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The educational activity approval process
APRIL 2000, VOL 71, NO 4
The educational activity
approval process ou have been given the responsibility of planning continuing education activities. You probably are excited and honored to have been selected by your peers for this important duty. I was when I was elected vice president of my local chapter several years ago. In our chapter, the vice president also chairs the education committee. I began planning the six continuing education activities that my chapter provides each year. As we offer continuing education at each business meeting, I also was responsible for sending out meeting notices. The easy part was finding a suitable restaurant in a central location and choosing a menu that was reasonably priced. The meat of the process, however, was choosing topics and finding speakers. I began by surveying our membership, and the person who previously had served as vice president gave me all her records. When I looked through the records, I discovered that you have to prepare an application to obtain approval from AORN to award contact hours. I called the Center for Perioperative Education to ask for necessary forms. When they amved, I quickly completed six sets, sent them, and waited for my approval notices. When the notices arrived, none of them was approved. I panicked. I called the person who oversaw the review process at Headquarters numerous times, reworked my applications, and eventually got the first three
applications approved. After speaking with me so many times, the Headquarters staff member suggested I might benefit from attending a threeday seminar AORN was offering, titled “OR Education Design: New Dimensions in Practice.” I signed up and went. What an eye opener those three days were for me. I learned about a needs assessment, the development of learning objectives, and various presentation styles. I also learned that all this information is available in the Chapter Resource Manual, which I had never seen. After the three-day seminar, I was ready to go home and complete my assignment. I re-sent the three remaining applications, and they were approved. After this experience, the staff member suggested that I consider serving on the Continuing Education Approval Committee (CEAC). I completed a willingness-to-serve form and was selected. Serving on CEAC as a reviewer and as cochair was very rewarding. After serving on another committee, I am once again serving as a CEAC reviewer. This article explains what CEAC is about, discusses some of the most frequent factors that cause applications to be reworked or denied, and provides tips for success in the application process. CONTINUING EDUCATION AORN, along with other specialty nursing organizations and state nursing associations, is given 882 AORN JOURNAL
the authority to approve continuing education from the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation, which is a subsidiary of the American Nurses Association (ANA). Specific guidelines set by ANCC must be followed in the approval process. The ANCC conducts periodic surveys, and compliance with guidelines is required for renewal of approver status.
CEAC believes that continuing education activities are a vehicle through which registered nurses may develop, maintain, and enhance the competence required in their practice. CEAC believes the peer review approval process is the most appropriate mechanism for assuring educational accountability. Participation in continuing education activities maximizes the nurserspotential for promoting and improving health. The approval unit believes that professionalism and the advancement of nursing is fostered through participation in the approval process.‘ The purpose of CEAC is to “maintain the AORN Continuing Education approval process that is consistent with ANCC established guidelines.”’ The CEAC goals include developing and implementing
APRIL 2000, VOL 71, NO 4
Table 1 SAMPLE ACTIVITY DOCUMENTATION FORM
Objective
Content
1 . Compare leaders to managers.
1 . a. Leaders Interpersonal process Group interaction Development Characteristics
Time frame
Faculty
Teaching method
1 . 15 minutes
Name, RN, CNOR
Discussion Handouts Slides Question and answer
2. 10 minutes
Name, RN, CNOR
Discussion Handouts Slides Question and answer
b. Managers Assignment Designated responsibility Roles Job description 2. Discuss the three dimensions of management.
2. a.Jab
b. Mission c. Relationships
Note: 50 minutes of content equal one contact hour. Question and answer time and evaluation time are included in the calculated time.
continuing education guidelines consistent with ANCC criteria, providing a timely peer review of applications and granting continuing education approval, educating applicants while they prepare an application for approval, using quality assurance and quality improvement results to respond to applicant needs.’ Approval of educational activities is restricted to continuing education rather than inservice education. Inservice education is defied as education consisting of educational activities intended to help professional nurses acquire, maintain, andlor increase competence in fulfilling nursing responsibilities specific to the expectations of an employer of nursing (eg, cardiopulmonary resuscitation, fire/ safety.) Continuing education is defined as educational activities intended to build on the educational and experiential bases
of professional nurses for the enhancement of practice, education, administration, research, or theory development: There are a few regulations that must be adhered to strictly, including the following. Nonnurses may not address nursing care. No application will be considered after an activity has been given. No commercial product can be endorsed. Activities that are cosponsored must include a letter delineating responsibility. The CEAC consists of two peer review teams. Each team member must be a current member of AORN and hold a bachelor of science degree in nursing. Members also must have knowledge of the educational needs of perioperative nurses and some experience in planning, implementing, and evaluating educational activities. 883 AORN JOURNAL
When receiving an application from a member or constituent, the coordinator sends copies of that application to two reviewers. When the reviews have been completed, the committee chair compares the reviews. If a differing status has been assigned by the two reviewers, the chair reviews the application and finalizes the approval status of the application. Those reviews are forwarded to AORN, and letters are sent to the applicant advising him or her of the approval status of the application. Consultation with the chair or Headquarters staff consultant may be necessary to assist the applicant. An application may be approved, approved with conditions, pended, or denied. Last year, 45% of applications were approved on first submission, 13%were approved with conditions, and 42% were pended. Approved means that an activity may be presented and contact
APRIL 2000, VOL 7 I , NO 4
hours may be awarded. Approved with conditions means that an activity may be presented and contact hours may be awarded provided that the requested changes are made and documentation is sent with the postactivity report. Pended means that the activity may not be given nor may contact hours be awarded until the necessary changes are made, documentation of said changes are sent to CEAC, and approval from CEAC is obtained. Denied means that the activity may not be presented nor contact hours awarded. Denial rarely occurs. Only subjects that are not appropriate for continuing education in nursing are denied. Although any portion of the application process may present a problem, the three most common
areas that cause applications to be approved with conditions or pended include I certificate of attendance (20%), m objectives/content (2 1 %), and biographical data forms (22%). The certificate of attendance is the documented proof of participation in an educational activity. The problems that most commonly are found in the completion of the certificate include the following. The name of the applicant is omitted. Contact hours are recorded incorrectly or omitted. The authorizing person's signature is omitted. I The address of the person authorizing contact hours is omitted. The activity documentation
Table 2 EXAMPLE OF EDUCATION AND QUALIFICATION SECTIONS
Institution (Name, city, state)
Major area of study
Year degree awarded
1. Diploma
Bryan Memorial Hospital School of Nursing Lincoln, Neb
Nursing
1971
2. Bachelor of science in nursing
Clarkson College Omaha
Nursing
1989
Degree
Note; This includes only higher education. If mere has been none simply state 'hone."
Qualifications
I have participated in planning educational offerings for my chapter in the past. I am a member of the workshop planning committee and am serving as the planning chair for this activity. I have also completed the course "OR Education Design: New Dimensions in Practice." Note: This statement refers to my qualification regarding planning an educationa1 activi!y. (A speaker's statement may state that the speaker is an expert in the subject matter and has spoken extensively on this matter. If it is your first attempt at planning an activity or it is the speaker's first presentation, simply state this.) 884 AORN JOURNAL
form often presents the greatest difficulty to applicants. The form includes five columns, of which the f i s t is objectives. The instructions include direction in the formation of behavioral learning objectives. The objectives must be expressed in measurable terms, specify one outcome per objective, and relate to the overall purpose and goals. Behavioral objectives describe the behavior to be evaluated and the content that will be presented. Each objective also must have representative content that is related directly to it. Each objective and its corresponding content must have a designated time frame sufficient to achieve the objective. The faculty and teaching method(s) also must be listed. Table 1 shows an example of an activity documentation form. Biographical data forms must be included for the planning and administrative chairs and any presenter. Areas of concern include education and qualification sections. Table 2 shows an example of correctly completed education and qualification sections. The CEAC reviews approximately 700 applications per year. One hundred fifty of our 300 chapters use this service. The application process has been streamlined greatly since I initidly was exposed to it. A checklist format is used for the majority of the planning checklist. This member service is very cost-effective for most of our members. State nursing associations generally charge much higher rates to approve activities. The fee structure also has been streamlined to assist smaller chapters whose budgets may not allow for higher fees.
APRIL 2000, VOL 7 1, NO 4
Individuals who are interested in serving on CEAC should obtain a willingness-to-serve form from the credentialing coordinator and return it. Members are appointed in
December each year and begin their terms (ie, two years) at the close of Congress the following spring. An orientation meeting is held in Denver after appointments. Those serving as CEAC
NOTES 1. AORN Approval Unit Philosophy, Purpose and Goals, Policies and Procedures 199912000 (Denver: Association of Operating Room Nurses, 1999). 2. Ibid. 3. h i d . 4. J Bietz, “Developing behavioral objectives for penoperative staff development,” AORN Journal 64 (July 1996) 87-95.
members receive half-price applications for their chapters. KAREN RUSTERMIER RN, BSN, CNOR CONTINUINGEDUCATION APPROVAL COMMIITEE
5. K Rustermier, “CEAC provides guidelines for learning objectives,” Inside AORN (October 1993) 2. 6. K Rustermier, “CEAC welcomes new members, explains outline formats,” Inside AORN (MayIJune 1993) L.
7 . K Rustermier, “CEAC explains approval process, welcomes new members,” Inside AORN (MarcWApril 1993) 3.
Children’s Obesity Linked to Parents’ Eating Habits The eating habits of parents may play an important role in the development of obesity in children, according a March 3 , 2000, press release from the American Heart Association. In a study presented at the association’s L. J. Filer, Jr, Third Annual Conference on Atherosclerosis in the Young, researchers examined the eating habits of the parents of 92 children, who were three to five years old at the beginning of the study. Researchers used a standardized questionnaire to assess three factors associated with parents’ eating behaviors: dietary restraint-measured with the dietary restraint scale, which reflects an individual’s conscious efforts to restrict food intake; disinhibited eating-measured with the disinhibition scale, which gauges impulsive eating and the resulting fluctuation in dietary intake and body weight; and self-perceived hunger-measured with the hunger scale, which dqtermines whether a person eats in response to internal or external cues. Parents were divided into three groups for each of the three scales, depending on whether they had high, medium, or low scores on each scale. Researchers then looked at changes in children’s weight and body fat during the next six years.
Researchers found that children whose parents scored highest on either the dietary restraint or disinhibition scales had greater increases in body fat than children whose parents scored lower. Researchers said parents who scored the highest on the dietary restraint scale may exert excessive control over their child’s eating choices, thus suppressing the child’s ability to internally regulate his or her own dietary intake. Children whose parents alternated between dietary restraint and impulse eating gained the most body fat over time, according to the release. Researchers said children often do what they see their parents do, rather than listen to what their parents say. As a result, parents often are unaware that they are passing on their own dietary habits and attitudes to their children. Researchers said this and similar studies may provide a twofold benefit to families: helping children develop health lifestyle behaviors, and motivating parents to change some of their own unhealthy habits. Your Kids Are What You Eat (press release, Son Diego: American Heati Association, March 3, 2000) 1-2. Available from hftp:/Zmwamericanheati.org/Whots-News/ AHA- News- Releases/O3-03-00~2-comment. html. Accessed 6 March 2000.
885 AORN JOURNAL
The educational activity
approval process ou have been given the responsibility of planning continuing education activities. You probably are excited and honored to have been selected by your peers for this important duty. I was when I was elected vice president of my local chapter several years ago. In our chapter, the vice president also chairs the education committee. I began planning the six continuing education activities that my chapter provides each year. As we offer continuing education at each business meeting, I also was responsible for sending out meeting notices. The easy part was finding a suitable restaurant in a central location and choosing a menu that was reasonably priced. The meat of the process, however, was choosing topics and finding speakers. I began by surveying our membership, and the person who previously had served as vice president gave me all her records. When I looked through the records, I discovered that you have to prepare an application to obtain approval from AORN to award contact hours. I called the Center for Perioperative Education to ask for necessary forms. When they amved, I quickly completed six sets, sent them, and waited for my approval notices. When the notices arrived, none of them was approved. I panicked. I called the person who oversaw the review process at Headquarters numerous times, reworked my applications, and eventually got the first three
applications approved. After speaking with me so many times, the Headquarters staff member suggested I might benefit from attending a threeday seminar AORN was offering, titled “OR Education Design: New Dimensions in Practice.” I signed up and went. What an eye opener those three days were for me. I learned about a needs assessment, the development of learning objectives, and various presentation styles. I also learned that all this information is available in the Chapter Resource Manual, which I had never seen. After the three-day seminar, I was ready to go home and complete my assignment. I re-sent the three remaining applications, and they were approved. After this experience, the staff member suggested that I consider serving on the Continuing Education Approval Committee (CEAC). I completed a willingness-to-serve form and was selected. Serving on CEAC as a reviewer and as cochair was very rewarding. After serving on another committee, I am once again serving as a CEAC reviewer. This article explains what CEAC is about, discusses some of the most frequent factors that cause applications to be reworked or denied, and provides tips for success in the application process. CONTINUING EDUCATION AORN, along with other specialty nursing organizations and state nursing associations, is given 882 AORN JOURNAL
the authority to approve continuing education from the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation, which is a subsidiary of the American Nurses Association (ANA). Specific guidelines set by ANCC must be followed in the approval process. The ANCC conducts periodic surveys, and compliance with guidelines is required for renewal of approver status.
CEAC believes that continuing education activities are a vehicle through which registered nurses may develop, maintain, and enhance the competence required in their practice. CEAC believes the peer review approval process is the most appropriate mechanism for assuring educational accountability. Participation in continuing education activities maximizes the nurserspotential for promoting and improving health. The approval unit believes that professionalism and the advancement of nursing is fostered through participation in the approval process.‘ The purpose of CEAC is to “maintain the AORN Continuing Education approval process that is consistent with ANCC established guidelines.”’ The CEAC goals include developing and implementing
APRIL 2000, VOL 71, NO 4
Table 1 SAMPLE ACTIVITY DOCUMENTATION FORM
Objective
Content
1 . Compare leaders to managers.
1 . a. Leaders Interpersonal process Group interaction Development Characteristics
Time frame
Faculty
Teaching method
1 . 15 minutes
Name, RN, CNOR
Discussion Handouts Slides Question and answer
2. 10 minutes
Name, RN, CNOR
Discussion Handouts Slides Question and answer
b. Managers Assignment Designated responsibility Roles Job description 2. Discuss the three dimensions of management.
2. a.Jab
b. Mission c. Relationships
Note: 50 minutes of content equal one contact hour. Question and answer time and evaluation time are included in the calculated time.
continuing education guidelines consistent with ANCC criteria, providing a timely peer review of applications and granting continuing education approval, educating applicants while they prepare an application for approval, using quality assurance and quality improvement results to respond to applicant needs.’ Approval of educational activities is restricted to continuing education rather than inservice education. Inservice education is defied as education consisting of educational activities intended to help professional nurses acquire, maintain, andlor increase competence in fulfilling nursing responsibilities specific to the expectations of an employer of nursing (eg, cardiopulmonary resuscitation, fire/ safety.) Continuing education is defined as educational activities intended to build on the educational and experiential bases
of professional nurses for the enhancement of practice, education, administration, research, or theory development: There are a few regulations that must be adhered to strictly, including the following. Nonnurses may not address nursing care. No application will be considered after an activity has been given. No commercial product can be endorsed. Activities that are cosponsored must include a letter delineating responsibility. The CEAC consists of two peer review teams. Each team member must be a current member of AORN and hold a bachelor of science degree in nursing. Members also must have knowledge of the educational needs of perioperative nurses and some experience in planning, implementing, and evaluating educational activities. 883 AORN JOURNAL
When receiving an application from a member or constituent, the coordinator sends copies of that application to two reviewers. When the reviews have been completed, the committee chair compares the reviews. If a differing status has been assigned by the two reviewers, the chair reviews the application and finalizes the approval status of the application. Those reviews are forwarded to AORN, and letters are sent to the applicant advising him or her of the approval status of the application. Consultation with the chair or Headquarters staff consultant may be necessary to assist the applicant. An application may be approved, approved with conditions, pended, or denied. Last year, 45% of applications were approved on first submission, 13%were approved with conditions, and 42% were pended. Approved means that an activity may be presented and contact
APRIL 2000, VOL 7 I , NO 4
hours may be awarded. Approved with conditions means that an activity may be presented and contact hours may be awarded provided that the requested changes are made and documentation is sent with the postactivity report. Pended means that the activity may not be given nor may contact hours be awarded until the necessary changes are made, documentation of said changes are sent to CEAC, and approval from CEAC is obtained. Denied means that the activity may not be presented nor contact hours awarded. Denial rarely occurs. Only subjects that are not appropriate for continuing education in nursing are denied. Although any portion of the application process may present a problem, the three most common
areas that cause applications to be approved with conditions or pended include I certificate of attendance (20%), m objectives/content (2 1 %), and biographical data forms (22%). The certificate of attendance is the documented proof of participation in an educational activity. The problems that most commonly are found in the completion of the certificate include the following. The name of the applicant is omitted. Contact hours are recorded incorrectly or omitted. The authorizing person's signature is omitted. I The address of the person authorizing contact hours is omitted. The activity documentation
Table 2 EXAMPLE OF EDUCATION AND QUALIFICATION SECTIONS
Institution (Name, city, state)
Major area of study
Year degree awarded
1. Diploma
Bryan Memorial Hospital School of Nursing Lincoln, Neb
Nursing
1971
2. Bachelor of science in nursing
Clarkson College Omaha
Nursing
1989
Degree
Note; This includes only higher education. If mere has been none simply state 'hone."
Qualifications
I have participated in planning educational offerings for my chapter in the past. I am a member of the workshop planning committee and am serving as the planning chair for this activity. I have also completed the course "OR Education Design: New Dimensions in Practice." Note: This statement refers to my qualification regarding planning an educationa1 activi!y. (A speaker's statement may state that the speaker is an expert in the subject matter and has spoken extensively on this matter. If it is your first attempt at planning an activity or it is the speaker's first presentation, simply state this.) 884 AORN JOURNAL
form often presents the greatest difficulty to applicants. The form includes five columns, of which the f i s t is objectives. The instructions include direction in the formation of behavioral learning objectives. The objectives must be expressed in measurable terms, specify one outcome per objective, and relate to the overall purpose and goals. Behavioral objectives describe the behavior to be evaluated and the content that will be presented. Each objective also must have representative content that is related directly to it. Each objective and its corresponding content must have a designated time frame sufficient to achieve the objective. The faculty and teaching method(s) also must be listed. Table 1 shows an example of an activity documentation form. Biographical data forms must be included for the planning and administrative chairs and any presenter. Areas of concern include education and qualification sections. Table 2 shows an example of correctly completed education and qualification sections. The CEAC reviews approximately 700 applications per year. One hundred fifty of our 300 chapters use this service. The application process has been streamlined greatly since I initidly was exposed to it. A checklist format is used for the majority of the planning checklist. This member service is very cost-effective for most of our members. State nursing associations generally charge much higher rates to approve activities. The fee structure also has been streamlined to assist smaller chapters whose budgets may not allow for higher fees.
APRIL 2000, VOL 7 1, NO 4
Individuals who are interested in serving on CEAC should obtain a willingness-to-serve form from the credentialing coordinator and return it. Members are appointed in
December each year and begin their terms (ie, two years) at the close of Congress the following spring. An orientation meeting is held in Denver after appointments. Those serving as CEAC
NOTES 1. AORN Approval Unit Philosophy, Purpose and Goals, Policies and Procedures 199912000 (Denver: Association of Operating Room Nurses, 1999). 2. Ibid. 3. h i d . 4. J Bietz, “Developing behavioral objectives for penoperative staff development,” AORN Journal 64 (July 1996) 87-95.
members receive half-price applications for their chapters. KAREN RUSTERMIER RN, BSN, CNOR CONTINUINGEDUCATION APPROVAL COMMIITEE
5. K Rustermier, “CEAC provides guidelines for learning objectives,” Inside AORN (October 1993) 2. 6. K Rustermier, “CEAC welcomes new members, explains outline formats,” Inside AORN (MayIJune 1993) L.
7 . K Rustermier, “CEAC explains approval process, welcomes new members,” Inside AORN (MarcWApril 1993) 3.
Children’s Obesity Linked to Parents’ Eating Habits The eating habits of parents may play an important role in the development of obesity in children, according a March 3 , 2000, press release from the American Heart Association. In a study presented at the association’s L. J. Filer, Jr, Third Annual Conference on Atherosclerosis in the Young, researchers examined the eating habits of the parents of 92 children, who were three to five years old at the beginning of the study. Researchers used a standardized questionnaire to assess three factors associated with parents’ eating behaviors: dietary restraint-measured with the dietary restraint scale, which reflects an individual’s conscious efforts to restrict food intake; disinhibited eating-measured with the disinhibition scale, which gauges impulsive eating and the resulting fluctuation in dietary intake and body weight; and self-perceived hunger-measured with the hunger scale, which dqtermines whether a person eats in response to internal or external cues. Parents were divided into three groups for each of the three scales, depending on whether they had high, medium, or low scores on each scale. Researchers then looked at changes in children’s weight and body fat during the next six years.
Researchers found that children whose parents scored highest on either the dietary restraint or disinhibition scales had greater increases in body fat than children whose parents scored lower. Researchers said parents who scored the highest on the dietary restraint scale may exert excessive control over their child’s eating choices, thus suppressing the child’s ability to internally regulate his or her own dietary intake. Children whose parents alternated between dietary restraint and impulse eating gained the most body fat over time, according to the release. Researchers said children often do what they see their parents do, rather than listen to what their parents say. As a result, parents often are unaware that they are passing on their own dietary habits and attitudes to their children. Researchers said this and similar studies may provide a twofold benefit to families: helping children develop health lifestyle behaviors, and motivating parents to change some of their own unhealthy habits. Your Kids Are What You Eat (press release, Son Diego: American Heati Association, March 3, 2000) 1-2. Available from hftp:/Zmwamericanheati.org/Whots-News/ AHA- News- Releases/O3-03-00~2-comment. html. Accessed 6 March 2000.
885 AORN JOURNAL