CME WorldwideCME Worldwide

BRAIDO F.BRAIDO F.FISM FISM

Task ForceTask Force

CANONICA G.W.CANONICA G.W.FISMFISM

Secretary GeneralSecretary General

Federazione delle Società Federazione delle Società Medico -Scientifiche ItalianeMedico -Scientifiche Italiane

Continuing Medical Education:Continuing Medical Education:

an international realityan international reality

In press 2005In press 2005

Braido F., Popov T., Ansotegui IJ., Gayraud J., Braido F., Popov T., Ansotegui IJ., Gayraud J., Nekam K.L., Delgado J.L., Malling H.J., Olson S,Nekam K.L., Delgado J.L., Malling H.J., Olson S,Larchè M., Negri A., Canonica G.W.Larchè M., Negri A., Canonica G.W.

EAACI CME Accreditation CommitteeEAACI CME Accreditation Committee

EU Member Countries

BelgiumDenmarkGermanyGreeceSpainFranceIrelandItalyLuxemburgHollandPortugalAustriaFinlandSwedenGreat Britain

Applicants

BulgariaCeska Rep.EstoniaCyprosLettonia LatvijaMagyarorszagMaltaPolskaRomanjaSlovenjaSlovackia.Turkiye

BELGIUMBELGIUMMandatory or Voluntary CME?Mandatory or Voluntary CME? •   VoluntaryVoluntary, but , but incentivesincentives exist for accredited doctors (they can ask exist for accredited doctors (they can ask

for higher fees, about 4.5%, + a yearly premium of 490 Euro.) There for higher fees, about 4.5%, + a yearly premium of 490 Euro.) There are no sanctions besides exclusion of accreditation and no re-are no sanctions besides exclusion of accreditation and no re-certification.certification.

Type of Credit:Type of Credit: Points Points Number of Credits:Number of Credits:• The number of credits required amounts to 200 per year (20 hours The number of credits required amounts to 200 per year (20 hours

of which 3 hours must be Ethics, and 4 hours in group peer review). of which 3 hours must be Ethics, and 4 hours in group peer review).

National Accreditor:National Accreditor: • CME in Belgium is regulated by an organization within the INAMI-CME in Belgium is regulated by an organization within the INAMI-

RIZIV (State Institution for Insurance against Disease and Invalidity) RIZIV (State Institution for Insurance against Disease and Invalidity) and hence, is monitored by the profession, the universities and and hence, is monitored by the profession, the universities and scientific organizations and the (mostly politically linked) insurance scientific organizations and the (mostly politically linked) insurance organizations.organizations.

BULGARIABULGARIA

MandatoryMandatory

CME Agreement with UEMSCME Agreement with UEMS

CROATIACROATIA

Mandatory or Voluntary CME?Mandatory or Voluntary CME?

Mandatory.Mandatory. Voluntary up to 1995, since then all physicians Voluntary up to 1995, since then all physicians have had to join the Croatian Medical Chamber. An Institute of have had to join the Croatian Medical Chamber. An Institute of Licensure and Re-licensure was established. All physicians Licensure and Re-licensure was established. All physicians with state examinations, already practicing medicine, were with state examinations, already practicing medicine, were granted a license for independent practice, renewed after six granted a license for independent practice, renewed after six years following the obtaining of 120 points of CME.years following the obtaining of 120 points of CME.

  

Type of Credit: Type of Credit: 1 1 hour = 1 credithour = 1 credit

  

National Accreditor: National Accreditor: Specialists Societies and Hospitals (1996)Specialists Societies and Hospitals (1996)

CZECH REPUBLICCZECH REPUBLICMandatory or Voluntary CME?Mandatory or Voluntary CME? • MandatoryMandatory, similar to Croatian system, similar to Croatian system

  

Type of Credit: Type of Credit: Credits systemCredits system

  

Number of Credits: Number of Credits: Credits obtained over 5 yearsCredits obtained over 5 years

  

National Accreditor: National Accreditor: Specialist Societies and HospitalsSpecialist Societies and Hospitals

  

Online CME? Online CME? YesYes

HUNGARYHUNGARYMandatory or Voluntary CME? Mandatory or Voluntary CME? Mandatory with sanctionsMandatory with sanctions

Type of Credit: Type of Credit: PointsPoints

Number of Credits: Number of Credits: 250 points over 5 years 250 points over 5 years

National Accreditor: National Accreditor: • Four Medical Schools under control of aFour Medical Schools under control of a Supervisory Steering Supervisory Steering

Committee Other: Incentive to comply,Committee Other: Incentive to comply, Doctors pay to register and Doctors pay to register and are punished if they do not. Also important is the Hungarian are punished if they do not. Also important is the Hungarian Physicians Chamber (HPC).Physicians Chamber (HPC).

Other: Other: • Pharma companies (local and international), from both a financial Pharma companies (local and international), from both a financial

point of view as well as giving scientific information, are playing keypoint of view as well as giving scientific information, are playing key role in the continuous medical education. Every activity concerning role in the continuous medical education. Every activity concerning the creditthe credit point system should be in close cooperation with the HPC point system should be in close cooperation with the HPC and the entire Doctors Collegium (Neurology, Gynecology etc.)and the entire Doctors Collegium (Neurology, Gynecology etc.)

POLANDPOLAND

Mandatory or Voluntary CME? Mandatory or Voluntary CME? • A law exists but doesn't work in practice. A law exists but doesn't work in practice.

VoluntaryVoluntary

National Accreditor: National Accreditor: • Polish Chamber of Physicians and DentistsPolish Chamber of Physicians and Dentists  Other: Other: • The Head of Polish Gynecological Society Prof. The Head of Polish Gynecological Society Prof.

WieslawWieslaw Szymanski can be interested in the Szymanski can be interested in the introduction of CME system and give assistance.introduction of CME system and give assistance.

ROMANIAROMANIAMandatory or Voluntary CME? Mandatory or Voluntary CME? Mandatory Mandatory 

Type of Credit: Type of Credit: Credits per type of activity Credits per type of activity 

Number of Credits: Number of Credits: • 50-200 credits every 5 years (depending upon specialty). A scale of 50-200 credits every 5 years (depending upon specialty). A scale of

crediting has been established according to the difference between crediting has been established according to the difference between courses with and without a final evaluation as well as taking part in courses with and without a final evaluation as well as taking part in conferences and congresses.conferences and congresses.

National Accreditor: National Accreditor: Romanian College of PhysiciansRomanian College of Physicians  Accreditation of providers: Accreditation of providers: • Providers are accredited with help of Scientific Societies and the Providers are accredited with help of Scientific Societies and the

Professional Organizations – rules include experience and no Professional Organizations – rules include experience and no commercial links.commercial links.

SLOVAKIASLOVAKIA

CME is about CME is about to be establishedto be established..

SLOVENIASLOVENIA

Mandatory or Voluntary CME? Mandatory or Voluntary CME? Mandatory.Mandatory.  Type of Credit: Type of Credit: Credit Points.Credit Points.  Number of Credits: Number of Credits:

75 points over 7 years for re-certification75 points over 7 years for re-certification  National Accreditor: National Accreditor: Slovenian Medical ChamberSlovenian Medical Chamber

Online CME? Online CME? Coming upComing up

TURKEYTURKEY

VoluntaryVoluntary CME CME with sanctions in certain areaswith sanctions in certain areas

UNITED STATESUNITED STATESMandatory or Voluntary CME? Mandatory or Voluntary CME? MandatoryMandatory in 40 states in 40 states..

Type of Credit: Type of Credit: Credit hoursCredit hours, move to credits, move to credits

Number of Credits: Number of Credits: 150 credit hours over three years150 credit hours over three years

National Accreditor: National Accreditor: • The Accreditation Council for Continuing Medical Education (The Accreditation Council for Continuing Medical Education (ACCMEACCME) )

Online CME Online CME • ACCME released policy 2002-A-11 stating eight points regarding online ACCME released policy 2002-A-11 stating eight points regarding online

CME program. In summary, they say that CME activities delivered via CME program. In summary, they say that CME activities delivered via the internet are expected to be in compliance with ACCME Essential the internet are expected to be in compliance with ACCME Essential Areas, Elements and Policies. Areas, Elements and Policies.

OtherOther• Reciprocity agreement between AMA and the EACCMEReciprocity agreement between AMA and the EACCME

302 millions302 millions 971 millions971 millions

1998 2003 USDUSD

N.E.J.M. february 10,2005N.E.J.M. february 10,2005

N.E.J.M. february 10,2005N.E.J.M. february 10,2005

Mandatory CMEMandatory CME

As in the United StatesAs in the United States

Reciprocity agreement with USAReciprocity agreement with USA

CANADACANADA

MEXICOMEXICO

Mandatory since 2002Mandatory since 2002

Bylateral agreement Bylateral agreement

with the USAwith the USA

ARGENTINAARGENTINA

Mandatory or Voluntary CME? Mandatory or Voluntary CME? • Voluntary Voluntary but there are plans to but there are plans to

make itmake it mandatory in the future.mandatory in the future.

  

National Accreditor:National Accreditor: • NationalNational CommissionCommission for Boardfor Board

Certification and ReCertification and Re--certificationcertification

BRAZILBRAZIL• Not a formal systemNot a formal system in place. Brazilian federal health in place. Brazilian federal health

council has no rules for CME.council has no rules for CME.

• Medical societies like: anesthesia, cardiology and Medical societies like: anesthesia, cardiology and gynecology are playing a major role in establishing gynecology are playing a major role in establishing standards for certifying and updating their members.standards for certifying and updating their members.

• There is a trend leaded by the major schools of There is a trend leaded by the major schools of

medicine to reduce the number of new physicians, medicine to reduce the number of new physicians, due to saturation of the market (9,000 new doctors due to saturation of the market (9,000 new doctors every year), the goal is to have better training and every year), the goal is to have better training and CME for future board certification.CME for future board certification.

CHILECHILEMandatory or Voluntary CME?Mandatory or Voluntary CME? VoluntaryVoluntary

  

National Accreditor:National Accreditor: • National Council for Medical Specialties Certification (CONACEM) National Council for Medical Specialties Certification (CONACEM)

established in 1985. certification is provided through a diploma of established in 1985. certification is provided through a diploma of CME issued by this council.CME issued by this council.

  

Online CME? Online CME? YesYes

  

Other: Other: • Government health authorities, “CONACEM” and Chilean Academy Government health authorities, “CONACEM” and Chilean Academy

of Medicine are now considering implementation of CME and board of Medicine are now considering implementation of CME and board certification standards for all specialists. certification standards for all specialists.

• Pharmaceutical industry is playing a major role in education by Pharmaceutical industry is playing a major role in education by delivering CME enduring programs (print and online)delivering CME enduring programs (print and online)..

COSTA RICACOSTA RICAMandatory or Voluntary CME? Mandatory or Voluntary CME?   • VoluntaryVoluntary for almost all medical specialties, but for almost all medical specialties, but

mandatory for public health employees.mandatory for public health employees.

National Accreditor:National Accreditor: • Board certification and reBoard certification and re--certification is ruled by the certification is ruled by the

committee for medical certification of the Costa Rica’s committee for medical certification of the Costa Rica’s national medical college. Renational medical college. Re--certification required now certification required now by 6 specialties every 3 years. by 6 specialties every 3 years. 

Other:Other: • Mexican influence in Costa Rica’s and Central America Mexican influence in Costa Rica’s and Central America

due many opinion leaders from the region have due many opinion leaders from the region have graduated or postgraduated in Mexico.graduated or postgraduated in Mexico.

PERUPERU

• In 1998 the National system for In 1998 the National system for board board certification andcertification and rere--certificationcertification under under the rule of the Peruvian college of the rule of the Peruvian college of medicine) was established. medicine) was established. Implementation process is starting.Implementation process is starting.

• There are many CME activities and There are many CME activities and

programs sponsored by pharmaceutical programs sponsored by pharmaceutical companiescompanies..

  

KUWAITKUWAIT

  

Mandatory or Voluntary CME? Mandatory or Voluntary CME? Looks voluntary.Looks voluntary.Type of Credit: Type of Credit: PointsPointsNumber of Credits: Number of Credits: Health professionals who acquire a total of 250 credit points during a period of Health professionals who acquire a total of 250 credit points during a period of

five years receive a Certificate of Satisfactory Completion of CME from KIMS. five years receive a Certificate of Satisfactory Completion of CME from KIMS. Category 1 Educational activities entitle the participants to claim 1 credit point Category 1 Educational activities entitle the participants to claim 1 credit point of CME for one contact hour of educational activityof CME for one contact hour of educational activity ( (Lectures, symposia, group Lectures, symposia, group learning, seminars etc. that are structured and formallearning, seminars etc. that are structured and formal). ). Practical/clinical training Practical/clinical training sessions yield 0.5 credit point per hour.sessions yield 0.5 credit point per hour. Category 2 activities earn 0.5 credit Category 2 activities earn 0.5 credit point of CME for every hourpoint of CME for every hour..

National Accreditor: National Accreditor: Kuwait Institute for Medical Specialization Kuwait Institute for Medical Specialization (KIMS)(KIMS)

Online CME? Online CME? YesYes

OtherOther Category 1 comprises formal learning opportunities provided by recognized Category 1 comprises formal learning opportunities provided by recognized

educational institutions or professional bodies, and accredited by the CME educational institutions or professional bodies, and accredited by the CME Council of KIMS. Educational activities Council of KIMS. Educational activities thatthat are less structured from are less structured from a a learning learning viewpoint than those under Category 1 are included under Category 2.viewpoint than those under Category 1 are included under Category 2.

SAUDI ARABIASAUDI ARABIA

MANDATORY MANDATORY CMECME

80 different nationalities practising medicine CME80 different nationalities practising medicine CME

as standard practice 30 Hours as standard practice 30 Hours

IRANIRAN

MandatoryMandatory CME CME

25 Credits a year25 Credits a year

Loss of licenceLoss of licence

SOUTH AFRICASOUTH AFRICA

Mandatory or Voluntary CME? Mandatory or Voluntary CME? MandatoryMandatory..

Type of Credit:Type of Credit:Credit Points (1 point = 1 hour of CME activity)Credit Points (1 point = 1 hour of CME activity)

Number of Credits: Number of Credits: 50 points50 points

National Accreditor: National Accreditor: • Medical and Dental Professional Board under the Medical and Dental Professional Board under the

jurisdiction of the Health Professions Council of South jurisdiction of the Health Professions Council of South Africa (HPCSA)Africa (HPCSA)..

SINGAPORESINGAPORE

MandatoryMandatory system for Specialists system for Specialists

AUSTRALIAAUSTRALIA

VoluntaryVoluntary for Specialists for Specialists

NEW ZEALANDNEW ZEALAND

VoluntaryVoluntary for Specialists for Specialists

COUNTRIES with COUNTRIES with MANDATORY CMEMANDATORY CME

AsiaAsia:: Iran, South Korea, Singapore, Iran, South Korea, Singapore,

Saudi Arabia, Arabian Emirates Saudi Arabia, Arabian Emirates

AfricaAfrica: : South AfricaSouth Africa

EuropeEurope: : Austria, Ireland, Italy, Netherlands,Austria, Ireland, Italy, Netherlands,

Norway (Norway (only GPsonly GPs.), Switzerland, U.K. (CPD).), Switzerland, U.K. (CPD)

Eastern EuropeEastern Europe: : BulgariaBulgaria,,Croatia, Check Republic,Croatia, Check Republic,

Romania, SloveniaRomania, Slovenia

North AmericaNorth America: : Canada, USA (40 States)Canada, USA (40 States)

Central AmericaCentral America : : MexicoMexico

CME EUROPECME EUROPE

CME WORLDCME WORLD

CME ITALYCME ITALY

usa

CME USACME USA

RECIPROCITYRECIPROCITY

EACCME EACCME ----ACCMEACCME CME CreditsCME Credits

till 2006till 2006

UNMET NEEDUNMET NEED&&

ABSOLUTE REQUIREMENTABSOLUTE REQUIREMENT

Harmonization of CME Systems Harmonization of CME Systems throughout Europethroughout Europe

Euro

Italian CME Credit System

German CME Credit System

French CME Credit System

European European CMECMECredit SystemCredit System

EACCMEEACCME

CurrencyCurrency

CMECME

A A harmonized systemharmonized system of CME of CME throughout Europe throughout Europe

is is

inevitableinevitable in the next few yearsin the next few years

GG.. Walter Canonica Walter Canonica, Chairman, European Academy of Allergology & Clinical , Chairman, European Academy of Allergology & Clinical Immunology Accreditation Council, Secretary General, World Allergy Organization, Immunology Accreditation Council, Secretary General, World Allergy Organization, Secretary, Italian Federation of Scientific Medical Societies, Genoa ItalySecretary, Italian Federation of Scientific Medical Societies, Genoa ItalyMurray KopelowMurray Kopelow, Chief Executive, Accr Council for Continuing Medical Education, , Chief Executive, Accr Council for Continuing Medical Education, Chicago, IL,Chicago, IL,Bernard MailletBernard Maillet, Secretary General, European Union of Medical Specialists, , Secretary General, European Union of Medical Specialists, Brussels, BelgiumBrussels, BelgiumHerve MaisonneuveHerve Maisonneuve, Task force on Health Care Professionals' Competencies, Paris, , Task force on Health Care Professionals' Competencies, Paris, France France Alfonso NegriAlfonso Negri, , Secretary General, Italian Council for Accreditation in Pneumology, Secretary General, Italian Council for Accreditation in Pneumology, Milan, ItalyMilan, ItalyHelios PardellHelios Pardell, Director, Spanish Accr Council for Continuing Medical Education , Director, Spanish Accr Council for Continuing Medical Education Madrid, SpainMadrid, SpainTeodor PopovTeodor Popov, European Academy of Allergology and Clinical Immunology, Sofia , European Academy of Allergology and Clinical Immunology, Sofia BulgariaBulgariaBarbara SchneidmanBarbara Schneidman, Vice President for Education, American Medical Association, , Vice President for Education, American Medical Association, Chicago, ILChicago, ILPasquale SpinelliPasquale Spinelli, Vice President, Italian Federation of Scientific Medical Societies , Vice President, Italian Federation of Scientific Medical Societies Milan, ItalyMilan, ItalyRiccardo VigneriRiccardo Vigneri, Chairman, Long Distance Learning Sub-Committee, Italian , Chairman, Long Distance Learning Sub-Committee, Italian Continuing Medical Education Commission of the Ministry, Catania, ItalyContinuing Medical Education Commission of the Ministry, Catania, ItalyKate LanceyKate Lancey, Royal College CPD London UK, Royal College CPD London UK

Milan - March Milan - March 20032003 Rome - OctoberRome - October 20032003 Rome - April Rome - April 20042004

““USA-EUUSA-EU:: Sharing the educational effortSharing the educational effort””

Next Meeting : Rome May 16, 2005Next Meeting : Rome May 16, 2005

ROME, April 25 - 26 , 2004ROME, April 25 - 26 , 2004

B.M.J. B.M.J. MayMay 2004 2004

Consensus on Basic Values and Responsibilities Underlying the Substantial Equivalency of CME and CPD Systems

Continuing medical education and life-long learning:Continuing medical education and life-long learning:1.      That enhances physician performance and thereby improves the health of people.2.      That is based on information concerning the educational needs of physicians with the ultimate aim of helping them improve health.

A process for the accreditation of providers/organizers A process for the accreditation of providers/organizers of CME/CPD activities that includes:of CME/CPD activities that includes:1.      Fairness, validity, innovation, honesty and consistency in accreditation practices.2.      Reasonable standards and criteria for CME providers/organizers.3.      Accountability, responsiveness, and leadership of accreditation bodies.4.      The promotion of continuous quality improvement of the accreditation process as well as the education systems it supports. 5.      Collaboration and partnership between and among accreditation bodies, and between accreditation bodies and providers/organizers

CME/ CPD systems should be based on the following enduring valuesCME/ CPD systems should be based on the following enduring values

Allergy 2005 in press

ValuesValues

Responsibilities of the Responsibilities of the provider/organizerprovider/organizer of CME/CPD of CME/CPD activitiesactivities to be fulfilled in order to grant credit to be fulfilled in order to grant credit

1. 1.  Any commercial sponsorship or interests of the programme planner, presenters, or facilitators must be disclosed to the provider / organizer and the learners.

2.      Any support, sponsorship or funding by commercial health care organisations must not influence the structure or content of the educational programme.

1.1. Ensure there are outcome measures of education effectiveness expressed Ensure there are outcome measures of education effectiveness expressed in terms of meeting the knowledge, competence or performance objectives in terms of meeting the knowledge, competence or performance objectives of the activity.of the activity.

2.2. Be able to make available a confirmation of participation, at a frequency Be able to make available a confirmation of participation, at a frequency and nature appropriate to regulatory requirements. and nature appropriate to regulatory requirements.

3.3. Ensure that the teaching methods used are appropriate to the stated Ensure that the teaching methods used are appropriate to the stated learning objectives. learning objectives.

4.4. Be able to show that they have evaluated the quality of any previous Be able to show that they have evaluated the quality of any previous education activities and have made improvements, where necessaryeducation activities and have made improvements, where necessary

Allergy 2005 in press

The provider / organizer mustThe provider / organizer must::

have responsibility for:have responsibility for:

1.1. Participating in CME/CPD that is based on their Participating in CME/CPD that is based on their individual educational needs.individual educational needs.

2.2. Ensuring that the needs are relevant to their Ensuring that the needs are relevant to their professional practice.professional practice.

3.3. Evaluating the extent to which their needs have been Evaluating the extent to which their needs have been met, in the context of a change in knowledge, met, in the context of a change in knowledge, competence or performance. competence or performance.

4.4. Verifying that mechanisms are in place to keep Verifying that mechanisms are in place to keep educational activities free of commercial bias. educational activities free of commercial bias.

Responsibilities of the learnerResponsibilities of the learner - to be fulfilled in order to claim credit -- to be fulfilled in order to claim credit -

Allergy 2005 in press

LearnersLearners

Does it Have Practical Application???Does it Have Practical Application???

EAACIEAACI-CME CME AccreditationCommitteeAccreditationCommittee

Chairman Chairman - G.W. Canonica- G.W. Canonica

MembersMembers: I.Ansotegui: I.Ansotegui F.BraidoF.Braido L.DelgadoL.Delgado J.GayraudJ.Gayraud

K.L. NekamK.L. Nekam M.LarchèM.Larchè

H-J. MallingH-J. Malling S.OlssonS.Olsson C.ÖströmC.Öström

T.PopovT.Popov

EUROPEAN ACADEMY EUROPEAN ACADEMY of of

ALLERGY and CLINICAL IMMUNOLOGYALLERGY and CLINICAL IMMUNOLOGY

Continuing Medical Education:Continuing Medical Education:

an international realityan international reality

In press 2005In press 2005

Braido F., Popov T., Ansotegui IJ., Gayraud J., Braido F., Popov T., Ansotegui IJ., Gayraud J., Nekam K.L., Delgado J.L., Malling H.J., Olson S,Nekam K.L., Delgado J.L., Malling H.J., Olson S,Larchè M., Negri A., Canonica G.W.Larchè M., Negri A., Canonica G.W.

EAACI CME Accreditation CommitteeEAACI CME Accreditation Committee

Feel free to contact us at:

Thank YouThank You

fulvio.braido@unige.itcanonica@unige.itcanonica@unige.it

Absolute Requirement

GLOBAL CME

GUIDELINES ARE

NECESSARY

JORDANJORDAN

• Licenses of the physiciansLicenses of the physiciansare for lifetime practices are for lifetime practices and and nono additionaladditional educationeducation after the university is required.after the university is required.

  

Responsibilities of Responsibilities of the provider/organizerthe provider/organizer to be fulfilled in order to grant creditto be fulfilled in order to grant credit,,

1.1. Any commercial sponsorship or interests Any commercial sponsorship or interests of of the programme planner, the programme planner, presenters, or presenters, or facilitators must be facilitators must be disclosed to the provider / disclosed to the provider / organizer organizer and the learners. and the learners.

2.2. Any support, sponsorship or funding by Any support, sponsorship or funding by commercial health care commercial health care

organisations must organisations must not influence the not influence the structure or content of the structure or content of the educational programme.educational programme.

The The provider / organizerprovider / organizer must must,,

1.1. Ensure there are outcome measures of Ensure there are outcome measures of education education effectiveness expressed in terms of effectiveness expressed in terms of

meeting the meeting the knowledge, competence knowledge, competence or performance objectives of or performance objectives of the activity.the activity.

2.2. Be able to make available a confirmation of Be able to make available a confirmation of participation, at a frequency and nature participation, at a frequency and nature

appropriate to appropriate to regulatory requirements. regulatory requirements. 3.3. Ensure that the learning objectives are Ensure that the learning objectives are specifically specifically defined in terms of knowledge defined in terms of knowledge

competence or competence or performance, and are performance, and are appropriate for the target appropriate for the target audienceaudience

4.4. Ensure that the teaching methods used are Ensure that the teaching methods used are appropriate to the stated learning objectives. appropriate to the stated learning objectives.

5.5. Be able to show that they have evaluated the Be able to show that they have evaluated the quality quality of any previous education activities of any previous education activities

and have made and have made improvements, where necessary.improvements, where necessary.