CPD Activity Accreditation Standards for the Maintenance of Certification (MOC) Program
Small Group Learning Activities (Section 1)

January 2018 (v.2)

The accreditation of a small group learning activity is accomplished through a self-approval process. Once accredited, MOC Section 1 credits may be claimed for these group learning activities.

Administrative Standards

All accredited small group learning activities must be developed by a planning committee whose responsibilities include the following:

1. The activity must be planned by the members of a cohesive group of health care professionals (12 or less) to discuss issues of common interest (can be outside a hospital setting).
2. The planning committee is responsible to receive any financial and in-kind support for the development of an accredited CPD activity.
3. The members of the small group function as the planning committee.
4. The small group/planning committee must plan and implement educational activities based on the perceived and/or unperceived needs of the group.
5. The planning committee Chair must assume responsibility for maintaining records of attendance for a 5 year period and provide confirmation of attendance to participants.

Educational Standards

All accredited small group learning activities must be developed to meet each of the following educational standards:

1. The series of regularly occurring activities (at least four to six times annually) must be planned and advertised in advance. Once approved, the Royal College accreditation statement must be placed on the promotional material.
2. Learning objectives for small group learning activities should be circulated to the target audience in advance, where appropriate.

   The identified learning needs of the target audience should be utilized in the creation/development of the learning objectives.

   Learning objectives must clearly describe the intent of the educational activity, be written from the perspective of the learner, and express the expected outcomes determined by the planners and faculty. Learning objectives must be incorporated into the evaluation strategy.

   For additional information on writing learning objectives, please click on the following link.

3. A variety of learning formats should be used to support the identified learning objectives.

   A variety of learning formats is encouraged to be be selected that (i) are linked to and support the identified perceived and/or unperceived educational needs and established learning objectives and (ii) address CanMEDS professional roles beyond the Medical Expert role.

4. 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 understand, 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 understand the content.

   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 Section 1 credits for the activity.

5. Participants must be provided with an opportunity to evaluate individual activities and the overall series of activities.

   Accredited small group learning activities must provide participants with an opportunity to evaluate each individual activity and the overall series.

   The evaluation system must:

   • allow participants to identify whether the individual and overall activities learning objectives were met.
   • provide opportunities for participants to identify the potential impact for their practice.
   • ask participants to identify whether the content was balanced and free of commercial or other inappropriate bias.

   Additional evaluation strategies may include intent to measure improved patient performance, intent to measure improved healthcare outcomes, and options for participants to receive feedback related to their learning.

Ethical Standards

Each of the following ethical standards, derived from the CMA Guidelines for Physicians interactions with Industry and the National Standard for the Support of Accredited CPD Activities must be met in order for small group learning activities to be developed and accredited under MOC Section 1.

1. The planning committee must have control over the selection of topics, content and speakers for the activity.

   The process by which the topics, content and speaker(s) are selected for an educational activity must be in the control of the planning committee at all times. Participants or sponsors can suggest faculty or topics; however they cannot direct the selection process. The final decision must reside with the planning committee.

2. The planning committee must assume responsibility for ensuring the scientific validity and objectivity of the content of the activity.

   The balance and scientific integrity of the activity is a joint responsibility between the planning committee and faculty.

   The planning committee may consider data or advice from all sources, but must ensure that decision-making related to the CPD program elements is under the SPC’s exclusive control.

   For CPD activities accredited for Royal College MOC Section 1, representatives of a sponsor or any organization hired by a sponsor may attend planning committee meetings but are not permitted to participate in decisions related to CPD program

3. The planning committee must disclose to participants all financial affiliations of faculty, moderators or members of the planning committee with any for-profit and not-for-profit organizations over the previous 2 years

   The Royal College defines a conflict of interest as a situation(s) that may occur where the personal and professional interests of individuals may have actual, potential or apparent influence over their judgment and actions. There must be policies and procedures in place for the planning committee to manage identified conflicts of interest once they are disclosed.

   All members of the planning committee and Faculty/Speakers must:

   1. Disclose, in writing, a description of all relationships with for-profit and not-for-profit organizations over the previous 2 years. It is the presenter’s responsibility to ensure that their presentation (and any recommendations) are balanced and reflect the current scientific literature.
   2. Unapproved use of products or services must be declared within the presentation. The only caveat to this guideline is where there is only one treatment or management strategy.
   3. All disclosures must be done verbally, displayed in writing on a slide at the beginning of a presentation or included in the written activity materials.

   Examples of relationships that must be disclosed include (but are not limited to):

   1. Any direct financial payments including receipt of honoraria;
   2. Membership on advisory boards or speakers’ bureaus;
   3. Funded grants or clinical trials;
   4. Patents on a drug, product or device; and
   5. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity.

   Any individual who fails to disclose their relationships cannot participate as a member of the SPC, speaker, moderator, facilitator or author of an accredited CPD activity.

4. 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 provide support for an activity in the form of an educational grant payable to the planning committee or “in-kind” support. In-kind support can include (but not limited to) logistical support, goods or services to support the educational activities, learning resources or tools.

   Additional funds management responsibilities of the planning committee include:

   • The planning committee must assume responsibility for the distribution of funds to all faculty or speakers, including the payment of honoraria, travel, accommodations or hospitality.
   • The planning committee can ONLY provide funding to support the travel, lodging, legitimate out of pocket expenses and any honoraria offered to members of the faculty, authors, or members of the planning committee and never for the activity participants and/or their families/guests.
   • The planning committee is accountable to ensure that all hospitality and other in-kind arrangements are modest and paid for directly by the planning committee.
   • Sponsors must be recognized in a location separately from the educational content.
   • Tagging (defined by the Royal College as the linking or alignment or a sponsor’s name to a specific educational session within an accredited group learning activity) is strictly prohibited.
5. No drug or product advertisements may appear on, or with, any of the written or presented materials for the activity.
6. Generic names must be used, or both generic and trade names, oral presentations and written materials.

   It is the responsibility of the planning committee and faculty to ensure that presentations and all related materials be consistent in their use of generic names, or both generic and trade name. Therapeutic recommendations for medications that have not received regulatory approval (“off-label” use of medication) must be declared to the audience.

Additional Resources

Self-approval Process

1. Review the CPD accreditation standards.
2. Complete the Self-Approval Checklist.
3. Chair of the planning committee to complete & sign the Self-Approval Form.
4. Submit the Self-Approval Checklist & the Self-Approval Form to rounds@royalcollege.ca
5. Royal College to confirm accreditation with the planning committee Chair.

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

Accreditation Statement

Once the activity is accredited, certificates of participation and activity promotional materials must include the following statement:

“The [insert exact title of accredited small group activity 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.”

Attendance Records

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

1. Title of the small group (please use exact title as was submitted to the Royal College on the self-approval form)
2. Name of the organizing hospital
3. Name of the Chair of the planning committee of the activity
4. Date range of the activity
5. Location of the activity (live/web-based)
6. Number of hours attended (yearly)
7. Applicable accreditation statement (see Accreditation Statement above)

The Chair is responsible for maintaining attendance records for a 5-year period.

Useful Web Links

• Frequently Asked Questions (FAQ)
• Self-Approval Checklist & Form
• Self-Approval Toolkit (including COI disclosure form, evaluation, certificate of participation, etc.)
• Needs assessments
• Learning objectives
• CMA Guidelines
• National Standard for the Support of Accredited CPD Activities
• Maintenance of Certification (MOC) Program