Frequently asked questions about rounds, journal clubs and small groups

General

What are the steps for self-approval of rounds, journal clubs and small groups?

Step 1: Review the CPD accreditation standards for: rounds, journal clubs or small groups.
(The CPD accreditation standards for rounds, journal clubs and small groups must be met to be considered accredited under Section 1 of the Royal College Maintenance of Certification (MOC) Program.)

Step 2: Complete the self-approval checklist and the self-approval form for rounds, journal clubs or small groups.

Step 3: Have the chair of the planning committee complete and sign the self-approval form.

Step 4: Submit both the self-approval checklist and the self-approval form to rounds@royalcollege.ca.

Step 5: Await confirmation of accreditation from the Royal College (confirmation is with the planning committee chair).

Please retain a copy of the completed Self-Approval documentation and confirmation email for your records.

When do I submit a self-approval form? / Do I have to re-accredit my activity each year?

A self-approval form must be completed and submitted to the Royal College:

When you wish to have a new rounds program, journal club or small group accredited or
When the Chair of a planning committee, contact information or activity title changes

Once the rounds, journal club or small group has been accredited, the accreditation does not expire and you do not have to re-accredit the program each year. This is pending review and may change in the future.

Can a rounds, journal club or small group activity be accredited retroactively?

No. Self-approved group learning activities are accredited effective the date on the signed self-approval form once it has been submitted to the Royal College. These activities cannot be retroactively accredited.

If our department has accredited one series of rounds, does that mean that all rounds in our department are accredited?

No. Each individual series must be accredited and registered with the Royal College separately.

Do I need to apply to an accredited CPD provider to have my rounds, journal club or small group accredited?

No. See Question 1) “steps to self-approval” above.

For conferences, self-assessment programs, and simulation-based activities, you will need to apply to an accredited CPD provider for accreditation.

How many credits can participants claim for attending accredited rounds, journal clubs and small group learning activities?

Under section 1 of the Royal College MOC Program, participants may claim one credit per hour for attending an accredited rounds, journal club and small group learning activity.

How many credits can speakers/faculty claim?

While the MOC Program does not provide credits for teaching or giving a presentation, speakers/faculty may record the new learning acquired while preparing or researching for your teaching sessions or presentations under Section 2 as a personal learning project (PLP). They cannot claim credit under Section 1 as they are presenting at and not attending the activity.

Can working or clinical rounds be self-approved for MOC Section 1 credits?

No. Typically, “working” or “clinical” rounds are not formal CPD activities rather, they are bedside visits by a physician—or other health professional—to evaluate treatment, assess current course and document the patient’s progress or recuperation. In order for rounds, journal clubs or small group learning activities to be self-approved for MOC Section 1 credits, they must meet the accreditation standards as defined by the Royal College. These standards include the establishment of a planning committee, the development of learning objectives based on a needs assessment conducted for the target audience, adherence to established ethical standards and the execution of an evaluation strategy of the rounds program.

Can morbidity & mortality (M&M) rounds be accredited for MOC Section 3 credits?

No. Morbidity & mortality (M&M) rounds cannot be accredited for MOC Section 3 credits because they typically review one patient/physician at a time. This is not considered feedback on performance in practice. A formal audit and feedback on a minimum of 10 patients is needed to be representative of one’s performance in practice.

Administrative Standards

Who should be on the planning committee? / Can a planning committee consist of one individual?

The planning committee must be representative of the target audience. Whether or not one individual can represent the needs of the entire target audience is a matter of judgment.It is preferable that the planning committee consist of more than one individual.

In the case of small group learning activities, the small group essentially forms the planning committee.

Who is the planning committee accountable to?

For rounds, journal clubs, and hospital-based activities, the planning committee must also be accountable to the head of the department, chief of staff or equivalent.

What are the responsibilities of the planning committee?

The planning committee is responsible for:

Identifying learning needs (perceived and unperceived) or the target audience
Planning and implementing educational activities based on these learning needs
Maintaining records of attendance
Issuing certificates of attendance to all participants
Choosing learning formats based on suitability to meet identified learning objectives
Controlling the process by which the topics, content and speaker(s) are selected
Conducting evaluations for individual sessions and the overall series
Establishing a process to manage disclosed conflicts of interest
Ensuring that presentations and all related materials be consistent in their use of either generic names or both generic and trade names
Ensuring that funds received are in the form of an educational grant payable to the planning committee

How can the planning committee assess perceived and unperceived needs?

Identifying the learning needs of the target audience will help inform the development of learning objectives and learning formats.

You can assess the perceived needs of the target audience through:

Input from planning committee members
Surveys
Questionnaires
Focus groups
Requests from the target audience

You can assess the unperceived needs of the target audience through:

Self-assessment tests
Chart audits
Chart stimulated recall interviews
Direct observation of practice performance
Quality assurance data from hospitals, regions
Standardized patients
Provincial databases
Incident reports
Published research and literature reviews

Access additional information on conducting needs assessments.

How long is the planning committee required to retain attendance records?

The Chair of the planning committee is required to retain attendance records for a 5-year period. This requirement is in place to ensure that Fellows and other MOC Program participants are able to confirm their participation in accredited group learning activities for the duration of their MOC cycle.

Does the Chair of the planning committee have to provide a certificate of attendance after each session?

No. Certificates of participation must be provided at least annually (usually at the end of each calendar year so that participants may record their credits before the January 31 reporting deadline). Organizers may choose to provide participants with a certificate after each session but this is not a requirement of the Royal College.

What information should be included on the certificate of attendance?

All participants must be provided a certificate/letter of participation which includes the following elements:

Title of the rounds, journal club or small group (please use exact title as was submitted to the Royal College on the self-approval form)
Name of the organizing hospital
Name of the Chair of the planning committee of the activity
Date range of the activity
Location of the activity (live/web-based)
Number of hours attended (yearly)
Applicable accreditation statement (see Accreditation Statement below)

What is the accreditation statement for rounds, journal clubs and small group learning?

The Accreditation Statement:

The [insert exact title of rounds, journal club or small group as indicated on self-approval form] is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada.

Where should the accreditation statement be communicated?

The accreditation statement should be placed on promotional materials, such as programs, brochures, emails, invitations, etc. The statement should also be placed on the certificate of attendance.

Educational Standards

How often must accredited rounds, journal clubs and small group learning sessions be held?

Accredited rounds, journal clubs and small group learning sessions must be held at least four to six times per year.

How should learning objectives be formulated?

Learning objectives must be linked to perceived and unperceived needs of the target audience. Learning objectives must describe the specific knowledge, behaviour, skill, attitude or learning outcomes that participants can anticipate from attending educational events.

Learning objectives for rounds, journal clubs and other hospital-based educational activities should be circulated to the target audience in advance (for example through the letter of invitation, the program, etc.).

Additional information on writing learning objectives

What types of learning formats should be incorporated in accredited rounds, journal clubs and small group learning sessions?

A variety of learning formats should be used to support the identified learning objectives. The planning committee must ensure that appropriate instructional methods are linked to the identified learning objectives for each of the educational events. For example, some topics are best suited to lectures, debates or panel discussions whereas others might be better suited to simulations.

Irrespective of the learning format(s) chosen, a certain portion of the activity must be interactive.

Additional information on Learning Formats and Techniques

Can learners who participate at a distance record MOC Section 1 credits?

Yes. As long as accreditation standards are met, MOC Section 1 credits can be claimed. For those participating in group learning activities online and/or remotely, there must be a system that allows participants to track their attendance, interact with the group, participate in discussions, and provide evaluation feedback in order for them to be able to record MOC credits for the activity.

An accredited activity is recorded and posted online for participants to view at a later date. There are no functions for group discussion, evaluation or attendance tracking. Can the individuals who view these online recordings earn MOC Section 1 credits?

No. This must be recorded under MOC Section 2: Self-Learning. In order for learners to record MOC Section 1 credits, the rounds program must meet the Royal College accreditation standards (which include group interaction, tracking of attendance and post-session evaluation).

How much time do accredited rounds, journal clubs and small group learning activities need to devote to interactive learning?

At least 25 per cent of the total education time must be allocated for interactive learning. Promoting interactive learning through (for example) question and answer periods, case discussions, skills training, etc. helps participants to translate and apply content to their specific practice contexts. Interaction builds a relationship between (and among) participants and the faculty, contributes to a supportive learning atmosphere and enables speakers to determine the degree to which participants receive the content.

How should activities be evaluated?

The planning committee must ensure that the individual sessions and the overall series are evaluated by participants. The degree to which the learning objectives are met, whether participants perceived any bias and whether adequate time for the interactive learning was provided must be evaluated. Evaluations can be done on paper or electronically.

How long must the planning committee retain evaluation results?

There is no Royal College accreditation policy for the retention of evaluation forms. Our recommendation is the planning committee retain a summary of the evaluation forms (which must be provided to each faculty member) for a period of time that will allow the planning committee to reflect on the evaluation results to inform program change, needs assessment data, overall CPD program evaluation, etc.

Ethical Standards

Can a sponsor suggest faculty or topics for accredited rounds, journal clubs or small group learning?

Yes. A sponsor can suggest faculty or a topic, however they cannot direct the selection process. The planning committee must retain control over selection of the topics, content and speakers at all times. The final decision must reside with the planning committee.

Can participants suggest faculty or topics for accredited rounds, journal clubs or small group learning?

Yes. Participants can suggest faculty or a topic, however they cannot direct the selection process, the planning committee must retain control over selection of the topics, content and speakers at all times. The final decision must reside with the planning committee.

Does the planning committee need to review content from each presentation?

No. But they may choose to review the content for the following reasons:

To ensure objectivity and validity of content
As part of their conflict of interest management process
To ensure learning objectives are met

Can the planning committee pay honoraria to faculty or cover expenses such as travel, food or accommodations? Is there a limit on how much this honoraria paid to faculty can be?

Yes. The planning committee may provide honoraria or pay expenses of faculty. The Royal College does not set a maximum dollar value for out of pocket honoraria. Sponsors may not pay faculty honoraria nor pay expenses directly.

Is sponsorship of rounds, journal clubs and small group learning permitted?

Yes. However all funds received in support of the activity must be provided in the form of an educational grant payable to the planning committee.

Sponsors may be acknowledged on the general sponsorship page in the syllabus or program of the activity. The sponsorship page(s) should be located on a page separate from the educational content/program.

Can drug or product advertisements be provided to participants of an accredited round, journal club or small group learning session?

No. Drug or product advertisements may not appear on, or with, any of the written or presented materials for the activity.

Can faculty mention trade names of drugs or devices during a presentation?

Trade names of drugs or devices can be used during an accredited activity only if the generic name is also used.

It is the responsibility of the planning committee and faculty/speakers to ensure that presentations and all related materials be consistent in their use of either generic names, or, both generic and trade names.

Are industry representatives permitted to attend MOC-accredited small group learning activities?

Yes. If the following conditions are met:

They must be non-contributing members of the discussion, acting as observers, or providing logistical support such as facilitating registration, audiovisual setup, seating, and distribution of certificates of attendance.
Only with the consent of the chair.
Only if seating remains, preferably at the back of the room.
They must wear no commercial identifiers (i.e. corporate logos).

Who needs to sign a conflict of interest declaration form?

All committee members and faculty (presenters) must complete a conflict of interest declaration form, irrespective of whether or not there is a conflict. See online toolkit for sample form. These forms are submitted to the planning committee.

It is important that the audience be made aware of any potential conflicts of interest held by anyone with responsibility for the planning or content of an activity. Faculty are also expected to include a slide at the beginning of their presentation informing the audience of any declared conflicts of interest. Declared conflicts of interest from all planning committee members, session chairs, moderators and/or facilitators should be communicated to participants in some way (for example, printed in the final program).

What are some strategies to manage identified conflicts of interest?

When a conflict of interest is declared, the planning committee must have a process in place to manage disclosed conflicts of interest.

There are a number of strategies that can be considered to manage and resolve such identified conflicts:

The speaker could be required to alter the focus of the talk to limit the areas where conflict of interest is significant.
The topic selected could be changed, but the same speaker be used.
The planning committee could ask for a peer review of the content to ensure that the principles of scientific integrity, objectivity and balance have been respected.
Eliminating the topic and speaker. This is a very uncommon occurrence, but can be used as a last resort if a significant conflict of interest cannot be otherwise managed.

Can a sponsor directly provide food and beverages to participants in an accredited rounds, journal club or small group activity?

No. All funds or “in-kind” support received in support of the activity must be provided in the form of an educational grant payable to the scientific planning committee. The scientific planning committee must assume responsibility for the distribution of educational grants and is accountable to ensure that all hospitality and other in-kind arrangements are modest and paid for directly by the scientific planning committee.

Can Royal College-accredited rounds, journal clubs or small groups receive sponsorship from only one sponsor?

Yes, this is ethically permissible as long as sponsorship is acknowledged separate from the educational content and not linked to a specific educational session within an accredited group learning activity. Additionally, funds received in support of the activity must be provided in the form of an educational grant payable to the scientific planning committee.

How can sponsors of accredited rounds, journal clubs or small groups be acknowledged for their support?

Sponsors providing an educational grant for a CPD activity approved for MOC credits may be acknowledged on the general sponsorship page in the syllabus or program of the activity. Sponsorship acknowledgements should be located on a page separate from the educational content (for example, on the back page of the program). Note that “tagging” is prohibited.

What is “tagging”?

Tagging is defined as the linking or alignment of a sponsor’s name to a specific educational session within an accredited group learning activity.

Does the tagging policy only apply to a pharmaceutical or medical device companies?

The application of the tagging policy is not restricted to members of the pharmaceutical/medical device industry and is applicable to any sponsor, including not-for-profit organizations. A “sponsor” is an individual, group, corporation or organization who contributes funds, goods or services to support accredited educational activities, learning resources or tools.