Medical Terminology 101: Enhancing the Content Review Process Alliance for CME 2009 Annual Meeting...

Medical Terminology 101: Enhancing the Content

Review Process

Alliance for CME 2009 Annual MeetingJanuary 30, 2009

©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA

DisclosureDisclosureKaren J. Thomas, BSBA, CCMEPKaren J. Thomas, BSBA, CCMEPAccreditation and Compliance Specialist

Elizabeth Paczolt, MD, FACNPElizabeth Paczolt, MD, FACNPChief Medical Officer

Institute for Continuing Healthcare Education601 Walnut Street, Suite 275-WPhiladelphia, PA

Disclosure: Neither presenter has an interest in selling a technology, program, product, and/or service to CME professionals.


2009 Alliance Theme2009 Alliance Theme

ELEVATING THE PROFESSION AND PRACTICE OF CONTINUING MEDICAL

EDUCATION: PROFESSIONAL CHALLENGES IN THE 21ST CENTURY

What challenges?


Ok…The Challenges Spelled OutWho: YOUWhat: How are educational activities developedWhy: Is the focus where it should be? Are we doing it right?Where: Every aspect of education developmentWhen: They are here and they now!

Ohhhh…these Ohhhh…these challenges…challenges…


Content Validation Content Validation Process: Competency Area Process: Competency Area 77COMPETENCYAREA 7: COMPETENCYAREA 7:

ADMINISTRATION MANAGMENTADMINISTRATION MANAGMENTCOMPETENCY 7.5: Develop a management

culture of the office that will reflect a collaborative, service oriented, continuous improvement system that meets the needs of the physicians served, the organization of the CME program and the accreditation standards.


Learning ObjectivesLearning ObjectivesAt the completion of this session,

participants should be able to: 1) identify updated medical terminology and

recognize appropriate and error-prone abbreviations to improve content reviews;

2) establish or assess content review process with the goal of performing better content evaluation reviews, and

3) demonstrate confidence when reviewing medical education content and interacting with faculty members.


““Content” Content” Main focus of activity Essence of education Initial step in behavior modification “How to steps” that will guide performance

change Helps inform physician learners on how to

improve patient outcomes Impacts “invisible learners” Represents your level of expertise in

providing important and correct medical education


Content Validation Content Validation Process Process Confirms main focus of activity Ensures that information matches the

established educational objectives Confirms content is based on scientific

evidence Ensures scientific data is stated correctly and

matches original referenced resources and clinical data

Ensures fair balance of presented information Ensures guideline basics are followed Represents your level of expertise in providing

important and correct medical education


Medical Abbreviations and Acronyms: The Good, The Bad, and What The Heck is THAT?????


“Seeing as how the V.P. is such a V.I.P. shouldn't we keep the P.C. on the Q.T. 'cause if it leaks to the V.C. he could become a M.I.A. and then we'd all be put out on K.P.”

Robin Williams as Adrian Cronauer, “Good Morning, Vietnam”

The Wonderful World of Acronyms…


Once Upon an Educational Planning Teleconference…

K-Ras H-Ras B-Raf PTEN MSI UGT1A2


OMG!!!!!


LOLLOL


Healthcare Professionals and Abbreviations/Acronyms MD DO PA PhD RN/MSN RPh/PharmD Etc., etc., etc.


Healthcare Professionals and Abbreviations/Acronyms FACC (Cardiology) FACP (College of Physicians) FACOG: (Ob/Gyn)


Healthcare Professionals and Abbreviations/Acronyms ASH: American Society of

Hematology ASH: American Society of

Hypertension ACR: American College of

Rheumatology ACR: American College of Radiology


Abbreviations and Acronyms: Why are they Used? Use has benefits for healthcare

practitioners (HCPs) Short, space-saving Convenient to use Simple, hard to misspell

Kuhn IF. Abbreviations and acronyms in healthcare: when shorter isn’t sweeter. Available at http://www.medscape.com/viewarticle/566966_1 Accessed January 25, 2009.


Abbreviations and Acronyms as a Patient Safety Issue Medical abbreviations responsible for

serious errors, even patient deaths Over 7,000 deaths per year attributed to

medication errors Use of abbreviations/acronyms contribute to

these statistics



Abbreviations and Acronyms as a Patient Safety Issue Common problems

Ambiguity – acronym standing for more than one word

Unfamiliar abbreviations – specialized nature of individualized services/disciplines

Look-alike abbreviations – involving both numbers and letters



Institute for Safe Medication Practices (ISMP): List of Error-Prone Abbreviations Reported to ISMP through an error-reporting program Should NEVER be used when communicating medical

information: Internal communications Prescriptions Medical records

Why use them in education????

Institute for Safe Medicine Practices. ISMP’s list of error-prone abbreviations, symbols, and dose designations. Available at: http://www.ismp.org/Tools/errorproneabbreviations.pdf Accessed January 25, 2009.


The “Do-Not-Use” List

Established by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Certain abbreviations/acronyms must appear on an accredited organization’s do-not-use list

ISMP encourages not using others beyond the JCAHO list



The “Do-Not-Use” List IU (international unit)

Mistaken for IV (intravenous) or 10 Use “units” instead

QOD (every other day) Mistaken for QID (four times daily) or QD (daily) Use “every other day”



Content ReviewContent Review &

Documentation Documentation of Validationof Validation


Know Know Your Role Your Role

and and ExpertiseExpertise

The Team ApproachThe Team Approach


The Team Approach: Internal Collaboration Accreditation Medical Faculty External Reviewers/Peer Reviewers


Internal Collaboration: How does that work? Who does what? How and where is it documented Who is the lead? Routing sheet for sign-off


Medical Medical ReviewReview


Content Review: Accuracy, Fair Balance, and Appropriateness The Overriding Issue: How will you insure

that content is evidence-based, accurate, balanced, and presented in an appropriate manner to the target audience?


Content Review: Accuracy, Fair Balance, and Appropriateness Content validation

Get the references!!! Review each statement/slide/portion of content against the

reference Work with faculty if you cannot locate the evidence When a clinical study is cited, it is best to check the actual study


Content Review: Accuracy, Fair Balance, and Appropriateness Hierarchy of evidence

Randomized, controlled trials Systematic review of randomized trials Systematic review of observational studies Unsystematic clinical observations (ie: case reports)

Opinion is not necessarily evidence!

Guyatt G, et al. In: Guyatt G, Drummond R, Eds. User’s Guide to the Medical Literature.: Essentials of Evidence-Based Clinical Practice. AMA Press; Chicago, IL. 2002:5-20.


Content Review: Accuracy, Fair Balance, and Appropriateness Work in partnership whenever possible

Collaboration between medical and accreditation Collaboration between members of the CME committee Collaboration between healthcare practitioners, medical staff

When internal collaboration is not possible, outside sources may need to be found/used


Content Review: Accuracy, Fair Balance, and Appropriateness Be careful with graphics, acronyms, numbers

Make sure recreated graphics match the original Make sure abbreviations are appropriate for the material Make sure that numbers match the evidence

Be careful with citations Make sure the citation matches the statement Don’t forget about permissions when using quotes and exact graphics


Content Review: Accuracy, Fair Balance, and Appropriateness The importance of an “extra set of eyes”

Get another colleague to review what you have reviewed if possible

An extra set of eyes can catch mistakes both large and small

Never, never, never be your sole proofreader, lest you make an “involuntary” error


AccreditatiAccreditationon

Review Review


Accreditation Review

Use of trade names vs. generic Logos and advertisements Color schematics Confirm medical review Use of pharma approved data slides


So how do you So how do you document your efforts?document your efforts?


The Big The Big “What If?”“What If?”


“What If?”The big conference is finally here and boy are you glad

it is almost over!!! As you sit-in on the 2pm session sipping your favorite beverage you get the following text:

“OMG, urgt…7am spk slides…content errors…fly, don’t run to office 101… PO people waiting for YOU.”


The Big “What If?” What if, despite your best efforts, a mistake is found

after the presentation…

Consult your medical team and activity planning faculty

Correct the mistake quickly and accurately Check content validation notes to decipher error Publish the correction Notify faculty/speaker Notify to participants (will depend on format) Notify supporter (s) If enduring activity

Pull activity Review for medical accuracy Forward for peer review

Document all steps taken

Medical Terminology 101: Enhancing the Content Review Process Alliance for CME 2009 Annual Meeting...

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