Many CME courses are free or offered at a discount for AMA members and some are free for nonmembers. Some courses may require a login.
This webpage is intended to provide physicians, accredited CME providers and others with information about the Performance Improvement Continuing Medical Education (PI CME) learning format. If you have additional questions after reading this information, you are encouraged to contact [email protected].
What is PI CME?
A PI CME activity is a process by which evidence-based performance measures and quality improvement (QI) interventions are used to help physicians identify patient care areas for improvement and change their performance. This type of CME activity differs in structure from other CME learning models that may also use PI/QI data (e.g., live activities, enduring materials).
The accredited CME provider develops a long-term, 3-stage process during which a physician or group of physicians learns about specific performance measures, assesses their practice using the selected performance measures, implements interventions to improve performance related to these measures over a useful interval of time and then reassesses their practice using the same performance measures.
A PI CME activity may address any facet (structure, process or outcome) of a physician’s practice with direct implications for patient care.
History and Background
The AMA Council on Medical Education approved AMA PRA rules for PI CME activities in September 2004. The AMA Division of Continuing Physician Professional Development (CPPD) had directed a pilot project over the preceding 3 years in order to develop the guidelines, which offer CME providers and physicians a different way to think about CME activities. PI CME activities focus on the physician’s clinical practice. Performance measurement and improvement activities had already emerged as a mechanism for physicians to systematically assess their practice, and to some extent, their patient outcomes. The pilot project helped develop the processes by which this could be structured as an AMA PRA Category 1 Credit™ educational activity.
AMA Format Specific Requirements
To be certified for AMA PRA Category 1 Credit™, a PI CME activity must:
- Meet all AMA core requirements for certifying an activity. The core requirements (that must be met for every activity certified for AMA PRA Category 1 Credit™) can be found on page 4 of the AMA PRA booklet (PDF).
- Have an oversight mechanism that assures content integrity of the selected performance measures. These measures must be evidence based and well designed (e.g., clearly specify required data elements, ensure that data collection is feasible).
- Provide clear instructions to the physicians that define the educational process of the PI CME activity (documentation requirements, timelines, etc.).
- Provide adequate background information so that physicians can identify and understand the performance measures that will guide their PI CME activity, and the evidence base behind those measures.
- Validate the depth of physician participation by a review of submitted PI CME activity documentation.
- Consist of the following 3 stages:
Stage A: Learning from Current Practice Performance Assessment
Assess current practice using the identified performance measures, either through chart reviews or some other appropriate mechanism. Participating physicians must be actively involved in the analysis of the collected data to determine the causes of variations from any desired performance and identify appropriate intervention(s) to address these.
Stage B: Learning from the Application of PI to Patient Care
Implement the intervention(s) based on the results of the analysis in Stage A, using suitable tracking tools. Participating physicians should receive guidance on appropriate parameters for applying the intervention(s).
Stage C: Learning from the Evaluation of the PI CME Effort
Reassess and reflect on performance in practice measured after the implementation of the intervention(s) in Stage B, by comparing to the assessment done in Stage A and using the same performance measures. Summarize any practice, process and/or outcome changes that resulted from conducting the PI CME activity.
Designating and Awarding Credit for Participation in a PI CME Activity
- Accredited CME providers should designate each PI CME activity for 20 AMA PRA Category 1 Credits™.
- Physicians that complete only Stage A or stages A and B should be awarded 5 AMA PRA Category 1 Credits™ for each stage that was completed. Completion of the full PI CME activity should be encouraged.
- Physicians completing, in sequence, all 3 stages (A-C) of a structured PI CME activity should be awarded 20 AMA PRA Category 1 Credits™. This acknowledges that the best learning is associated with completing the entire 3-stage PI CME activity.
FAQ Specific to PI CME
AMA PI CME Activities
The AMA currently has 2 active PI CME activities for which the AMA is the accredited CME provider: