CPD Activity Accreditation Standards for the Maintenance of Certification (MOC) Program
Self-Assessment Programs (Section 3)

January 2018 (v.3)

In order for an activity to be accredited in the Royal College Maintenance of Certification (MOC) Program, it must be developed or co-developed with a physician organization, planned to meet the following accreditation activity standards, and reviewed by a Royal College accredited CPD provider.

Part A: Administrative Standards

Administrative Standard 1: All accredited self-assessment programs must be developed or co-developed by a physician organization as defined by the Royal College.

A physician organization is a not-for-profit group of health professionals with a formal governance structure, accountable to and serving, among others, its specialist physician members through continuing professional development, provision of health care and/or research.

This definition includes (but is not limited to) the following groups:

  • Faculties of medicine
  • Hospital departments or divisions
  • Medical societies
  • Medical associations
  • Medical academies
  • Physician research organizations
  • Health authorities not linked to government agencies

The physician organization(s) developing or co-developing a CPD activity is responsible to ensure that all accreditation standards are met and to submit the application to an accredited CPD provider.

Note: Accredited CPD providers are permitted to self-approve CPD activities they have developed or-co-developed.

Types of organizations that are not considered physician organizations

  • Pharmaceutical companies or their advisory groups
  • Medical/surgical supply companies
  • Disease-oriented patient advocacy organizations (e.g. Canadian Diabetes Association)
  • Government departments or agencies (e.g. Health Canada, Public Health Agency of Canada)
  • Industry (e.g. pharmaceutical companies, medical device companies, etc.)
  • Medical education or communications (MEC) companies (e.g. CME Inc.)
  • 'For-profit' on-line educators, publishing companies or simulation companies (e.g. Medscape, CAE)
  • Small number of physicians working together to develop educational programming
  • Any other for-profit organizations/ventures

All activities must be developed by a planning committee that is representative of the target audience.

See Part C - Ethical Standards for additional requirements for the planning committee.

Administrative Standard 2: All accredited self-assessment programs must have a self-assessment development or scientific planning committee (SPC) that is representative of the target audience.

All CPD activities must be developed by a scientific planning committee (SPC) that is representative of the target audience. The target audience is defined as the specific group of physicians, specialist or other healthcare professionals CPD activity will be aimed. Therefore the target audience must be determined from the inception of the CPD activity so that the SPC can be chosen accordingly.

There is no minimum or maximum number of members required to sit on the SPC. Best practice would suggest that if the CPD activity is aimed at only one specialty, representatives with other demographic factors should be included on the SPC to allow for more comprehensive representation from within a singular target audience.

The SPC is ultimately responsible for the following program elements:

  • Identification of the educational needs of the target audience
  • Development of educational objectives
  • Selection of educational methods
  • Selection of all individuals (planning committee members, faculty) or organizations in a position to control the development of content
  • Development and delivery of content
  • Evaluation of outcomes

Administrative Standard 3: All accredited self-assessment programs must maintain attendance records and provide participants with a certificate of participation that includes the appropriate accreditation statement(s).

A certificate of participation or written confirmation signed by the chair of the planning committee must be issued to participants for all accredited self-assessment programs. The certificate must specify the following elements:

  1. The title of the activity.
  2. The name of the physician organization (and co-developer if applicable) responsible for the activity.
  3. The date(s) the activity took place.
  4. The location of the activity (i.e. city, country, web-based).
  5. The total number of hours for which the activity is accredited.
  6. The number of hours the registrant attended the activity (or a blank space for the registrant to complete themselves).
  7. All applicable accreditation statements (include co-development statement when necessary).

The physician organization is responsible for maintaining attendance records for a 5 year period.

Part B: Educational Standards

Educational Standard 1: The self-assessment program must be planned to address the identified needs of the target audience with a specific subject area, topic or problem.

Self-Assessment Programs must be based on a needs assessment of the target audience that must be performed to identify areas of knowledge, skills, performance and/or health outcomes that the CPD activity intends to address or improve. The needs assessments can identify either perceived or unperceived needs and should be used to inform:

  • the development of learning objectives
  • the identification of appropriate educational or delivery methods
  • the selection of relevant educational content
  • the development of evaluation strategies.

Educational Standard 2: Learning objectives that address the identified needs of the target audience must be created for the overall program and each individual module (if applicable). Learning objectives must be printed on the program, brochure and/or handout materials.

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 Scientific Planning Committee and faculty.

Learning objectives must be made available to participants prior to the activity and must be incorporated into the evaluation strategy (See Educational Standard 6). The planning committee must ensure that the selected educational methods and delivery are consistent with the identified need(s) and stated learning objectives as well.

Educational Standard 3: Self-assessment programs must describe the methods that enable participants to demonstrate or apply knowledge, skills, clinical judgment and/or attitudes.

Self-assessment programs must provide participants with a strategy to assess their knowledge, skills, clinical judgment and/or attitudes in comparison to an established scientific evidence base (clinical practice guidelines, meta-analysis or systematic review, etc.).

All self-assessment programs must use methods that enable participants to demonstrate these abilities across the key areas of the subject area, topic or problem(s). The selected format must also enable participants to review their current knowledge or skills in relation to current scientific evidence.

Educational standard 4: All accredited self-assessment programs must provide participants with a process to record their answers to the assessment questions.

Recording answers to each assessment question will enable the self-assessment program to provide participants with a summary of their responses to each question.

Educational Standard 5: The self-assessment program must provide detailed feedback to participants on their performance to enable the identification of any areas requiring improvement through the development of a future learning plan.

Providing specific feedback on which answers were correct and incorrect with references enables specialists to determine if there are important aspects of their knowledge, skills, clinical judgment or attitudes that need to be addressed through engaging in further learning activities.

You may also wish to include a reflective tool that provides participants with an opportunity to document:

  • Knowledge or skills that are up-to-date or consistent with current evidence
  • Any deficiencies or opportunities they identified for further learning
  • What learning strategies will be pursued to address these deficiencies; and
  • An action plan or commitment to change to address any anticipated barriers

Educational Standard 6: The self-assessment program must provide participants with an opportunity to evaluate the overall program and each individual module (if applicable).

Accredited self-assessment programs must provide participants with an opportunity to evaluate each individual module(s), if applicable, and the overall CPD activity. The evaluation system must:

  • Allow participants to identify whether the individual session and overall CPD activity learning objectives were met;
  • Ask participants to identify whether the content was balanced and free of commercial or other inappropriate bias;
  • Provide opportunities for participants to identify the potential impact of the CPD activity for their practice.

Additional evaluation strategies may include:

  • An intent to measure improved patient performance
  • An intent to measure improved health care outcomes
  • An option for participants to receive feedback related to their learning

Part C: Ethical standards

Note: All activities accredited after January 1, 2018 must comply with the National Standard for support of accredited CPD activities. The Standard applies to all situations where financial and in-kind support is accepted to contribute to the development, delivery and/or evaluation of accredited CPD activities.

Element 1: Independence

This section describes the membership, roles, responsibilities and decision authority of a scientific planning committee.

  1. 1 Every accredited CPD activity must have an SPC that includes representatives of the intended target audience. The SPC is the group responsible for all decisions noted throughout the Standard.
  1. 2 The SPC may consider data or advice from all sources, but must ensure that decision-making related to the following CPD program elements is under its exclusive control:
    1. Identification of the educational needs of the intended target audience;
    2. Development of learning objectives;
    3. Selection of educational methods;
    4. Selection of speakers, moderators, facilitators and authors;
    5. Development and delivery of content; and
    6. Evaluation of outcomes.
  1. 3 Representatives of a sponsor or any organization hired by a sponsor cannot participate in decisions related to CPD program elements a) through f) within 1.2.

Element 2: Content Development

This section describes the processes and requirements for members of the SPC and speakers to develop content that is responsive to the needs of the intended target audience.

  1. 1 The SPC must have mechanisms in place to support the development of content and/or materials that address the identified educational needs of the intended target audience. Specific interests of any sponsor must have no direct or indirect influence on the content and/or materials of an accredited CPD activity.
  1. 2 A process must be in place to ensure that those responsible for developing or delivering content are informed about:
    • the identified needs of the target audience,
    • the need to ensure that the content and/or materials presented provide (where applicable) a balanced view across all relevant options related to the content area,
    • the intended learning objectives for the activity,
    • ensuring that the description of therapeutic options utilize generic names (or both generic and trade names) and not reflect exclusivity and branding.
  1. 3 The SPC must have a process to collect from participants their assessment of the degree to which the accredited CPD activity:
    • met the stated learning objectives,
    • achieved appropriate balance,
    • was perceived to be biased.
  1. 4 The SPC must have a process in place to deal with instances where CPD activities are not in compliance with the Standard.

Element 3: Conflict of interest

This section describes the processes and requirements for gathering, managing and disclosing conflicts of interest to participants.

  1. 1 All members of the scientific planning committee (SPC), speakers, moderators, facilitators and authors must provide to the SPC a written description of all relationships with for-profit and not-for-profit organizations over the previous 2 years including (but not necessarily 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.
  1. 2 The SPC is responsible to review all disclosed financial relationships of speakers, moderators, facilitators and authors in advance of the CPD activity to determine whether action is required to manage potential or real conflicts of interest. The SPC must also have procedures in place to be followed if a conflict of interest comes to its attention prior to or during the CPD activity.
  1. 3 All members of the SPC, speakers, moderators, facilitators, and authors, must disclose to participants their relationships as described in 3.1
  1. 4 Any individual who fails to disclose their relationships as described in 3.1 and 3.3 cannot participate as a member of the SPC, speaker, moderator, facilitator or author of an accredited CPD activity.

Element 4: Receiving Financial and in-kind Support

This section provides a description of the requirements for the scientific planning committee (SPC) in receiving and distributing financial and in-kind support.

  1. 1 The SPC is responsible to receive any financial and in-kind support for the development of an accredited CPD activity.
  1. 2 The SPC cannot be required to accept advice from a sponsor as a condition of receiving financial and in-kind support. Specific interests of any sponsor must have no direct or indirect influence on any aspect of the development, delivery or evaluation of an accredited CPD activity.
  1. 3 The terms, conditions and purposes by which sponsorship is provided must be documented in a written agreement signed by the SPC and the sponsor.
  1. 4 The SPC can assume or delegate to a third party the payment of travel, lodging, legitimate out of pocket expenses and any honoraria offered to members of the SPC, speakers, moderators, facilitators and/or authors. The SPC must approve what payments are delegated and retain overall accountability for these payments.
  1. 5 Participants (who are not members of the SPC, speakers, moderators, facilitators and/or authors) cannot accept payment or subsidies for their travel, lodging or other out of pocket expenses to participate in an accredited CPD activity. This provision does not preclude participants’ claiming and receiving compensation from residency programs, employers or provincial CPD support funds, even when activities they attend have received support from these sources.
  1. 6 The travel, lodging or other out of pocket expenses of spouses, partners or other family members of: the SPC, speakers, moderators, facilitators, authors or participants cannot be paid for or subsidized by the CPD provider organization, sponsor or any organization hired by a sponsor.
  1. 7 Social activities associated with CPD activities cannot occur at a time or location that interferes/competes with or takes precedence over accredited CPD activities.
  1. 8 Upon request, the SPC must disclose how the financial and in-kind support was used for the accredited CPD activity.
  1. 9 The SPC has an obligation to ensure that their interactions with sponsors meet professional and legal standards including the protection of privacy, confidentiality, copyright and contractual law regulations.

Element 5: Recognizing Financial and in-kind Support

This section provides a description of the requirements for the SPC in recognizing financial and in-kind support received from sponsors.

  1. 1 The SPC must recognize and disclose to participants all financial and in-kind support received from sponsors of CPD activities as part of a sponsorship acknowledgement page separate from the educational content.
  1. 2 Beyond the standard acknowledgement statement of financial and in-kind support outlined in 5.1, the linking or alignment of a sponsor’s name (or other branding strategies) to a specific educational session or section of an educational program within an accredited CPD learning activity is prohibited.

Element 6: Managing Commercial Promotion

This section defines the requirements related to exhibits and the types of materials that can and cannot be displayed.

Element 6: Managing Commercial Promotion

This section defines the requirements related to exhibits and the types of materials that can and cannot be displayed.

  1. 1 Product-specific advertising, promotional materials or branding strategies cannot be included on, appear within, or be adjacent to:
    • any educational materials, slides, abstracts and handouts used as part of an accredited CPD activity;
    • activity agendas, programs or calendars of events (preliminary and final);
    • any webpages or electronic media containing educational material.
  1. 2 Product-specific advertising, promotional materials or branding strategies cannot be included on/appear within locations where accredited CPD sessions are occurring (e.g. lecture halls, small group discussion rooms) immediately before, during or immediately after an accredited CPD activity.
  1. 3 Commercial exhibits or advertisements must be arranged in a location that is clearly and completely separated from the accredited CPD activity.
  1. 4 The SPC cannot be required by an exhibitor or advertiser to accept advice concerning the CPD activity development, delivery or evaluation as a condition of their exhibit or advertisement. Specific interests of any exhibitor or advertiser must have no direct or indirect influence on any aspect of the CPD activity development, delivery or evaluation.
  1. 5 Any incentive provided to participants associated with an accredited CPD activity must be approved by the SPC.

Element 7: Unaccredited CPD Activities

This section defines the roles and responsibilities of the SPC in relation to unaccredited CPD activities.

  1. 1 The SPC cannot schedule unaccredited CPD activities to take place at times and locations that interfere or compete with accredited CPD activities.
  1. 2 Unaccredited CPD activities cannot be listed or included within activity agendas, programs or calendars of events (preliminary and final).

Additional Resources

Accreditation Process

  1. Review the CPD accreditation standards.
  2. Contact a Royal College accredited CPD provider to obtain the appropriate forms, policies and procedures or applicable fees for having the program reviewed and accredited (See Directory of Accredited CPD Providers below under Useful Web Links).
  3. Once the activity is accredited, certificates of participation and activity promotional materials can be updated to include the applicable accreditation statement.

Web links