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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
2009 Alliance Theme2009 Alliance Theme
ELEVATING THE PROFESSION AND PRACTICE OF CONTINUING MEDICAL
EDUCATION: PROFESSIONAL CHALLENGES IN THE 21ST CENTURY
What challenges?
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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…
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
““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
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Medical Abbreviations and Acronyms: The Good, The Bad, and What The Heck is THAT?????
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
“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…
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Once Upon an Educational Planning Teleconference…
K-Ras H-Ras B-Raf PTEN MSI UGT1A2
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
OMG!!!!!
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
LOLLOL
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Healthcare Professionals and Abbreviations/Acronyms MD DO PA PhD RN/MSN RPh/PharmD Etc., etc., etc.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Healthcare Professionals and Abbreviations/Acronyms FACC (Cardiology) FACP (College of Physicians) FACOG: (Ob/Gyn)
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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”
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Content ReviewContent Review &
Documentation Documentation of Validationof Validation
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Know Know Your Role Your Role
and and ExpertiseExpertise
The Team ApproachThe Team Approach
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
The Team Approach: Internal Collaboration Accreditation Medical Faculty External Reviewers/Peer Reviewers
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Internal Collaboration: How does that work? Who does what? How and where is it documented Who is the lead? Routing sheet for sign-off
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Medical Medical ReviewReview
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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?
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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.
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
AccreditatiAccreditationon
Review Review
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
Accreditation Review
Use of trade names vs. generic Logos and advertisements Color schematics Confirm medical review Use of pharma approved data slides
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
So how do you So how do you document your efforts?document your efforts?
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
The Big The Big “What If?”“What If?”
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
“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.”
©Karen Thomas, Institute for Continuing Healthcare Education, Philadelphia, PA
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
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