Successes and Challenges for Organizations Providing Accredited Continuing Pharmacy Education

ACPE.pngAccreditation of Continuing Education Providers in Pharmacy

By Dimitra V. Travlos, PharmD, assistant executive director and director, Continuing Pharmacy Education (CPE) Provider Accreditation; Jennifer L. Baumgartner, PharmD, BCPP, assistant director, CPE Provider Accreditation; and Peter H. Vlasses, PharmD, DSc (Hon.), FCCP, executive director, Accreditation Council for Pharmacy Education

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Background

Accreditation Council for Pharmacy Education (ACPE) entered into accreditation of continuing education providers in 1975 in response to requests by ACPE’s founders to address evolving efforts to ensure pharmacists’ continued competence over time. ACPE expanded its mission to include the accreditation of providers of continuing education in pharmacy based on a published set of standards.

In the late 1960’s, some states began requiring continuing education for re-licensure of pharmacists — an effort that was ultimately supported by the National Association of Boards of Pharmacy (NABP) in 1972. The American Pharmacists Association and the American Association of Colleges of Pharmacy also developed a joint task force to address this issue.1 This collaboration identified continuing education as the best mechanism at the time for assuring pharmacist proficiency post-licensure. ACPE’s governing structure was modified in 2007 to establish a continuing pharmacy education (CPE) commission of leaders in CPE that reports to the ACPE Board with recommendations on accreditation decisions and strategic issues. By 2008, all U.S. states and territories required CPE for re-licensure and accepted CPE conducted by ACPE-accredited providers. 2

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Standards

In 1999, again at the request of its sponsors, ACPE developed new standards for CPE providers who were conducting certificate programs in pharmacy. The first major rewrite of the CPE provider accreditation standards was released in 2009. After more than 30 years in existence, the title of our quality assurance standards changed from ACPE Criteria for Quality and Interpretive Guidelines, to ACPE Standards for Continuing Pharmacy Education3 for clarity and organizational consistency. Their philosophy and emphasis were designed to facilitate the continuum of learning as defined in Standards 2007: Accreditation Standards for Professional Degree Programs in Pharmacy. Standards 2007 emphasized the foundation needed for development of the student as a lifelong learner, and the Standards for Continuing Pharmacy Education provide a structure as students make the transition to practicing pharmacists. The standards are organized in four sections — content, delivery, assessment and evaluation. The standards emphasize that pharmacists and pharmacy technicians should:

  • identify their individual educational needs underlying practice gaps
  • pursue educational activities that will produce and sustain more effective professional practice in order to improve practice, patient and population healthcare outcomes
  • link knowledge, skills and attitudes learned to their application of knowledge, skills and attitudes in practice
  • continue self-directed learning throughout the progression of their careers
  • engage in activities that are fair, balanced, free from commercial bias and conducted independently without any commercial influence

These standards included adoption of the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support™. Of importance, the standards also identified three types of CPE: knowledge, application, and practice (Table 1). Providers are encouraged to guide pharmacists and/or pharmacy technicians to the best combination of CPE activity types to meet their learning, professional development and practice needs. Currently, all providers are still conducting more knowledge-based activities (87 percent) than application-based (12 percent) and practice-based (1 percent) activities. Consultation with staff and accreditation evaluations encourage providers to move towards application- and practice-based activities.

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ACPE CPE Enterprise

ACPE initially recog­nized 72 providers in 1978 and now accredits 356 providers of CPE (ACPE recognized a maximum 410 providers in 2005)4, which include colleges and schools of pharmacy (24 percent); local, state, national pharmacy and other healthcare profession associations (22 percent); pub­lishers and government agencies (5 percent); educational companies (18 percent); hospitals and health systems (22 percent); and others (9 percent). There has been a general trend upward for all types of ACPE-accredited providers. Most of the providers are located on the east coast, with Texas and Florida in the south, and California in the west. Many of the states in the Midwest and Northwest only have 1-3 providers per state.

The number of CPE activities has exponentially increased over the years (Table 2). Live CE activities (i.e., direct interaction between faculty and learners) have always outnumbered the home study CPE activities (i.e., enduring). In recent years, this may be attributed to the additional live formats available via the Internet; i.e., webcasts. All provider types conduct both live and home study activities with only the publishers conducting more home study activities than live activities.

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The number of participants engaged in CPE activities have increased over the years. Learners have received most of their CPE credit taking home study activities. This may be due to the convenience of the Internet-based activities being easily accessible and in abundance. Over the last 10 years the number of learners has increased primarily due to the increased need for pharmacy technician CE, increased number of pharmacy graduates and increased interprofessional education opportunities.

The Provider Web Tool, ACPE’s secure, web-based platform containing CPE activity information submitted by providers, generates the unique ACPE numbering system for CPE activities. This number was revised to differentiate content of CPE designated for pharmacists (P-designated) from those educational activities targeted to pharmacy technicians (T-designated). Additionally, ACPE and NABP co-developed a tracking service, CPE Monitor®, to authenticate and store data for completed CPE units received by pharmacists and pharmacy technicians from ACPE-accredited providers. The only continuing education credit now recognized by ACPE is the information submitted by providers through CPE Monitor®.

Continuing Professional Development

In 2015, ACPE approved an updated Definition of CE and Guidance on Continuing Professional Development (CPD) for the Profession of Pharmacy5. The latter describes the components of CPD as a modern approach to self-directed, lifelong learning and, based on feedback from the pharmacy profession, offered categories and examples of learning activities beyond CPE that can contribute to the development of pharmacy professionals, including academic/professional study, scholarly activities, teaching/precepting, workplace activities, and professional/community service. ACPE defines CPD as a self-directed, ongoing, systematic and outcomes-focused approach to lifelong learning that is applied into practice. It involves the process of active participation in formal and informal learning activities that assist in developing and maintaining competence, enhancing professional practice, and supporting achievement of career goals. The CPD approach is cyclical in nature where each stage of the process can be recorded in a personal learning portfolio (Figure 1).

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Joint Accreditation for Interprofessional Continuing Education™

In 2009, ACPE advanced an innovative collaboration to foster interprofessional continuing education and collaborative practice by partnering with continuing education accreditors for medicine (ACCME) and nursing (American Nurses Credentialing Center [ANCC]) to establish the Joint Accreditation for Interprofessional Continuing Education™ program. Joint Accreditation™ is the first and only innovation in the world offering three professional accreditations in one review process. To date there are 54 Jointly Accredited providers comprised of associations, healthcare systems, government, regulators, accreditors, private education companies and colleges and universities7. In 2017, ACCME, ANCC and ACPE announced interprofessional continuing education (IPCE) credits and the identification of continuing education (CE) activities designed by and for the healthcare team.

Successes and Challenges

ACPE-accredited providers have endured many successes and challenges. Successes included increased collaboration among providers, companies and vendors for the development of quality education. CPE professionals plan CPE activities by identifying professional practice gaps with the goal to narrow or rid the gap for a better healthcare system and ultimately better patient outcomes. CPE organizations have increased resources and efficiencies specifically with the paperless credit system, CPE Monitor®. 20 years ago, CPE units were staffed by one person, and over the years the unit has evolved to teams of CPE staff working collectively to plan and conduct CPE activities. For many years ACPE hosted bi-annual conferences to support ACPE-accredited providers’ education and training around ACPE standards. With the expansion of the mission and membership of the Alliance, ACPE encourages pharmacy provider attendance at the Alliance meetings for their CPD.

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Challenges include practitioners turning to their state boards for approval of courses for CPE, in particular in states where pharmacists and technicians are located in rural geographic locations. The state boards of pharmacy approval across the states are not very consistent in their procedures and thus the quality of the CPE suffers. The roles and responsibilities of the CPE administrator (team) have increased in number and complexity. ACPE has adopted the Alliance competencies6 to assist CPE units to identify individuals and teams to effectively manage and lead the CPE units. Moreover, the application of technology has caused a divide in learners. In general, millennial learners will not sit through a one-hour lecture, and our ‘seasoned’ pharmacists look for that type of educational format. The millennials look for active learning activities and for the ‘click of a button,’ whereas seasoned learners would rather network with one another. Recent generation of pharmacists look for continuing professional development opportunities beyond accredited CPE to meet their educational needs to enhance the practice of pharmacy. Thus completion of CPD cycles become more pertinent in workplaces. The changing economic environment is also a challenge for the CPE units. With the dwindling amount of commercial support over the years, the funds available for quality staff to conduct quality programming have decreased. Despite these challenges, ACPE-accredited providers continue to thrive and produce quality CPE.

ACPE will continue to work diligently and collaboratively to assure and advance the educational preparation and lifelong learning of pharmacists and pharmacy technicians that comprise the pharmacy workforce. We will also work to ensure that pharmacists are integrated as part of the future interprofessional team-based, patient-centered, quality- and safety-focused healthcare system.

 References

  1. AACP/APhA Task Force on Continuing Competence in Pharmacy. The Continuing Competence of Pharmacists. J Am Pharm Assoc. 1975 Aug:15(8):432-7, 457.
  2. National Association Boards of Pharmacy. NABP Survey of Pharmacy Law. 2015.
  3. Accreditation Council for Pharmacy Education. Accreditation Standards for Continuing Pharmacy Education. Available at: https://www.acpe-accredit.org/pdf/CPE_Standards_Final.pdf. Accessed October 26, 2017.
  4. Travlos DV, Sesti AM, Evans HE, Chung UK, Vlasses PH. Pharmacy’s Continuing Education Enterprise – 2005 Update. Poster: 2006 American Association Colleges of Pharmacy Annual Meeting, July 2006.
  5. Accreditation Council for Pharmacy Education (2015). Guidance on Continuing Professional Development (CPD) for the Profession of Pharmacy. Available at: https://www.acpe-accredit.org/continuing-professional-development/.
  6. Alliance for Continuing Education in the Health Professions. National Learning Competencies. http://www.acehp.org/p/cm/ld/fid=15. Accessed October 26, 2017.
  7. Joint Accreditation for Interprofessional Continuing Education. Available at: http://www.jointaccreditation.org. Accessed October 26, 2017.

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