Dealing with Controversial Topics in Your CME Program

September 21, 2017
Posted by: 
Patty Harrison

There are many topics in the field of medicine that remain experimental, unproven and/or unconventional. It’s essential that clinicians are informed about the full range of approaches their patients may be using, and that CME is a place where clinicians can learn about and debate controversies.

Equally important, clinicians should be able to trust that accredited CME activities are evidence-based and balanced. As described in the CME Clinical Content Validation Policy, accredited CME providers are responsible for validating clinical content to ensure that education supports safe, effective patient care. This responsibility belongs to the accredited CME provider — whether the activity is directly provided or jointly provided.

To protect the integrity of accredited CME and of the clinician/patient relationship, all patient care recommendations must be based on evidence that is accepted within the profession of medicine and all scientific research used to support patient care recommendations must conform to generally accepted standards of experimental design, data connection, and analysis.

Thus, CME providers need to develop activities that encourage free and rigorous scientific discourse — while ensuring that faculty do not advocate or promote unscientific treatments and that clinical care recommendations are based on established scientific consensus. When a CME activity includes information about an approach to diagnosis or treatment that is not generally accepted, it is allowable to facilitate debate and discussion about the approach, but it is not allowable to advocate for the test or treatment, or teach clinicians how or when to use it.

Several strategies can be utilized to facilitate discussion about controversial topics without promoting unscientific care recommendations in accredited CME activities: 

  • Set firm parameters for faculty: explain that they can facilitate debate and discussion about controversial topics without recommending diagnostic or treatment approaches that have not reached scientific consensus or teaching clinicians how to use or perform those treatments or interpret those tests.
  • Construct the activity as a debate or dialogue. Choose faculty who represent a range of opinions and perspectives; presentations should include a balanced, objective view of research and treatment options.
  • Design the activity to teach about the merits and limitations of a therapeutic or diagnostic approach rather than how to use it.
  • Identify content that has not been accepted as scientifically meritorious by regulatory and other authorities, or when the material has not been included in scientifically accepted guidelines or published in journals with national or international stature.
  • Encourage faculty to clearly describe the level of evidence on which the presentation is based and to provide sufficient information about data (study dates, design, etc.) to enable learners to assess research validity.
  • Clearly communicate the objectives of the activity to faculty and learners. For example, “This activity will teach you about how your patients may be using XX therapy and how to answer their questions. It will not teach you how to administer XX therapy.”

Remember that your status as an accredited provider depends on your compliance with the CME Clinical Content Validation Policy, as well as with the other accreditation requirements.

You will become ineligible for accreditation or reaccreditation if your activities, or the activities or CME programs of your joint providers, promote treatments that are known to have risks or dangers that outweigh the benefits or are known to be ineffective in patient treatment.

Queries or complaints about content validity will be evaluated by qualified expert reviewers, our staff, and when necessary, committees of the ACCME. For more information, please see the Process for Handling Complaints regarding ACCME-Accredited Providers.

We recommend that you periodically review the CME Clinical Content Validation Policy to make sure that your process for planning, delivering, and evaluating activities includes effective strategies for validating clinical content.

If you have questions about your activities, we are happy to help. Contact us at info@accme.org.