Forms and Policies
The forms and policies below provide step-by-step instructions, policies, definitions, and required documentation needed when developing an Indiana University School of Medicine (IUSM), Division of Continuing Medical Education (CME) accredited activity. For more information or questions, please contact us.
The Application and Planning Worksheet is the primary starting point for planning an accredited activity. To get started, the planner must establish a planning team based on the “question in practice” (area of focus or concern) to address. With that in mind, the planning worksheet asks planners to think through and complete these steps:
- Identify practice gaps.
- Provide needs assessment data.
- Write objectives and expected results.
- Identify your target audience.
- Suggest an appropriate educational format(s).
- List desirable learner attributes/core competencies that will be addressed.
- Identify potential or known barriers to learning.
- Determine how the activity will be evaluated against the objectives.
- Identify potential partners and allies.
To complete the online form, click CME Application and Planning Worksheet and login into the portal. Select “NEW APPLICATION” in the blue box to start 30-90 prior to the activity date.
A standard evaluation questionnaire used to illicit basic information following an activity. This is the minimum required. Methods of evaluation are determined by the objectives and desired results. To download the template, click Evaluation Basic Form.
If a client revokes or withdraws interest in accreditation of an approved activity less than 30 days of the scheduled activity date, a cancellation fee may be charged to the client and/or department. The cancellation fee amount is based on 50 percent of the base accreditation fee quoted on the original cost estimate. Cancellations should be made via email or phone to the IUSM CME office.
Commercial Promotion is the product-promotion material or product-specific advertisement at a accredited activity by a ACCME defined Commercial Interest. The juxtaposition of editorial and advertising material on the same products or subjects must be avoided. Live (staffed exhibits, presentations) or enduring (printed or electronic advertisements) promotional activities must be kept separate from CME and follow the provisions contained in the following documents and forms:
IUSM CME Commercial Exhibitor Agreement
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Commercial Support is financial, or in-kind, contributions given by a commercial interest which is used to pay all or part of the costs of a CME activity. When there is commercial support there must be a written agreement that is signed by the commercial interest and the accredited provider, Indiana University prior to the activity taking place.
To download the template, click Commercial Support Letter of Agreement Form.
The content or format of a CME activity or its related materials must promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. Presentations must give a balanced view of therapeutic options. Use of generic names will contribute to this impartiality. If the educational material or content includes trade names, where available trade names from several companies should be used, not just trade names from a single company.
A directly provided activity is one that is planned, implemented and evaluated by the accredited provider, Indiana University. Include co-provided activities (provided by two accredited providers) in this category if you are the accredited provider awarding the credit. In contrast, a jointly provided activity is one that is planned, implemented and evaluated by the accredited provider and a non-accredited entity.
For each presenter, author or educational partner who is in a position to control content, a Disclosure of Relevant Financial Relationships form must be submitted.
Indiana University School of Medicine (IUSM) policy ensures that those who have influenced the content of a CE activity (e.g. planners, faculty, authors, reviewers and others) disclose all relevant financial relationships with commercial entities so that IUSM may identify and resolve any conflicts of interest prior to the activity. All educational programs sponsored by Indiana University School of Medicine must demonstrate balance, independence, objectivity, and scientific rigor. *Indiana University School of Medicine (IUSM) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
To complete the online form, click Disclosure of Relevant Financial Relationships Form and login to the portal. Those who fail to complete the form in advance are not eligible to be involved in the activity.
IUSM CME is required to identify and resolve conflicts of interest for all individuals responsible for development, management, presentation and /or evaluation relevant to an accredited activity. Disclosed information is reviewed in advance of the activity in order to manage and resolve any possible conflicts of interest. Specific disclosure information will be shared with the audience prior to the session.
IUSM CME is required to demonstrate compliance from Joint Accreditation for Interprofessional Continuing Education. The Joint Accreditation Criteria, Designation of Credits, and the ACCME Standards for Commercial Support are the practices that a provider, such as IUSM CME, must implement to achieve and maintain accreditation.
Regularly Scheduled Series (RSS) is a course planned as a series with multiple, ongoing sessions, e.g., offered weekly, monthly, or quarterly. Examples include grand rounds, tumor boards, and morbidity and mortality conferences.
View and download helpful guides and templates below:
Coordinator Checklist and Reference Sheet
Attendance Sheet Templates
Accreditation Statement Template