amount of credit 

awarded will be 100% of the reported time with a maximum of 6 credits per 

application and a maximum of 20 hours per year. After approval, the physician 

will receive certification of the amount of credit awarded. At its discretion, the 

CME Committee may make specific recommendations regarding further 

dissemination of the project report. 


Responsibilities 

Project Facilitator-member of the CMEC 

Review, revise, and approve the project educational objectives 

Notify the physician of project approval 

Answer questions during the project 

Contact the physician regarding an uncompleted project 

Review and submit a satisfactory report to CME Committee 

Return an unsatisfactory report for revision 

Review project evaluation forms 

Summarize evaluations and periodically report to the CME Committee 

Learning Resources 

Assist the physician in identifying and obtaining information resources 

Maintain online access to the self directed learning program 

Post project reports on the designated system web page 

CME Coordinator 

Receive finished projects from the project facilitator 

Obtain disc copies of project reports 

Place finished projects on the CME Committee agenda 

Record credit certification upon project approval 

Provide the CME Committee with summary reports of credit hours granted 

CME Committee 

Review finished projects 

Approve CME credit 

Recommend appropriate dissemination of project information 


Project Application 

Name: 

Date submitted: 

Date of anticipated completion: 

N.B. Project expires 30 days after due date 

 

What prompted you to begin this project? 

 

What question would you like to answer? 

 

What information resources do you plan to use? 

Upon completing this project, what do you expect to be able to do . . . 

 

How many hours are you willing to spend doing this project? 


Time Sheet 

Record time to the nearest ¼ hour. 

Preparation: 

This includes time spent seeking out information resources such as doing a 

literature search, reviewing abstracts, ordering articles, visiting the library, 

speaking with consultants, contacting agency representatives, or communicating 

with the project facilitator. The maximum allowable time for this stage is one 

hour. 

Preparation Time = 

Reading: 

This includes time spent reading journal articles, textbooks, or computer-based 

information resources. 

Resource #1 = 

Resource #2 = 

Resource #3 = 

Resource #4 = 

Resource #5 = 

Reading Time = 

Writing: 

This includes time spent reviewing information resources, writing and/or typing 

the report, and completing the evaluation form. 

Writing Time = 

Grand Total = 


Attestation 

Time Report: 

Record your time to the nearest ¼ hour: 


Reading Time = 


Grand Total = 

Attestation: 

I have accurately completed this time report. This project reflects learning that I 

have done by myself. I have not otherwise received CME credit for the time 

spent doing this project. 

Name & Date: 


Evaluation 

Review your application form. Underline the appropriate x: 

Have you met your objectives? 

x x x x x 

None Some All 

How valuable was this project in terms of time spent versus information gained? 

x x x x x 

Not Somewhat Very 

Would you do another project? 

x x x x x 

No Way Maybe Definitely 

Answer the following questions, please: 

 

What was the most important thing that you learned? 

 

How do you anticipate using what you learned? 

If you were to do this project again, what would you do differently? 


Mini-fellowship CME Projects 


Geisinger Health System’s (GHS) Continuing Medical Education (CME) Committee 

recognizes that physicians have unique educational needs. The CME Committee 

encourages physicians to take an active, self-directed role in satisfying their own 

educational needs. The Committee approves the following procedure by which 

physicians can obtain Category 1 Credit for their participation in a structured 

mini-fellowship designed to develop or improve clinical skills. 

Procedure 

Upon the recognition of an educational need, the physician completes an 

application form. This form contains the educational objectives and plan, which 

is reviewed, revised if necessary, and approved by the project facilitator and a 

member of the CME Committee. The physician then proceeds with identifying 

background resources, and a clinical site for the fellowship. The physician 

systematically records the amount of time spent completing the project. Upon 

project completion, the physician submits the following to the project facilitator: 

1. Project report 

2. Total time report 

3. Attestation regarding total time accuracy and non duplication of 

CME credit 

4. Project evaluation form 

The project facilitator (a member of CMEC) reviews, approves, and forwards the 

materials to the CME Committee for final assignment of Category 1 Credit. After 

approval, the physician will receive certification of the amount of credit awarded. 


Responsibilities 

Project Facilitator-member of the CMEC 

Review, revise, and approve the minifellowship objectives 

Notify the physician of project approval 

Answer questions during the project 

Review and submit a satisfactory report to CME Committee 

Return an unsatisfactory report for revision 

Review project evaluation forms 

Summarize evaluations and periodically report to the CME Committee 

Preceptor 

Assist the physician in identifying and obtaining information resources; 

learning objectives and plan 

Supervise the minifellow’s activity 

Provide feedback and evaluation of the minifellow’s performance and 

competence in new skills 

CME Coordinator 

Receive finished project reports from the preceptor/minifellow 

Place finished projects on the CME Committee agenda 

Record credit certification upon project approval 

Provide the CME Committee with summary reports of credit hours granted 

CME Committee 

Review finished projects 

Approve CME credit 

Recommend appropriate dissemination of project information 

Review Policy annually 


Project Application 

Name: 

Preceptor 

Date submitted: 

Date of anticipated completion: 

 

What prompted you to begin this project? 

 

What skills would you like to obtain? 

 

What clinical setting(s) do you intend to use? 

 

Upon completing this project, what do you expect to be able to do? 

 

How many hours are you expecting to spend doing this project? 

I agree to precept this physician 

in obtaining their skills. 

_________________________ 

Applicant Signature 

__________________________ 

Preceptor Physician Signature 


Time Sheet 


Preparation: 

This includes time spent in background reading and communicating with the 

project preceptor(s). The maximum allowable time for this stage is two hours. 


Clinical Skills Development: 

This includes time spent in the clinical training setting observing and performing 

procedures and evaluating performance. 

Clinical Skills Development Time = 

Writing: 

This includes time spent writing the report, and completing the evaluation form 

up to one hour. 


Grand Total = 


Attestation 

Time Report: 

Record your time to the nearest ¼ hour: 


Clinical Skills Development Time = 


Grand Total = 

Attestation: 

I have accurately completed this time report. This project reflects skills I have 

obtained during this minifellowship. I have not otherwise received CME credit for 

the time spent doing this project. 

Name & Date: 


Evaluation 

Review your application form. Underline the appropriate x: 


x x x x x 

None Some All 


x x x x x 



x x x x x 



 


 




CME Enduring Materials Policy 

The Geisinger Health System Continuing Medical Education Committee (CMEC) is 

dedicated to providing continuing medical education that is convenient, up-todate 

and linked to providing quality patient care. The Geisinger Health 

System/Continuing Medical Education Committee enduring materials are CME 

activities that “endure” or exist beyond a single event and can be used over a 

specified period and can be effective in distance learning. 

1. All enduring materials must be planned with the CMEC. Planning begins 

with the intent to apply for a development of an activity. The intent to 

apply can be verbal, written or electronic (i.e. email or fax). 

2. Documented needs assessment reviewed by or performed in cooperation 

with the CMEC, must be the basis for the material. 

3. Detailed learning objectives must be listed at the beginning of each 

activity. Any accompanying or advance printed materials must provide a 

preliminary set of objectives. 

4. A description of the course requirements for CME assignment including 

estimate of time required to complete the activity; method of 

participation; a list of faculty with titles and degrees; current release date; 

expiration date; and date of most recent review must be included on 

promotional materials and labels of each unit. 

5. All accredited CME enduring materials must include the following 

statements on the labels, printed materials and in the opening segments 

of any activity: 

Accreditation 

Geisinger Health System is accredited by the Pennsylvania Medical Society 

to sponsor continuing medical education for physicians. 

Designation 

Geisinger Health System designates this continuing medical education 

activity for a maximum of ___ credit hours in Category 1 credit toward the 

American Medical Association Physicians Recognition Award and the 

Pennsylvania Medical Society membership requirement. Each physician 

should claim only those hours of credit that he/she actually spent in the 

educational activity. 

Disclosure 

All faculty participating in continuing medical education programs 

sponsored by the Geisinger Health System are expected to disclose to the 

program audience whether they do or do not have any real or apparent 

conflict(s) of interest or other relationships related to the content of their 

presentation(s). 


Commercial support disclosure must also be listed at the beginning. 

• Bibliographic references should direct the learner to further study 

or support/confirm the presentations. 

• Pretests should help focus the learner on upcoming key points. 

The post-test should provide the learner with a graded response 

and feedback. 

• All activities must be evaluated for efficacy in meeting the stated 

objectives and for compliance with continuing medical education 

standards. 

• Enduring material files must include documentation of the above 

items, as well as, planning/development meetings, letters of 

agreement and disclosure documentation. 

All enduring materials must also include the following information: 

Target Audience 

Geisinger Health System employed and Geisinger Health Plan network 

providers, referring and community physicians are the primary audience 

for Geisinger Health System CMEC enduring materials. Other learners, 

whose specific needs mirror those of this community of learners, may also 

participate. This group may include but are not limited to physicians in 

group practice, those in a managed care environment and primary care 

practitioners. 

Credit 

CMEC enduring materials may be designed to meet criteria for Category 1 

Credit. A panel of subject matter experts for appropriate content will 

review materials. The Continuing Medical Education Executive Committee 

or its designated CMEC members will review the activity in order to assign 

credit. 


Check List for On-line CME activities 

Prior to CME credit being assigned to a particular activity, the CME Committee 

must review all On-line CME activities. A CME application must be fully 

completed, including needs assessment data. All CME files will include 

documentation of planning/development meetings regarding the activity 

material, any correspondence, flyers and letters of agreement. All CME credited 

on-line activities must include the following: 

• Statement of accreditation on cover screen or second screen: “Geisinger 

Health System is accredited by the Pennsylvania Medical Society to sponsor 

continuing medical education for physicians.” 

• Designation statement on cover screen to state: “Geisinger Health System 

designates this continuing medical education activity for a maximum of ___ 

credit hours in Category 1 of the Physician’s Recognition Award of the 

American Medical Association and the Pennsylvania Medical Society 

membership requirements. Each physician should claim those hours of credit 

that he/she actually spent in the educational activity. 

• Title of activity on cover screen 

• Learning objectives present on cover screen 

• Specified target audience (physician specialties) on cover screen. 

• Commercial support disclosure must be mentioned once at the beginning of 

the activity. No advertising is allowed within the text. 

• List of principle faculty and their credentials must be listed on the third screen 

or linked with buttons or hypertext. Faculty in an on-line CME activity is the 

person(s) responsible for developing, writing, and verifying content. 

• Faculty disclosure must be included with the faculty information 

• Disclosure of any discussions of off-label uses should be noted in the text at 

the appropriate area. 

• To be included on all promotional materials and labels of each unit: 

- Description of method of physician participation 

- Method of completion 

- Dates of original release, expiration, and review update or approval. Each 

course must be reviewed and approved or updated every year. 

- Description of media used must be described within the materials. 

• Include an evaluation form with the material. 

• Pre and post tests are recommended for each activity 

• Attach a bibliographical reference section to provide further resources for 

learners. This is an AMA requirement, not an accreditation requirement. 


On-Line Continuing Medical Education 

Fee Policy: 

On-line Continuing Medical Education (CME) activity development incurs 

expenses that will be off set in various ways (i.e. GHS, GHP, Clinical departments 

and grants). Billing takes place at the time of approval and before the online 

course goes live. As CME enters the web-based market in FY 2005, the following 

schedule of charges will be implemented: 

Basic Activity construction and initiation $1500.00 

To include dated electronic text, bibliography, pre/post tests, evaluations and 

method of completion. 

Anticipated development resources: 

• Professional consult with subject matter expert 

Estimated time = 2 hrs. 

• Technical hours allotted for development of material 

Estimated time = 10 hrs. 

• CME Executive review 

Estimated time = .5 hrs. 

• CME Committee review (3 members) 

Estimated time per member = 1 hr. 

Additional technical time beyond allotted time $35.00/hour 

• Annual review of activity with subject matter expert 

• Update of activity 

Credit maintenance (unit of credit = 1 to 8 hours) 

• Certificates and yearly CME transcript 

• Record (6 years) of all completed activities 

$15.00/person 

Sources of payment: Intercompany or Invoiced 

• Individual CME funds - employed provider 

• GHP - paneled providers 

• Self pay for all others 


Joint Sponsorship Application Process 

A requirement of an accredited sponsor engaging in joint sponsorship is that the 

accredited sponsor be integrally involved in the planning of the jointly sponsored 

activity. Documentation of all of the other Essentials must also occur. 

Therefore, adequate documentation of the planning process with early 

involvement of the CME Office is necessary. 

Non-accredited providers interested in receiving educational credit for an activity 

must contact the CME Office as soon as the planning process begins. The CME 

Office will work with the planning committee to insure compliance with the 

Essentials and Standards. 

Under no circumstances will credit be awarded retroactively. 

Fees for joint sponsorship will vary based on the scope of the activity, amount of 

staff time involved and the relationship to a Geisinger practice site. Either the 

Associate Chief Medical Officer of Academic Affairs and Continuing Medical 

Education or the CME Manager will approve all fees. 


Joint Sponsorship Definition 

Joint sponsorship allows non-accredited organizations to present educational 

activities that qualify for Category 1 credit. 

An accredited sponsor may enter into joint sponsorship with other nonaccredited 

organizations by taking full responsibility for the planning and 

evaluation of the program. 

Co-sponsorship represents two accredited providers providing an educational 

offering with one assuming responsibility for compliance with the Essentials. 

Joint Sponsorship’s Policy 

The Geisinger CME Office may, from time to time, wish to enter into a joint 

sponsorship relationship with a non-accredited provider to produce quality 

educational programming. 

The following guidelines are necessary for successful implementation of a jointly 

sponsored activity: 

1. The content, target audience and scope of the activity must be 

compatible with Geisinger’s CME mission and strategic goals. 

2. Joint sponsorship will only occur with other health care providers or 

recognized specialty organizations. 

3. The non-accredited sponsor must adhere to Geisinger’s policy 

regarding joint sponsorship documentation, deadlines, etc. 

4. A complete budget of the activity must be available and approved by 

the CME Office prior to the activity. 


Fees for Joint Sponsorship of Continuing Medical Education Activities 

Credit Application and Review Fee $500.00 

Review process includes input from GHS CME Executive Committee, 

CME Committee and appropriate feedback to requestor regarding 

needs assessment and objectives. This fee must accompany the application. 

Types of activities: 

• Recurring course/year 

• Single event 

• Symposium 

• Other educational designs 

• Brochure review 

• Telephone/email inquiries 

• Follow-up evaluations 

Activity with Commercial Support $50.00/letter of agreement 

Planning oversight: 

• Letters of Agreement 

• Documentation and maintenance of commercial support 

Credit Maintenance 

$15.00/attendee 

This cost is for CME credit maintenance per event for each attendee. These 

records are maintained for six years. You will be billed following the event for 

the actual number of participants. 

On Site Conference Support 

$50.00/hour/person 

+ travel expense 

Geisinger Health System CME Office personnel provide registration services and 

on-site facilitation. All new major activities (1/2 day or longer) require GHS CME 

personnel on site. 

Educational Consultation 

$100.00/hour 

Our CME professionals will help you build a program based on your needs, credit 

requirements, speaker recruitment and instructional design. 

These are just a sample of the services our CME Office can offer you. We will 

work within your budget to plan a very successful meeting. Please call the 

Geisinger Health System CME Office at 570-271-6692 for all your continuing 

medical education needs. 


Team CME Policy 

Team performance improvement projects can be effective sources of physician 

continuing education. The CMEC (Continuing Medical Education Committee) will 

consider applications for PMS Category 1 credit for these team activities. The 

application will be previewed by the CMEC. Once approval to proceed is given, a 

CMEC member will be assigned as a liaison. This CMEC member will review the 

advanced plan, make recommendations and advocate for the team at the CMEC 

meeting. 

An educational planning process must be followed: 

• The project goal must clearly relate to the CMEC mission 

• A written needs assessment with data must be submitted 

• Objectives must be clearly stated 

• Participants must be identified in advance with a leader and/or secretary 

to ensure documentation 

• The committee process including educational methods must be described 

• Outcome measurements must be planned 

• Time frame for completion must be stated 

• An activity evaluation must be done by each participant 

• Each participant must submit a final attestation of hours devoted to the 

activity 

Projects should normally be completed within one year. Once completed and 

above documentation is submitted and reviewed, CME credit of hour to hour up 

to 20 hours/project/year will be awarded to each participant. 


The Geisinger Health System Continuing Medical Education Office 

Application For Team Credit 

I submit the following team educational plans for Category 1 credit approval. 

Title________________________________________________________ 

____________________________________________________________ 

Time Frame___________________Total Hours(Up To 20/Yr)___________ 

Team Leader______________________________Phone#_____________ 

Team Secretary_______________________________________________ 

Team Members_______________________________________________ 

___________________________________________________________ 

___________________________________________________________ 

___________________________________________________________ 

• Needs Assessment - how have you identified the educational needs of your 

target audience? Please check the methods you used*: 

_____ peer review 

_____ self assessment 

_____ M&M statistics 

_____ patient care audit 

_____ consensus of experts _____ other_____________ 

Copy of data must accompany application before it will be submitted for approval. 

• Instructional Goals and Objectives: 

*See attached Mission Statement 

_________________________________________________________ 

_________________________________________________________ 

_________________________________________________________ 


• Identify your educational process: 

How will team work?____________________________________________ 

_____________________________________________________________ 

What resources will you use?_____________________________________ 

_____________________________________________________________ 

• Identify outcomes you will measure_________________________________ 

__________________________________________________________________________ 

• How will this activity be evaluated to see that it meets your instructional 

objective(s)____________________________________________________ 

______________________________________________________________ 

FOR CME OFFICE USE: 

_____Fast track approval to proceed with project 

CMEC Liasion ______________________ Preview Date _____________ 

Final Approval and Credit Granted: 

Signature ______________________________________ Date________ 



CME Committee Action ___________________________ Date________ 


Team Planning Time Sheet 


Preparation: 

This includes time spent seeking out information resources such as doing a 

literature search, reviewing abstracts, speaking with consultants, contacting 

agency representatives, or communicating with the team leader. The maximum 

allowable time for this stage is one hour. 


Meeting: 

This includes time spent meeting to discuss the issues: 

Date = 

Date = 

Date = 

Date = 

Date = 

Meeting Time = 

Writing: 

This includes time spent reviewing information resources, writing and/or typing 

the report, and completing the evaluation form. 


Grand Total = 


Attestation 

Time Report: 

Record your time to the nearest 1/2 hour: 


Meeting Time = 


Grand Total = 

Attestation: 

I have accurately completed this time report. This project reflects learning that I 

have done as part of this team project. I have not otherwise received CME credit 

for the time spent doing this project. 

Name (please print) 

____________________________________________________ 

Date________________________________________________ 


Evaluation 

Review your application form. Circle the appropriate x: 


x x x x x 

None Some All 


x x x x x 



x x x x x 



 


 





Standards for Commercial Support of Continuing Medical Education 

As adopted by the Accreditation Council for Continuing Medical Education Board 

of Directors on April 1, 2004 (reprinted verbatim from ACCME). 

Standards to Ensure Independence in CME Activities 

STANDARD 1: Independence 

1.1 A CME provider must ensure that the following decisions were made 

free of the control of a commercial interest. The ACCME defines a 

“commercial interest” as any proprietary entity producing health care 

goods or services, with the exemption of non-profit or government 

organizations and non-health care related companies. 

(a) Identification of CME needs; 

(b) Determination of educational objectives; 

(c) Selection and presentation of content; 

(d) Selection of all persons and organizations that will be in a 

position to control the content of the CME; 

(e) Selection of educational methods; 

(f) Evaluation of the activity. 

1.2 A commercial interest cannot take the role of non-accredited partner 

in a joint sponsorship relationship. 

STANDARD 2: Resolution of Personal Conflicts of Interest 

2.1 The provider must be able to show that everyone who is in a position 

to control the content of an education activity has disclosed all relevant 

financial relationships with any commercial interest to the provider. The 

ACCME defines “’relevant’ financial relationships” as financial relationships 

in any amount occurring within the past 12 months that create a conflict 

of interest. 

2.2 An individual who refuses to disclose relevant financial relationships 

will be disqualified from being a planning committee member, a teacher, 

or an author of CME, and cannot have control of, or responsibility for, the 

development, management, presentation or evaluation of the CME 

activity. 


2.3 The provider must have implemented a mechanism to identify and 

resolve all conflicts of interest prior to the education activity being 

delivered to learners. 

STANDARD 3: Appropriate Use of Commercial Support 

3.1 The provider must make all decisions regarding the disposition and 

disbursement of commercial support. 

3.2 A provider cannot be required by a commercial interest to accept 

advice or services concerning teachers, authors, or participants or other 

education matters, including content, from a commercial interest as 

conditions of contributing funds or services. 

3.3 All commercial support associated with a CME activity must be given 

with the full knowledge and approval of the provider. 

Written agreement documenting terms of support 

3.4 The terms, conditions, and purposes of the commercial support must 

be documented in a written agreement between the commercial supporter 

that includes the provider and its educational partner(s). The agreement 

must include the provider, even if the support is given directly to the 

provider’s educational partner or a joint sponsor. 

3.5 The written agreement must specify the commercial interest that is 

the source of commercial support. 

3.6 Both the commercial supporter and the provider must sign the written 

agreement between the commercial supporter and the provider. 

Expenditures for an individual providing CME 

3.7 The provider must have written policies and procedures governing 

honoraria and reimbursement of out-of-pocket expenses for planners, 

teachers and authors. 

3.8 The provider, the joint sponsor, or designated educational partner 

must pay directly any teacher or author honoraria or reimbursement of 

out-of–pocket expenses in compliance with the provider’s written policies 

and procedures. 


3.9 No other payment shall be given to the director of the activity, 

planning committee members, teachers or authors, joint sponsor, or any 

others involved with the supported activity. 

3.10 If teachers or authors are listed on the agenda as facilitating or 

conducting a presentation or session, but participate in the remainder of 

an educational event as a learner, their expenses can be reimbursed and 

honoraria can be paid for their teacher or author role only. 

Expenditures for learners 

3.11 Social events or meals at CME activities cannot compete with or take 

precedence over the educational events. 

3.12 The provider may not use commercial support to pay for travel, 

lodging, honoraria, or personal expenses for non-teacher or nonauthor 

participants of a CME activity. The provider may use commercial support 

to pay for travel, lodging, honoraria, or personal expenses for bona fide 

employees and volunteers of the provider, joint sponsor or educational 

partner. 

Accountability 

3.13 The provider must be able to produce accurate documentation 

detailing the receipt and expenditure of the commercial support. 

STANDARD 4. Appropriate Management of Associated Commercial 

Promotion 

4.1 Arrangements for commercial exhibits or advertisements cannot 

influence planning or interfere with the presentation, nor can they be a 

condition of the provision of commercial support for CME activities. 

4.2 Product-promotion material or product-specific advertisement of any 

type is prohibited in or during CME activities. The juxtaposition of editorial 

and advertising material on the same products or subjects must be 

avoided. Live (staffed exhibits, presentations) or enduring (printed or 

electronic advertisements) promotional activities must be kept separate 

from CME. 

 

For print, advertisements and promotional materials will not be 

interleafed within the pages of the CME content. Advertisements 


and promotional materials may face the first or last pages of 

printed CME content as long as these materials are not related 

to the CME content they face and are not paid for by the 

commercial supporters of the CME activity. 

 

 

 

For computer based, advertisements and promotional materials 

will 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. 

For audio and video recording, advertisements and promotional 

materials will not be included within the CME. There will be no 

‘commercial breaks.’ 

For live, face-to-face CME, advertisements and promotional 

materials cannot be displayed or distributed in the educational 

space immediately before, during, or after a CME activity. 

Providers cannot allow representatives of Commercial Interests 

to engage in sales or promotional activities while in the space or 

place of the CME activity. 

4.3 Educational materials that are part of a CME activity, such as slides, 

abstracts and handouts, cannot contain any advertising, trade name or a 

product-group message. 

4.4 Print or electronic information distributed about the non-CME 

elements of a CME activity that are not directly related to the transfer of 

education to the learner, such as schedules and content descriptions, may 

include product promotion material or product-specific advertisement. 

4.5 A provider cannot use a commercial interest as the agent providing a 

CME activity to learners, e.g., distribution of self-study CME activities or 

arranging for electronic access to CME activities. 

STANDARD 5. Content and Format without Commercial Bias 

5.1 The content or format of a CME activity or its related materials must 

promote improvements or quality in healthcare and not a specific 

proprietary business interest of a commercial interest. 


Presentations must give a balanced view of therapeutic options. Use 

of generic names will contribute to this impartiality. If the CME 

educational material or content includes trade names, where available 

trade names from several companies should be used, not just trade 

names from a single company. 

STANDARD 6.Disclosures Relevant to Potential Commercial Bias 

Relevant financial relationships of those with control over CME 

content 

6.1 An individual must disclose to learners any relevant financial 

relationship(s), to include the following information: 

The name of the individual; 

The name of the commercial interest(s); 

The nature of the relationship the person has with each commercial 

interest. 

6.2 For an individual with no relevant financial relationship(s) the learners 

must be informed that no relevant financial relationship(s) exist. 

Commercial support for the CME activity. 

6.3 The source of all support from commercial interests must be disclosed 

to learners. When commercial support is ‘in-kind’ the nature of the 

support must be disclosed to learners. 

6.4 ‘Disclosure’ must never include the use of a trade name or a productgroup 

message. 

Timing of disclosure 

6.5 A provider must disclose the above information to learners prior to the 

beginning of the educational activity. 


Disclosure Policy 

(Conflict of Interest) 

Disclosure of real or perceived conflict of interest will be made in accordance 

with the Standards for Commercial Support of Continuing Medical Education. All 

faculty and members of the planning committee must declare any real or 

perceived conflicts of interest that may be contained within their presentation, 

interest or with the financial supporters of the activity. Current policy requires 

written documentation. 

This policy does not mean that a speaker or planner with a conflict of interest 

may not make a presentation. It means that any potential conflict will be 

identified openly so that the listeners may form their own judgments about the 

presentation with the full disclosure of the facts of the presenter's involvement 

with the company or manufacturer of the drug or device, which is the topic of 

the presentation. All faculty participating in continuing medical education 

activities sponsored by Geisinger are expected to disclose to the audience any 

real or apparent conflict(s) of interest related to the content of their 

presentation(s). Failure to return the "Disclosure Statement for Faculty" will be 

sufficient cause to replace or eliminate the faculty presenter. 

Examples of situations requiring disclosure include: 

1. Service as a paid or non-paid consultant or employee 

2. Receive support from commercial sources for honoraria, travel and 

lodging 

3. Receipt of financial support from commercial sources for research projects 

4. Major financial interests or stock holdings 

5. Member of a commercial supporters speakers bureau 


MANAGEMENT OF CONFLICTS OF INTEREST POLICY 

Personal conflicts of interest will be managed utilizing a four (4)-part approach: 

1) Notification of Conflict Policy 

All sponsor employees will read and sign Geisinger Health System’s Code of 

Conduct, which describes behavioral standards. 

2) Identification of Conflicts 

All CME Committee members are required to complete a conflict of interest 

document annually and the Chair of the CME reviews them 

Committee. 

All planning personnel must also complete a conflict of interest document as 

part of the application process. 

All faculty are required to complete a disclosure form before the CME 

application receives final credit. 

3) Resolving Conflicts 

The CME Executive Committee will review all conflicts of interest. Any 

significant conflicts will result in canceling of the activity or not issuing the 

CME credits. Perception of conflict will be disclosed in writing prior to the 

activity. 

4) Auditing Effectiveness of Conflict Management Process 

Participants will be surveyed for perceptions of bias/commercialism. Noted 

biases will be compared to any disclosed conflict. Faculty or planner conflicts 

which are associated with perceived bias will result in ban of 

speaker/planner/support from future programs for one (1) year. 

Appeals can be made to the full CME Committee at its next regularly 

scheduled meeting. 

An anonymous compliance hotline number will be published in all handout 

materials. 

Approved June, 2005 


TO: CME Activity Directors 

RE: Commercial Support Standards 

All accredited sponsors of CME (including Geisinger) must comply with the 

standards including faculty and planning committee disclosure of potential 

conflicts of interest and funding guidelines that must be followed by all 

accredited sponsors. Current policy requires written documentation. 

Regarding the "Policy on Disclosure" - you will find attached our policy as well as 

a "Disclosure Statement" for the CME faculty. All faculty, whether Geisinger staff 

or outside speakers must fill out a disclosure form and return it immediately to 

the CME Office. The disclosure will be noted in the handout materials. A 

disclosure statement must also be made at the start of each lecture. CME 

Activity Directors are expected to aid the CME Office in obtaining this 

documentation. 

Funds from commercial sources must be in the form of an educational grant with 

the letter of agreement originating from the CME Office and made payable to the 

CME Office, which will be deposited in your activity account. It is not permissible 

to have commercial funds deposited into departmental accounts and expenses 

paid to the CME Office. 

If you have any questions regarding this policy and/or form, please feel free to 

contact the CME Office at (570) 271-6692. 

Warm Regards, 




FACULTY DISCLOSURE 

Geisinger Health System must insure balance, independence, objectivity, and scientific rigor in all its 

individually sponsored or jointly sponsored educational activities. All faculty are expected to disclose to the 

activity audience any significant financial interest or other relationship (1) with the manufacturer(s) of any 

commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation 

and (2) with any supporters of the activity. (Significant financial interest or other relationship can include 

such things as grants or research support, employee, consultant, major stock holder, member of speakers 

bureau, owner of a company or product, designer of a product, etc.) 

NAME OF CME ACTIVITY 

TITLE OF PRESENTATION 

DATE OF PRESENTATION 

CIRCLE YOUR RESPONSES: 

1. With respect to the presentation, I, my spouse/partner and my department (CIRCLE ONE) 

DO HAVE/DO NOT HAVE any relevant financial interest/arrangements or affiliations with 

any commercial/corporate organization(s) within the past 12 months associated with the manufacture, 

license, sale, distribution or promotion of the drug or device which is the topic of the presentation. 

If “have”, with which companies are you related? 

Nature of Relationship: 

( ) Speakers Bureau 

( ) Research Grant 

( ) Major Stockholder 

( ) Employment Affiliation 

( ) Other 

(CIRCLE ONE) 

2. I confirm that I AM/AM NOT receiving direct payment from a commercial entity for 

honorarium, travel, or other expenses. 

______________________________________________ 

Signature 

________________ 

Date 

_____________________________________________ 

Printed Name of Presenter 

Revised & Approved 7/27/05 



WRITTEN AGREEMENT 

Regarding Terms, Conditions and Purposes of an Educational Grant 

between GEISINGER CONTINUING EDUCATION and 

Title of CME Activity: 

Location: 

Date(s) 

Commercial Supporter (Company name/Branch): 

Telephone: Fax: Contact Person: 

The above company wishes to provide support for the named continuing medical education activity by 

means of (indicate which option): 

1. Unrestricted educational grant for support of the CME activity in the amount of $ 

A. Speaker(s) 

To include: All Expenses ______ Travel Only ______ Honorarium Only __ ____ 

Honorarium Amount (to be determined by Course Director) $ 

B. Support for catering functions (specify) in the amount of $ 

C. Other (e.g., equipment loan, brochure distribution, etc.) 

Make check payable to: Geisinger Health System Tax ID: #23-6291113 

Mail to Department of Continuing Education, Geisinger Health System, 100 North Academy Avenue, 

Danville, PA 17822-1350. 

CONDITIONS 

1. Statement of Purpose: The activity is designed for a specific educational purpose and will not promote 

the commercial supporter’s products or services, directly or indirectly. 

2. Control of Content and Selection of Presenters and Moderators: Geisinger is ultimately responsible for 

control of content and selection of presenters and moderators. The commercial supporter, or its agents, 

will respond only to Geisinger initiated requests for suggestions of presenters or sources of possible 

presenters. If a commercial supporter is asked for suggested faculty, the commercial supporter will 

suggest more than one name (if possible); will provide speaker qualifications; will disclose financial or 

other relationships between the commercial supporter and the speaker; will provide this information in 

writing. Geisinger will record the role of the commercial supporter, or its agents, in suggesting 

presenter(s); will seek suggestions from other sources; will make selection of presenter(s) based on 

balance and independence. 


3. Disclosure of Financial Relationships: Geisinger will ensure disclosure to the audience of (a) company 

funding and (b) any significant relationship between Geisinger and the commercial supporter (e.g., grant 

recipient) or between individual speakers or moderators and the commercial supporter. 

4. Involvement in Content: There will be no “scripting,” emphasis, or influence on content by the 

commercial supporter or its agents. 

5. Ancillary Promotional Activities: No promotional activities will be permitted in the same room or obligate 

path as the educational activity. No product advertisements will be permitted in the program room. 

6. Objectivity and Balance: Geisinger will make every effort to ensure that data regarding the commercial 

supporter’s products (or competing products) are objectively selected and presented, with favorable and 

unfavorable information and balanced discussion of prevailing information on the product(s) and/or 

alternative treatments. 

7. Limitations of Data: Geisinger will ensure, to the extent possible, disclosure of limitations of data (e.g., 

ongoing research, interim analyses, preliminary data, or unsupported opinion). 

8. Discussion of Unapproved Uses: Geisinger requires that presenters disclose when a product is not 

approved in the United States for the use under discussion. 

9. Opportunities for Debate: Geisinger will ensure opportunities for questioning or scientific debate. 

10. Independence of Sponsor in the Use of Contributed Funds: 

a. Funds should be in the form of an educational grant made payable to Geisinger Health System. 

b. All other support associated with this CME activity (e.g., distributing brochures, preparing slides, 

etc.) must be given with the full knowledge and approval of Geisinger. 

c. No other funds from the commercial company will be paid to the program director, faculty, or others 

involved with the CME activity (additional honoraria, extra social events, etc.). 

___________agrees to abide by all of the requirements of the Accreditation Council for Continuing 

Medical Education (ACCME) Standards for Commercial Support of Continuing Medical Education 

(appended), 

Geisinger agrees to: 1) abide by the ACCME Standards for Commercial Support of Continuing Medical 

Education; 2) acknowledge educational support from commercial companies in program brochures, syllabi, 

and other program materials; 3) upon request, furnish to the commercial supporter a report concerning the 

expenditure of the funds provided by the commercial supporter. 

SIGNATURES OF AGREEMENT 

Company Representative (Name)__________________________________________________ 

Signature__________________________________________________ Date_______________ 

CME Manager (Name)_______Sharon K Hanley, RMP, CEP____________________________ 

Signature__________________________________________________Date________________ 

CME Administrator (Name)____________Linda Famiglio, M.D._________________________ 

Signature__________________________________________________Date________________ 


Various CME Policies And Samples 

Activity Cancellation Policy 

Geisinger reserves the right to cancel an activity due to the lack of registration as 

late as one week prior to the activity. All registrants will be notified and full 

refunds will be processed. 

Activity Refund Policy 

Full refund will be given for cancellations received 5 days prior to the date of the 

activity. A $25 processing fee will be charged for cancellations after that date. 

No refunds will be granted for no-shows. 

Full refunds will be granted if the activity is canceled for any reason. 

Confirmation Letters 

A confirmation letter is sent to everyone who registers for an activity whether 

they have paid a registration fee or not. The computer will tell them if they paid 

in full or have been invoiced. Confirmation letters are sent the day the 

registration is received. (Sample attached) 


Sample Confirmation Letter 

Dr. XYZ 

100 North Academy Avenue 

Danville, PA 17822 

Date 

Dear Dr. XYZ: 

This letter is to acknowledge receipt of your registration in our activity entitled, 

“A Day with the Dermatologists”, to be held on May 31, 2004 in the Hemelright 

Auditorium at the Geisinger Medical Center. 

The program start time is 8:30 am with registration starting at 8:00 am. A 

continental breakfast will be available at the registration area. A luncheon will be 

provided, as well as, two refreshment breaks. 

Please dress in layers, as it is difficult to regulate the temperature of the meeting 

room with large groups attending. 

Should you have any questions concerning this or any other continuing education 

activities, please feel free to call the CME Office at 570-272-6692. A 24-hour 

answering service is available. Office hours are 7:00 am – 4:00 pm daily. 

Looking forward to seeing you soon. 


CME Office 


Attendance Record Samples 


Sign-In Form 

Activity Title: 

Activity Date (S): 

Please Print (if not legible, no credit will be issued) 

Name 

Complete Address 

Or Internal Zip 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_________________________________________________________________ 

_____________________________________________________________________________________ 


Certificates Of Attendance 

The Continuing Medical Education Office has many different certificates of 

attendance for example: 

• physicians/nurse practitioners/physician assistants 

• pharmacists 

• nurses (LPN & RN) 

• allied health professionals 

• dieticians 

• athletic trainers 

• occupational therapists 

A certificate of attendance is given to everyone who attends an activity on the 

day of the activity. The certificate of attendance reflects the activity title, date, 

location and any credit that was issued. 


Physician, Physician Assistants, and Nurse Practitioners 


Pharmacist 

Statement of Continuing Pharmaceutical Education Credit 

Provider Information 

Program Information 

Name Geisinger Health System Title 

ACPE I.D. 

Univ. Prog. No. 

Date 

Participant Information 

Credit Information 

Name Credits Issued CEU 

Address Or Contact Hrs 

City, State, Zip 

Date 

License No. (s) 

Authorized 

Signature 


Statement of Continuing Pharmaceutical Education Credit 

Geisinger Health System Office of Continuing Medical Education 

Name 

Program Information 


ACPE Universal Program Number Title Date CEUs Contact Hours 


Participant Information 

Credits Issued 

CEU 

License No. (s) 

Name 

Address 

Or 

Date 

Contact Hrs 

City, State, Zip 

________________________________ 

Signature 


Nursing 


Allied Health Professional 


Brochure Design 

Brochure Design Policy 

The Continuing Medical Education (CME) Office has a standard brochure design 

for all activities held at the Geisinger Medical Center. All one-day activities are 

printed on white bond paper with red, blue and black ink. 

The CME Office prepares the information and layout for the brochure and then 

sends it to the print shop to be typeset. When the "blue line" is returned to the 

CME Office, it is given to the Activity Director to proof as well as the staff in the 

CME Office. The Activity Director signs off on the final proof before printing the 

brochure. 

There are also other brochure designs available for multi-day activities held at 

resort areas. These brochures are generally four-folded and larger than our 

standard one-day brochures. In most cases, we stay with the same paper and 

ink as used in one-day brochures. 

Required Brochure Credit Statements 

All activities designated for credit must have all of the following statements on 

the brochure and/or announcement. 

Accreditation 

Geisinger Health System is accredited by the Pennsylvania Medical Society to 

sponsor continuing medical education for physicians. 

Designation 

The Geisinger Health System designates this continuing medical education 

activity for a maximum of ___ credit hours of Category 1 credit toward the AMA 

Physicians Recognition Award, and the Pennsylvania Medical Society membership 

requirement. Each physician should claim only those hours of credit that he/she 

actually spent in the educational activity. 

Disclosure 

All faculty participating in continuing medical education programs sponsored by 

the Geisinger Health System are expected to disclose to the program audience 

whether they do or do not have any real or apparent conflict(s) of interest or 

other relationships related to the content of their presentation(s). 


Joint Sponsored Accreditation 

This activity has been planned and implemented in accordance with the 

Essentials and Standards of the Accreditation council for Continuing Medical 

Education (ACCME) through the joint sponsorship of Geisinger Health System 

and _____________________. Geisinger Health System is accredited by the 

Pennsylvania Medical Society to provide continuing medical education for 

physicians. 

Deadlines 

The deadline for Continuing Medical Education activities that follow established 

formats can be considered for credit up to 7-10 business days prior to the 

activity. 

Urgent needs should be discussed with the CME Manager. 

The deadline for consideration of credit for any novel and/or unique activity 

should be received 12-16 weeks prior to the activity for full CME Committee 

approval. 

Proofreading Policy 

It is the policy of the CME Office to have the CME Activity Director for each 

individual activity do the final proofreading of his/her activity. 

The CME Office receives the material from the Activity Director and sets it up to 

be typeset. The print shop then lays out the brochure on a blue-line to be 

proofread. The CME Specialist makes sure everything is there, laid out properly, 

and proofread. The corrections are then made and a second proof is given to 

the CME Manager and also the CME Activity Director who have final say on the 

proof. It is his/her responsibility to make sure that there are no typing errors on 

the brochure. He/she signs the form stating that everything is fine and ready for 

printing. 

Samples of brochures are on file in the CME Office. 


8. Internal and external benchmarks will be used to set honoraria at 

reasonable levels. 

Guidelines For Disposition Of Surplus Continuing Education Funds 


Education, the Manager of Continuing Medical Education and the Continuing 

Medical Education Committee will serve as the approval committee for continuing 

medical education programs sponsored by the Geisinger Health System. They 

will examine proposals for continuing medical education activities for scientific 

merit, organization, audience appeal, projected costs, etc. Based on this 

examination, they shall recommend changes as necessary and render a final 

recommendation of acceptance or rejection. They shall determine the 

attendance fee for these activities based upon projected costs and the prevailing 

rates of continuing education nationally. Surplus funds will be placed in the 

Control Account of the Continuing Medical Education Office and will remain until 

the end of the Fiscal Year (June). Expenditures from the control account are 

restricted to the support of approved continuing medical education activities 

within the following guidelines: 

1. Purchase of audiovisual hardware 

2. Purchase and/or production of learning materials 

3. Purchase and/or production of advertising 

4. Mailing costs 

5. Cost of conference facilities, other than those of the Medical Center 

6. Cost of food and beverages for faculty and/or attendees when 

considered an integral part of the activity 

7. Travel, lodging, and per diem costs incurred by the Geisinger faculty 

for activities held at a distance from their Geisinger site 

8. Travel, lodging, per diem, and honorarium costs for visiting faculty 

participating in these activities 





Miscellaneous 

Facilities 

A majority of the Continuing Medical Education (CME) programming will be held 

on campus in the Hemelright Auditorium and surrounding breakout rooms. 

Occasional meetings will be held at area conference centers. Depending on 

budget and audience appeal, an occasional meeting may be held at a facility 

outside of Pennsylvania. 


Education or the Manager of Continuing Medical Education, following discussions 

with the CME Activity Director, must approve all facility locations. 

All logistic arrangements, room reservations, facility, equipment rentals, etc., are 

the sole responsibilities of the CME Office. 


Faculty Check Sheet 


Budget Check Sheet 


Activity Request Policy 

A standard form is mailed to the GHS staff in February of each year asking them 

if their department would like to schedule a continuing medical education 

program for the coming year. (Sample Attached) 

We then use these forms to set up our calendar for the coming year. 


Activity Request Form 

TO: 

RE: 

Physician and Professional Staff 

Continuing Education Activities 

The time has rolled around already to make the continuing education calendar 

for fiscal year _______. 

We schedule physician conferences on Wednesdays. Activities for other 

professionals are best scheduled on Thursdays or Fridays as the Hemelright 

Auditorium is heavily used on Mondays and Tuesdays. Multidisciplinary activities 

are encouraged when curriculum is appropriate because of their wider base of 

appeal. Attendance might be higher at such activities. 

Please fill out the form below and return it to the CME Office by _____. You will 

be contact to negotiate dates. 

CONTINUING EDUCATION ACTIVITIES FOR ________ 

My department_____________________would like to have a full day_____ or a 

half-day _____ program. If multi-day, please indicate duration and 

dates_______________________________. 

CME Activity Director_____________________________________ 

Preferred month or date___________________________________ 

Title (if known)__________________________________________ 

Preferred location________________________________________ 

Please return to the CME Office at 13-50 by_______________ 


Activity Request Confirmation 

Dear CME Activity Director 

The CME Office has received your request for sponsorship of a continuing 

medical education activity for academic year____to_____. I have booked your 

meeting at the _____________________________on ____________. 

If this is not acceptable, please let me know immediately. 

Before proceeding with further planning, it will be necessary to schedule a brief 

meeting with the CME Manager and the Associate Chief Medical Officer of 

Academic Affairs and Continuing Medical Education to discuss your proposed 

meeting. 

At that time, the following will be reviewed: 

• Planning timetable 

• Prior needs assessment and evaluations to help you design appropriate 

subject matter 

• Budget development 

• Standards regarding disclosures policies, commercial support, faculty 

letters, etc. 

• Responsibilities of Activity Directors and the CME Office 

As we move forward with our organizational strategic plan, programming which 

will have an impact on primary care practice and managed health care will be 

given a high priority. 

I look forward to working with you. 

Sincerely,

Disclosure Policy (Conflict of Interest) - Geisinger Health System

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