College CPD accreditation guidelines

Introduction

Pharmacists have a commitment to the Pharmacy Board of Australia (the Board) as determined by their Codes, Guidelines, and Policies, and the profession, to maintain competency in their relevant areas of practice.

Pharmacists must undertake a self-assessment of their learning needs and formulate a CPD learning plan in order to meet this commitment. Continuing Professional Development (CPD) helps to facilitate this commitment by maintaining and improving the knowledge, skills and competence of pharmacists. Activities must broaden and enhance the knowledge and skills pharmacists use in their regular practice. Providers of accredited CPD activities must utilise adult learning principles and knowledge of pharmacy professional practice to meet the learning needs of pharmacists.

As authorised by the Australian Pharmacy Council (APC) the College may accredit continuing professional development activities for pharmacists for recognition of continuing competence. The accreditation of CPD activities assures pharmacists that the activity has been assessed for educational quality and relevance to pharmacy practice. To assess if the activity can be accredited according to the Board’s CPD standards, the College applies the Australian Pharmacy Council Accreditation Standards and Guidelines for CPD Activities, Standards for the Accreditation of Programs to support Pharmacist Administration of Vaccines and Accreditation Marketing Policy as well as the College CPD Accreditaiton Guidelines in the assessment of CPD activities.

What you will need for the CPD accreditation application

The following is a list of documents and other information that will be required to submit a complete application for CPD accreditation under the Australian Pharmacy Council CPD Accreditation Standard.

1. Completed CPD accreditation application form.
2. CV, bio or resume of all people involved in development and delivery of the CPD activity including authors, presenters, and reviewers.
3. Declaration for all people involved in development and delivery of the CPD activity including authors, reviewers, presenters, and applicants for CPD accreditation. Please direct these parties to the College Declaration Form.
4. Final content. The College needs to see the content as it will be presented to pharmacists. Please inform us in the application form if the final version is not yet ready and when it will be ready.
5. Final assessment tool/s.
6. Template of your certificate of completion. 
7. Participant evaluation/feedback form. (The College has developed a CPD Activity Participant Feedback Form Template which you are welcome to download and amend for your own CPD activity).
8. Marketing and promotional materials for the CPD activity.
9. Another other supporting documents, resources, and tools used in the accredited activity.

Please submit an enquiry at the bottom of this page if you need further clarification before submitting your CPD accreditation application.

Needs assessment

Accredited CPD activities should be accompanied by a detailed justification for delivery of the activity (Needs Assessment). There should be a detailed statement of the learning need that is met by the activity and the relevance of the learning activity to phar,acy practice. The learning objectives for the activity are derived from the learning need.

The applicant will be required to provide details in the application for CPD accreditaiton of how the needs assessment for the activity was carried out, the outcomes of the needs assessment that informed development of the learning objectives of the activity, and the relevance of the learning activity to pharmacy practice.

Raising awareness of the existence or benefits of a product or service is not considered to be a sufficient justification for delivery of an accredited activity.

Tools commonly used to undertake a needs assessment for an accredited CPD activity include:

• Survey of potential participants
• Summary of previous CPD evaluation data
• Results of self-assessment of practice audit
• Request from organisation
• Literature review
• Revised medicine information
• Healthcare data
• Reports and/or studies
• Recent changes to standard therapy, guidelines or regulatory frameworks
• Evidence errors are being made by pharmacists in this area
• New avenues for pharmacist remuneration
• New roles for pharmacists
• New medicines or therapies

Setting learning objectives for the activity

The APC Accreditation Standards state that ‘… information provided to pharmacists about the activity includes the intended outcome objectives presented in such a way as to support pharmacists to choose suitable activities in accordance with their scope of practice and learning plan/needs’.

The APC guidelines state:

Learning objectives are not required to be made available in each of the CPD activity materials as long as they are available for access by the participants in some manner or form (i.e. could be in the activity presentation slides, online brochure, conference app and etc.). Your application should provide the learning objectives and the form in which they will be presented to participants.

A set of global objectives for conference promotional purposes is acceptable. However, there must be unique learning objectives for each individual conference CPD session/activity. Your application for accreditation of conference CPD activities should list individual CPD activity learning objectives and if required the overall (global) learning objectives for the conference.

The learning objectives must be linked to the National Competency Standards Framework for Pharmacists in Australia (2016):

• They must be actionable statements i.e. they must define what the pharmacist should know or be able to do at the completion of the activity
• They must be specific and measurable
• A statement of the learning objectives must be accessible to pharmacists so that they can determine if the activity is appropriate to help fulfil their commitment to CPD
• The learning outcomes must be stated during the presentation or within the article

Below are some examples of learning objectives:

‘After completing this activity pharmacists should be able to’

• Describe the symptoms of allergic rhinitis
• Explain the risks associated with cardiovascular disease
• Discuss the treatment options for rheumatoid arthritis
• Demonstrate the use of a metered dose inhaler
• Formulate a topical cream for psoriasis
• Counsel a patient with diabetes about a healthy diet
• Prepare a profit and loss statement
• Design a health promotion for cervical cancer vaccination
• Take a comprehensive medication history
• List the side effects of chemotherapy drugs

Verbs such as ‘understand’ and ‘learn’ are ambiguous, not actionable or measurable and should be avoided.

Determining pharmacist competencies applicable to the activity

Providers of CPD activities applying for accreditation must take the National Competency Standards for Pharmacists in Australia (2016) into consideration when designing the activity.

Competencies must be mapped to at least the standard level. However, the applicant may map down to the enabling competency level if required.

The College can assist with clarification of pharmacist competencies and will allocate competencies to your accredited activity in your accreditation response letter. We urge providers to consider the pharmacist competencies when planning and developing the activity, as activites that do not relate to at least one of the pharmacist competencies cannot be accredited for CPD.

Developing content for the activity

The provider of the activity applying for accreditation must undertake an appropriate development process for the activity. This includes a justification for why the activity should be conducted in the first place (needs assessment).

The development process must have significant involvement from a suitably qualified pharmacist and/or another subject matter expert (SME).  That is, in some instances, this may be both a pharmacist(s) and a SME(s). People involved in development of the content must be able to demonstrate they are suitably qualified and/or experienced. A bio, resume or CV must be submitted with the application for accreditation for each person involved in the planning, development, and delivery of the activity.

The College highly recommends that a pharmacist be involved in development of the activity to ensure that the content is relevant to pharmacist practice. A medical writer is not generally considered to be an SME, unless they can demonstrate their expertise in the area via their qualifications and/or experience.

The content must be based on critical evaluation of the literature or practice based experience in clinical or other areas of pharmacy practice. The limitations of the content must be communicated (this includes if the content pushes the boundaries of currently accepted practices or if the evidence base underpinning the content is limited or varied). Non-evidence based content must be disclosed.

The content must be applicable to pharmacy practice as determined by the learning objectives. It should add to the pool of knowledge of pharmacists. This can include both introduction of innovation and overview of existing standard therapy and business practices.

The quality of the evidence base underpinning the content should be of high standard. The intent of accredited CPD is to deliver education as opposed to information. Product driven training is highly discouraged. However, product information may accompany activities involving in-depth discussions of disease states and medicines.

The CPD activity provider must formally notify the College if the content of the CPD activity has been changed following accreditation by the College. The extent to which the content has been changed must be outlined even if the change appears minor, e.g. change in qualified presenter. Major changes to a CPD activity require a (new) accreditation application process.

Major changes include:

• The subject matter area has changed significantly due to emerging research/evidence, legislation, professional standards or guidelines or program/service prerequisite.
• The structure of the program to be delivered has changed.
• The learning objectives or assessment methodology has changed.
• The time needed to undertake the activity has changed.
• The method of delivery has changed. 

Content must be based on adult learning principles. These principles include:

• Adults are internally motivated and self-directed – foster the participants’ internal motivation and move them toward self-directed learning.
• Adults bring life experience and knowledge to learning experiences – give the participant the opportunity to apply their existing knowledge and experiences to the new material.
• Adults are goal oriented – present why the new knowledge or skill is necessary and applicable to real world practices.
• Adults are relevancy oriented – communicate why the material is relevant to what the participant wants to achieve.
• Adults are practical – encourage the participant to practice what they have learned with customers/patients.
• Adult learners like to be respected – regard the participant as a colleague and acknowledge their experience and need to express new ideas.

The method of delivery of the activity must promote effective learning for adults. Face-to-face activities must allow time for interaction and enquiry from the audience. This can also be accomplished by problem solving and case study discussion. Written materials, online presentations or webinars should be prepared using the adult learning principles if discussion or group interaction is not achievable. The activity provider must offer participants support should they require it e.g. via email.

Any disseminated instructional materials must be technically sound and current. They must be dated and include references.

The activity must be developed free of bias. Therapeutic goods should be discussed under their generic (active ingredient) name. Where brand names are used, a comprehensive reference to other brand names that also include the active ingredient should be detailed. Where services are discussed, a list of similar services should be included.

The content and any associated assessment should be reviewed for accuracy by the author/presenter (or their reviewer) prior to submitting to the College for accreditation. While the College will provide help with identifying errors and inconsistencies in the material, it is not the role of the College to act as co-author or to re-write substantive portions of the activity due to error etc.

Designing assessment of the activity

The Pharmacy Board of Australia CPD Standard requires that all group 2 CPD activities must include a mechanism for assessing attainment of the stated learning objectives by the participant. The assessment must be designed to address all of the stated learning objectives.

Face-to-face presentations can achieve this by group discussion and interaction with the presenter/s. Discussion should challenge the participant and stimulate them to become involved. Interactive activities must be structured and facilitated to allow each participant to demonstrate attainment of the learning objectives. This might involve a case study presentation where participants consider a theoretical patient and make recommendations based on the content of the education. It might also involve role-plays to demonstrate counselling or history taking skills. Business CPD might involve preparation of financial statements or planning strategies.

The interactive component of a face-to-face activity must form two thirds of the time allocated for the CPD activity. The maximum facilitator:participant ratio for activities involving group work is 1:20.

In cases where discussion is not achievable, written or online assessment must be involved. Written assessment might be in the form of short answer or essay tasks to be graded by a delegated marker.

Alternatively, multiple choice questions (MCQs) can be utilised. The minimum number of MCQs is 5 per hour of activity (or 3 per 30 minutes etc). Participants must attain at least 75% to pass the assessment. There is a maximum of 2 attempts allowed. If more than 2 attempts to pass the assessment is allowed, the assessment questions must be differrent to those in the first 2 attempts.

Correctly written MCQs can assess knowledge, application and analysis. The MCQ should be posed as a question that could be answered without knowledge of the associated choices.

Negatively worded questions can be used in some instances. However, they should not dominate the block of questions. If used, the negative term should be capitalised. Avoid double negatives (negatives appearing in both the question and the answer), as they are very confusing. Avoid using directions such as ‘choose the best option’ or ‘the most correct option’ as these are subjective and misleading. While discouraged, True or False MCQs may be used (maximum of one T/F question per 5 MCQs). The requirements for passing the MCQs must be clearly stated.

Some examples of appropriately worded CPD questions are below:

• What is the most common adverse effect of methotrexate?
• At what age does paediatric asthma most commonly begin?
• How is the dose of warfarin determined?
• What training activity has the greatest impact on staff retention?

Some examples of poorly worded questions are below:

• Select the most problematic side effect of beta-blockers from the following.
• Which of the following is the most effective method for counselling about antibiotic use?
• Which of the following statements is most correct?

There should be at least four (preferably five) options for the participant to consider (the number of options does not need to be uniform for each MCQ in the block of questions). If there are more than 1 correct option, this should be stipulated in the question stem (e.g. Choose the 2 correct options). The correct option should be completely defensible. The position of the correct option should be varied between questions a, b, c, d and e.

The participant should be able to identify one or two incorrect options directly after reading the question. They must then use their acquired knowledge to differentiate between the remaining options. Incorrect options should be plausible but clearly incorrect. While tempting, it is not recommended to use wildly implausible incorrect options. The grammar, length and style of the incorrect options should mirror that of the correct option.

While potentially controversial, ‘None of the above’ or ‘All of the above’ options can be used, provided each of the above options agree with the statement if it is intended to be correct. Avoid using ‘None of the above’ or ‘All of the above’ in only one out of five of the MCQs as this highlights to the participant that it could be the correct option. Conversely, ‘None of the above’ and ‘All of the above’ can also be used as incorrect options.

As discussed above, different levels of understanding can be highlighted in MCQs. Testing of attainment of knowledge is simple. However, testing of ability to apply knowledge or to use knowledge to analyse a scenario is more difficult. These can be achieved by posing the question as a case study or as a calculation.

Some examples of challenging MCQs testing application of knowledge are below:

1. Mary (67) shows the following medication history in your dispensing system:

• Perindopril 8 mg daily
• Timolol (0.5%) daily to the right eye
• Risedronate 35 mg once weekly
• Calcium 1200 mg daily
• Vit D 1000 IU daily

Which of her medicines is potentially the cause of her recent onset of reflux symptoms?

2. How much SVU (70%) is required to produce 1000 mL of ethanol 50% (v/v)?

Avoid asking MCQs that involve simple comprehension. The aim of the assessment is to test the attainment of knowledge and skills, application of that knowledge and improvement of knowledge, as opposed to the ability of the participant to scan text for words and identify phrases.

Some examples of MCQs to avoid are below:

• How many patients were enrolled in the ENRICH trial?
• What was the risk ratio for prostate cancer in the treatment group?
• In what year was polio eradicated from Australia?

Participants can be given one second chance to answer the question if they fail at the initial attempt, provided the correct answer is not revealed between attempts. While not ideal, supplementary MCQs can be undertaken by participants in the case of failure of the second attempt. The content of the replacement MCQs must be distinct from previous quiz attempts.

There must be a method of reporting back outcomes of the MCQs to each participant.

Group 3 activities must be preceded by a documented structured reflection on practice and then followed by a post-activity reassessment to evaluate practice change or outcomes resulting from the activity. Group 3 activities may extend over a number of weeks or months and may require peer review.

Some examples of group 3 activities are below:

• Assess your current clinical services offer and then produce a marketing plan to improve participation. Review your practices and implement a quality improvement process. Reflect on the changes achieved.
• Reflect on your process for patient history taking. Use what you have learned in this course to take a comprehensive history from five patients with diabetes. Compare and contrast the changes in your process and reflect on the quality improvement.

Promoting the activity

The APC has an Accreditation Marketing Policy outlining the use of their approved CPD logo. Providers of CPD activities must not give the impression that the activity is accredited for CPD before accreditation has been granted. However, providers of CPD activities can use statements such as ‘currently applying for CPD accreditation’ or ‘seeking CPD accreditation’ in material promoting the activity prior to granting of accreditation.

If the activity is accredited, the College will provide the applicant with the Australian Pharmacy Council CPD accredited logo, an accreditation number, and accreditation wording. All 3 of these must be used (adjacent) when promoting the activity as accredited CPD.

The College requires the applicant for CPD accreditation to provide it with all promotional content and resources relating to accreditation of the activity.

Promotion of the activity must not imply that the Australian Pharmacy Council itself has assessed or accredited the activity and must not identify the organisation that has accredited the activity. The Australian Pharmacy Council Accredited CPD logo must not be displayed within close proximity of sponsor logos so as the give the impression that the two organisations are somehow related or endorsed by each other.

Sponsors of an activity and/or hospitality associated with an activity may only be acknowledged during the activity in such a way as to make it clear that the educational content is independent. While the College identifies that many if not all CPD activities potentially could not be produced without sponsorship, we require that the education component of the activity takes priority over sponsor credit and brand placement. Sponsor representation cannot account for more than 20% of the space allocated in and around the educational content including presentation slides and space in print media. This requirement is also supported by the APC Accreditation Marketing Policy.

Disclosing conflicts of interest

All parties involved in the development, delivery, and accreditation of CPD activities, including athors, presenters, reviewers, and applicants for CPD accreditation must disclose conflict/s of interest, whether real or perceived.

Any association between the sponsor/supporter of the activity and the authors, presenters, reviewers of the content or applicant/s for CPD accreditation must be disclosed in the CPD accreditation applicatio and to the participants in the activity. Refer to Sponsorship or support of accredited CPD activities in this guide for more information about the duties of sponsors/supporters of accredited CPD activities.

CPD credits

The College will assess the number of CPD credits the activity can offer participants, and inform the applicant of this in the accreditation response letter. The CPD credits are calculated on the estimated time (hours) it will take for the activity (including assessment) to be completed (for accredited content only e.g. excluding break times).

CPD credits are divided into Group 1, 2, and 3.

1. Group 1 - Activities without assessent (e.g. read, listen, atttend) - 1 Group 1 credit per hour of activity
2. Group 2 - Activities with assessment - 2 Group 2 credits per hour of activity
3. Group 3 - Activities with pre- and post- reflections that demonstrate practice change - 3 Group 3 credits per hour of activity.

The estimate of duration of the activity is based on the depth and breadth of the content and assessment task/s. An accepted industry standard for a 1 hour activity is 3000 words (excluding references and MCQs).

Pharmacists must complete a total of 40 CPD credits per CPD year (with a maximum of 20 group 1 CPD credits).

Duration of CPD accreditation

The College can accredit CPD activities for a maximum of 2 years. Some activities cannot be accredited for the maximum period e.g. if the content is likely to be outdated before the maximum accreditation duration occurs. Therefore, the College reserves the right to determine the accreditation period. The College will issue the applicant for CPD accreditation with an accreditation expiry date after which the applicant can no longer use the accreditation details (including the Australian Pharmacy Council CPD accredited logo) in the delivery or promotion of that activity. Providers of an accredited CPD activity can re-apply for accreditation of their activity at the end of the accreditation expiry period.

It is the responsibility of the applicant to organise periodic review of the validity and currency of the content of the activity while it is available for access by pharmacists during the accreditation period, and inform the College of any changes. Major changes to the content may require a new application for accreditation (refer to Developing Content for the Activity for guidance on what constitutes a major change).

The College acknowledges the rights of an applicant to appeal an accreditation assessment decision.

The College will work with the applicant, to an extent, before application confirmation, to assist with the approval of the activity.

An applicant who is advised that their application for accreditation of a CPD activity has not been approved is entitled to appeal the decision as follows:

• Submit an appeal to the College within 10 working days after receipt of accreditaiton rejection letter.
• The accreditor will consider the basis of the appeal and either uphold the decision or consult further with the Chief Pharmacist who will then contact the applicant to obtain additional information or discuss an appropriate approach to resolve any issue/s related to the process of the review.
• The accreditor will escalate the appeal to the Chief Pharmacist if an outcome agreeable to the applicant and the assessor cannot be reached.
• The Chief Pharmacist will make the final decision.
• The College will respond to any appeal within 10 working days from receipt of an appeal by an applicant.
• If the applicant is not satisfied with the outcome, they will be advised to contact the Australian Pharmacy Council.

CPD accreditation revocation

In the event of an applicant not complying with the conditions of accreditation, the College reserves the right to review and revoke the accreditation approval for that activity. This would also trigger a review of any other activity of the applicant that has been or is subject to accreditation approval.

Accreditation would be considered for revocation under the following criteria:

• Failure to meet the undertakings given in the CPD Accreditation Application Form and/or Conditions of Approval of CPD Accreditation. For example, the content delivered did not meet the stated learning objectives; the content was delivered by different presenters (now considered not appropriate presenters); different assessment methodology was used (compared to the approved assessment method); the assessment methodology implemented does not comply with the CPD standards and guidelines (e.g. number of MCQ attempts).
• The applicant refuses to address any shortcomings advised to it by the College.

This process would be informed by:

• The receipt of a formal notification or complaint from an individual, the Australian Pharmacy Council, or the Pharmacy Board of Australia about a specific activity or applicant
• Feedback received by the College through the individual activity evaluation forms
• An independent assessment, either specifically undertaken or as part of the routine audit of accredited activities, by the College as to the suitability of the activity as pharmacist CPD.

Upon becoming aware of an issue with a specific activity or applicant, the College will, depending on the specific circumstances:

• Contact the complainant to acknowledge the receipt of the complaint and ascertain full details of the issue
• Contact the applicant to request an explanation as to the circumstances of the complaint
• Investigate the complaint, including comparing what was actually presented with what had been accredited to present
• Advise the applicant of any remedial action to be taken and identify responses times (e.g. 10 days) to respond to the advice and also the time required to subsequently implement any changes identified
• Advise the complainant of the outcome
• Monitor the applicant to ensure that remedial action has been undertaken
• Formally advise the provider of revokation of accreditation if no response is received or any identified remedial requirements are not undertaken; and
• Formally advise Australian Pharmacy Coincil of the outcome.

Sponsorship or support of accredited CPD activities

The College identifies that development of quality education and practice guidelines for pharmacists, pharmacy assistants and industry professionals is limited by available funds, and providers of accredited CPD activities and/or applicants for CPD accreditation may arrange or accept support from organisations in the form of grants, gifts, payments, subsidies, or other economic benefit or means of support, to enable the development and delivery of education activities or practice guidelines. 

Support for accredited education activites may be in the form ot:

• Unrestricted educational grants - support the development of an educational activity, the subject and content of which is at the discretion of the provider receiving the support.
• Restricted educational grants - support development of an educational activity for a specific purpose.
• Partnership agreement - a commercial arrangement in which the supporting organisation is closely involved with development of the activity.

The supporting organisation must not unduly influence the educational activity such as requiring favourable treatment of a certain product or influence the planning, content, or execution of the activity. The application for CPD accreditation must outline any associated educational grants or other support arrangements and the activity must carry statements clearly explaining the support to participants.