CME Policies

Gaps and Needs for 2015-16

In compliance with the Updated Accreditation Criteria of the Accreditation Council for Continuing Medical Education (ACCME), the Continuing Medical Education (CME) Committee of the ACNS has identified “professional practice gaps.” Definition: A “professional practice gap” is the difference between what a health professional is doing or accomplishing compared to what is achievable on the basis of current professional knowledge.

The following professional practice gaps and educational needs were identified by a combined effort of the Program, Course and CME Committees.

Gap #1. Emerging Areas of Practice. Neurological intraoperative monitoring (NIOM) and intensive care unit EEG monitoring (ICU EEG) are new and rapidly evolving areas of clinical neurophysiology. Few practicing neurologists have adequate training in these techniques, and physicians with competence in these areas are in great demand. Educational activities should cover both basic methodologies for those practitioners new to ICU EEG and NIOM, and innovative techniques.

Gap #2. General Practice of Clinical Neurophysiology. Clinical neurophysiology procedures are performed by a large proportion of practicing US neurologists, many of whom have little or no formal training in clinical neurophysiology. Many clinical neurophysiology procedures (e.g. evoked potentials, invasive EEG) are performed at low volume at most centers, and a forum for review and hands-on interpretation are essential to maintain competence in these areas.

Several specific topics with significant gaps between current practice and ideal practice have been identified via review of the literature, review of clinical neurophysiology fellowship curricula, and surveys of ACNS members and Annual Meeting attendees.

These include:

  • Peripheral neurophysiology, Pediatric electromyography (EMG), critical illness related neurophysiology, and muscle ultrasound
  • Basic Electroencephalography (EEG): Identification of normal variants, identification of artifacts, clinical correlation
  • Pediatric EEG, especially neonatal EEG
  • Digital EEG processing, e.g. quantitative EEG and trends for use in the intensive care unit, source localization, coregistration with neuroimaging, etc.
  • Full band EEG, Ultrafast and ultraslow EEG
  • Neurophysiologic Intraoperative Monitoring (NIOM): Motor evoked potentials, guidelines and standards of care for NIOM (e.g. indications, cost effectiveness)
  • Evoked potentials (EPs): Current role of short-and long-latency EPs
  • Video-EEG monitoring, especially invasive EEG
  • Sleep: Use of new scoring system, implications for patient care
  • Magnetoencephalography (MEG)

Changes in Behavior / Objectives

It is intended that, as a result of attending ACNS educational activities, physicians will be able to identify changes in competence or performance that are desirable. Definitions: “Competence” is knowing how to do something. “Performance” is what the physician would do in practice, if given the opportunity.


The updated ACCME accreditation criteria are designed to integrate with the new requirements for maintenance of certification (for more information see Physicians are expected to perform self assessments of their practice, but the ACNS, as an organization accredited by the ACCME, is expected to measure how its educational activities assist physicians in this activity. Thus, there are new questions in the evaluation form. These questions address intended changes in competence or performance. Attendee responses assist ACNS to determine which educational activities are most useful to learners.

ACNS Policy on Commercial Support

All programs designated as CME abide by the ACCME rules and restrictions regarding CME designated activities. These programs are designed to be free of commercial interest or bias. Programs contained on this website may contain links to pharmaceutical and device manufacturer product sites, but these links are accompanied by a clear notification that the learner is leaving the ACNS educational website. Links to external websites are permitted before or after the educational content of a CME activity, but cannot be contained within the educational content of a CME program.

Advertising of any kind is prohibited within the educational context of CME activities on the ACNS website. This includes banner ads and pop up ads. Advertisements cannot be visible during CME activities.

CME Policy on Disclosure and Resolution of Conflicts of Interest

In accordance with the ACCME’s Standards for Commercial Support of Continuing Medical Education, the Policy on Disclosure and Resolution of Conflict of Interest (COI) exists to provide guidance for staff, planners, and faculty of CME activities sponsored by ACNS and applicable educational partners. This policy addresses the underlying philosophy of disclosure to learners, mechanisms to collect disclosure information and the parties from which COI shall be collected, the mechanisms to resolve COI, and requirements to make actual disclosure to learners.

ACNS is guided by what is in the best interest of the public and its learners. ACNS maintains independence from commercial interests and keeps CME separate from product promotion. These are the basic guiding principles for the collection and management of COI.

Identifying Conflict Of Interest

A Conflict of Interest Disclosure Form shall be provided to individuals involved with a CME activity that have the following roles:

  • Instructor/Faculty
  • Course Director
  • Content Reviewer
  • Staff and Members of the Planning Committee who manage the content/development of the CME activity

Recipients of COI forms must complete and return the document prior to involvement in planning or speaking in the CME activity. Refusal to disclose a conflict or the inability to resolve an identified conflict precludes participation in the CME activity.

Reporting guidance is as follows:

  • Any personal financial relationship during the previous 12-month period represents a potential conflict of interest, and therefore must be reported. This also includes spouses and life partners.
  • A COI is present when both (a) the relationship is financial and occurred within the past 12 months and (b) the individual has the opportunity to affect the content of CME about the products or services of that commercial interest.

Options for resolution of COI are overseen by the CME committee and include:

  • Independent review of presentation(s) required by non-conflicted activity director or physician member of planning or CME committee (content reviewer); faculty may be restricted to discussion of evidence-based information.
  • Substitution of a person with no COI or minimal levels of COI
  • Development of a stringent Peer Review Process in which content is validated
  • Referencing the best available evidence in all CME activities in which potential conflicts exist
  • Requesting the instructor or planner to sever financial relationships with the commercial interest
  • Relegating the person with COI to a role in which therapeutic options will not be recommended
  • Excluding that part of the instruction or disqualification of the presenter
  • Consider not certifying specific lectures by conflicted presenters for credit

ACNS Guidelines for Interpreting COI and Methods of Resolution

Reported COI Guidelines for Interpreting COI Prescribed Action for Resolution Suggested Language for Conflict Resolution Form
No reported COI N/A No action required; faculty letter instructs presenter on rules. No action required
Discloser has relationships with multiple commercial interests (e.g., speakers’ consultancies, research, etc.) which do not relate to the activity Validate expertise. Activity Director determines that presentation topic(s) do not relate to speaker’s relationship with commercial interests. No action required; Faculty letter instructs presenter on rules. Activity Director or non-conflicted Content Reviewer has reviewed the reported relationships and has concluded that there are no potential conflicts of interest for this activity and no further action is required
Discloser has relationships with multiple commercial interests (e.g., speakers’ consultancies, research, etc.) which relate to the activity Validate expertise. Faculty letter instructs presenter on rules.


Options listed below.

Typically independent review of presentation(s) required by non-conflicted activity director or physician member of planning or CME committee (content reviewer); faculty may be restricted to discussion of evidence-based information.

Activity Director or non-conflicted Content Reviewer has reviewed the presentation and deemed it be fair, balanced and free of commercial bias.


Documenting Resolution of COI

  • Completed COI Disclosure Forms will be maintained in the activity file
  • The resolution of COI will be documented on the Resolution of COI Form.

Transparency to Learners
Learners will be provided with disclosure information prior to the execution of the CME activity. This will include:

  • For live activities, disclosure must be provided in printed form to the learners. This information may be included in the course handout, final program or syllabus materials. In addition, disclosure slides may be presented prior to each presentation by the speaker.
  • For enduring materials, disclosure will be provided in the front matter of the CME activity. This is also required for audio, print, podcast, Internet and video CME.
Last updated: September 29, 2015