Some of the terms used in this document were carefully selected to indicate the specific meaning and relative weight attached to each statement. These terms are used in an educational context, not used for strict legal interpretation.
Continuing Professional Development (CPD) is the process by which health professionals keep updated to meet the needs of patients, the health service, and their own professional development. It includes the continuous acquisition of new knowledge, skills, and attitudes to enable competent practice.
Continuing Medical Education (CME) consists of educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession. The content of CME is that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public.
We preferably use the term CPD since these types of activities promote positive changes in practice .
Residency surgical education assumes completion of a formal, recognized training program, such as an Accreditation Council for Graduate Medical Education (ACGME) or Royal College of Physicians and Surgeons of Canada Accredited surgical residency training program in surgery.
Post-residency education: coursework which is separate from formal residency or fellowship programs. While directed at the board certified surgeon, residents or fellows in training will often participate in such coursework.
Must or shall: indicates a mandatory or indispensable recommendation.
Should: indicates a highly desirable recommendation.
May or could: indicates an optional recommendation; alternatives may be appropriate.
Declarative knowledge (knows): the degree to which participants state what the continuing medical education (CME) activity intended them to know.
Procedural knowledge (knows how): the degree to which participants state what the CME activity intended them to know.
Competence (shows how): the degree to which participants state how to do what the CME activity intended them to know how to do (observation in educational setting).
Performance (does): the degree to which participants do what the CME activity intended them to be able to do in their practices (observation in clinical setting).
Patient health: the degree to which the health status of patients improves due to changes in the practice behavior of participants after the CPD activity (Outcomes in clinical setting).
Credentials: documents provided following successful completion of a period of education or training.
Clinical privileges: authorization by a local institution (usually an accredited hospital) to perform a particular procedure.
Pre-test: a quantifiable examination of a trainee level of clinical knowledge and/or operative skills prior to commencing a training course.
Post-test: a quantifiable examination of a trainee level of clinical knowledge and/or operative skills upon completion of a training course.
Investigational procedure: a procedure is considered investigational if (1) it has not been substantially accepted into general clinical practice, (2) it has not been critically assessed in peer-reviewed medical literature, and/or (3) it has not been presented and discussed at suitable scientific meetings. Alternatively, a procedure is not investigational if sufficient studies are available to prove its efficacy and safety or if it has already been accepted into general clinical practice without existing rigorous scientific study.
Surgical progress would be impeded if every logical surgical innovation were required to be tested by randomized trials prior to clinical use. Furthermore, it is impossible to rigorously test every aspect of clinical practice. The surgeon should use his/her judgment to determine when such directed coursework and study is appropriate. Introduction of an investigational procedure may require the approval of the appropriate Institutional Review Board (IRB). Self-training in new procedures must take place on a background of basic surgical skills. The surgeon should recognize when and how much additional training in each new procedure is necessary.
Certification: certification is a symbol of successful completion of a program of study. Successful completion of any one or more training components or objectives does not necessarily signify an individual’s clinical competence in a specific procedure or technique.