FAQs About Requirement 3 for CE Providers: Instructional Personnel and Planner Disclosure Questions (Required Practice 3.2)
How to Manage the Disclosure Process
Who Has to Disclose
What to Disclose
What Might Disqualify Instructional Personnel
Disclosing to Learners
How to Manage the Disclosure Process
How should the Continuing Education Administrator work with the cooperative organization to ensure that they comply with the instructional personnel disclosure process according to Requirement 3?
A cooperative CE course is defined as one offered jointly by an ASHA Approved CE Provider and an organization that is not an ASHA Approved CE Provider (aka cooperative organization). The cooperative organization must contact an ASHA Approved CE Provider before course development begins. The ASHA Approved CE Provider must be actively involved in planning, promoting, implementing, evaluating, and reporting the course. ASHA has a cooperative offering model policy and agreement that may be used to define the roles and responsibilities of the Provider and the cooperative organization.
The ASHA Approved CE Provider must oversee the identification, resolution, and disclosure of relevant financial and nonfinancial relationships and work with the non-Provider co-op party to do this for all instructional personnel and planners. The process developed by the ASHA Approved CE Provider should be the process used with the Provider's CE courses as well as co-op courses.
The ASHA Approved CE Provider should send the cooperative organization the Guidelines for Cooperative Courses developed by ASHA CE. This document details all of the steps (including disclosure) necessary to plan and implement a course in accordance with Continuing Education Board requirements.
How can my organization review the disclosures of instructional personnel for events with hundreds or even thousands of instructional personnel? We don't have the resources to engage in guided discussions with all instructional personnel.
One option is to train and then deputize the individuals responsible for vetting papers to also review instructional personnel disclosures. The reviewers could either notify the Provider when they believe a discussion with the instructional personnel is needed or, with appropriate training, conduct the discussions themselves. Either way, having the reviewers familiar with and responsible for reviewing the disclosure statements will give you additional resources.
In addition to the required review of disclosures during course planning, consider asking learners to evaluate the degree to which they perceived that instructional personnel had, but did not disclose, relevant relationships. Though this information is gathered after the event, you would know if there were instructional personnel that next year might need some extra attention in terms of disclosing.
Some accreditors ask instructional personnel to identify conflicts of interest, whereas ASHA asks for identification of relevant financial and nonfinancial relationships. If we are accredited by multiple organizations and are offering a course to multiple disciplines, how do we meet differing instructional personnel disclosure requirements?
You might create a disclosure form that captures all of the disclosure information that each accreditor requires. The disclosure form could include sections for each accreditor (e.g., ACCME, ACPE, ANCC, ASHA, etc.). Instruct individuals completing the form to complete only those disclosure sections related to the types of credit (e.g., ASHA CEUs, CMEs, CNEs, etc.) to be offered for the course.
From the information provided, develop a statement or slide that incorporates all of the disclosed information to be presented prior to the start of the course.
When is bias relevant?
All of us have biases. In the spirit of being open and transparent, if a presenter has a bias that pertains to the information presented in the course, it should be disclosed. When learners have this information about the presenter, they have a better understanding of the presenter's perspective on the information being presented.
What is a guided discussion? Should I have guided discussions with all instructional personnel?
In a guided discussion, you'll want to:
- ask questions about instructional personnel's relevant relationships based on his/her disclosure form, biography, and the course's learning outcomes;
- listen to the instructional personnel's reactions to your questions;
- dialogue with the instructional personnel based on the objective information and the individual's explanation of the relevant relationships;
- agree on which relationships are relevant and those that are not and determine where disclosure is sufficient or that other mechanisms need to be used to manage significant conflicts.
Guided discussion with instructional personnel is highly recommended. The guided discussion helps the individual to identify financial and nonfinancial relationships that he/she didn't remember or think of when completing the disclosure form.
What constitutes a relevant financial relationship? If, for example, a presenter wrote a book 15 years ago on phonetics and now discusses phonetics, is that relevant?
If the book is still for sale and the presenter receives any financial or nonfinancial benefit and the content of the course pertains to information in the book, it is best to disclose that. If the presenter discloses this situation to the Provider, then the presenter and provider can discuss whether the situation is relevant and needs to be disclosed to learners.
What are some examples of relevant nonfinancial relationships that planners and instructional personnel should disclose to the ASHA Approved CE Provider?
- Personal: The individual has a personal friendship with someone in the company whose products are discussed in the course; the individual has a family member or friend with a disorder that will be talked about in the course
- Professional: The individual is a member of an association or group that is talked about or referenced in the course; the individual has a professional bias about a way to deliver a particular service; he or she is employed by a company who is the ASHA Approved CE Provider of the course
- Political: The individual has a political bias about a topic (e.g., health care reform) and his or her bias is toward supporting a particular party's position on this issue
- Institutional: The individual is affiliated with an institution or organization (e.g., serves on a committee or board of that organization); the person is a member of that organization or gives money to its causes
- Religious: The individual has a bias based on religious tenets (e.g., a bias toward service delivery at end of life based on religious beliefs).
Who Has to Disclose
Do members of the program planning committee have to complete a disclosure form at every meeting to plan that same course?
At the initial planning meeting, all program planning committee members must complete a disclosure form. At subsequent meetings, the Provider should ask committee members if they have any new, relevant financial or nonfinancial relationships since initial or subsequent disclosures. The Provider follows its procedure for reviewing those new relationships and determines if the planning committee member can continue to be involved or needs to recuse himself or herself.
Why is it necessary for each course to have a speaker disclosure and, when appropriate, content disclosure?
It's necessary to ask instructional personnel to provide disclosure information for every course because relevant financial and nonfinancial relationships may differ depending on the focus of the presentation. For example, a speaker's relevant relationships for a presentation on assistive listening devices may be different from his/her relevant relationships for a presentation on auditory training techniques.
The Provider must disclose prior to the course (we recommend in promotional efforts) that content is focused on a specific product or service and will not include information on similar or like products/services. Using the example of assistive listening devices, if the speaker is going to focus on one particular device or the products of one particular device manufacturer, the speaker must disclose this fact to the CE Provider and the Provider, in turn, must disclose the course's singular focus to learners.
Course content disclosure is required, and it is also helpful to potential participants who are making decisions about attending a course. For example, participants interested in a particular device or brand would be interested in the speaker's knowledge of and clinical skills with that device/brand. Different speaker experience/skills would be of interest to participants seeking an overview of all devices in a particular category.
More information on instructional personnel disclosure.
For more information on course content disclosure.
Is it necessary to get a disclosure form from a presenter each and every time the individual presents the same course on multiple dates in multiple locations?
The individual should complete a disclosure form prior to the Provider's confirming that the individual will be the presenter. Prior to each subsequent course offering presentation, the Provider should contact the presenter to determine if she or he has new, relevant financial or nonfinancial relationships since the initial disclosure was completed. If so, the presenter should revise the disclosure form information and the Provider should determine whether the new information disqualifies the individual from presenting the course. Disclosures made to attendees may need to be revised as well.
We have a pool of individuals who create and present courses throughout the year. Must they complete a disclosure form for each course they work on?
All planners and instructional personnel must complete a disclosure form each time he or she participates in the development of a course, so that the Provider can identify financial or nonfinancial relationships that are relevant to that particular course content.
Do employee-presenters need to complete a disclosure form, and does the provider have to disclose to participants that the presenter received a stipend?
All planners and presenters, even if they are employees, must go through the disclosure process (filing out a form, CEA reviewing, and resolving conflicts, etc.). Presenter disclosure information must be made prior to the course and at the course. As part of the presenter's disclosure, he or she would disclose receipt of financial compensation for the preparation and presentation of the course and from whom. They should also disclose any other financial or nonfinancial information relevant to the course content.
What to Disclose
What are the three things that have to be disclosed about a course?
- If a course focuses on one product or service that fact must be disclosed prior to the course.
- Instructional personnel must make a disclosure that includes any and all of his or her financial and nonfinancial relationships—or lack thereof—to the course content. The disclosure must be made available to potential attendees prior to the course and to attendees at the beginning of the course.
- If financial or in-kind support is received for the course from an entity other than the CE Provider that fact must be disclosed prior to the course.
We use CE presentations as a tool for recruiting new employees (free course for 1 or 2 hours in a local market with associated CE). The speaker is typically an employee of our company. What are we required to disclose, given that we obviously benefit from people coming to these courses?
Requirement 3 is all about openness and transparency. It is important to be transparent in marketing the course; the Provider should reveal the intention to interest attendees in employment with the company. Also, it is important to disclose that the speaker is an employee and has a financial and perhaps a nonfinancial relationship with the company. If the course is offered for ASHA CEUs, course content must pertain to the science or practice of the professions of audiology or speech-language pathology and not to marketing the company or promoting employment benefits.
Would an organization that is also an ASHA Approved CE Provider need to disclose a stipend given to an organization's employee who develops and presents a CE course?
Yes. That employee has a financial relationship with the organization, so that needs to be disclosed. The employee likely has a nonfinancial relationship as well, and that needs to be disclosed. The nonfinancial relationship might be an allegiance to that organization or a personal or professional bias toward that organization's products and services.
What has to be disclosed about a nonfinancial relationship?
Planners and instructional personnel should think about the course content they are presenting and then determine if they have any personal, professional, political, institutional, religious, or other relationship(s) that needs to be disclosed. The planners and instructional personnel must disclose all nonfinancial relationships related to course content to the Provider. The Provider will determine through a guided discussion with the planners and instructional personnel if anything they disclosed cannot be resolved through disclosure to the attendees. Nonfinancial relationships must be disclosed during promotional efforts about the course and prior to the beginning of the course. If there are no nonfinancial relationships, this must be disclosed as well.
Does every relevant nonfinancial relationship need to be disclosed by an instructor?
Instructor disclosure statements are intended to inform course participants of the relevant relationships that could influence the information presented in the course. Disclosure is not intended to reveal every financial and nonfinancial relationship the instructor has listed on his/her resume. It is not an opportunity for instructors to promote every achievement, award, grant, appointment, and recognition they have received in their respective careers. Only the instructor's nonfinancial relationships that pertain to the course content are considered relevant and must be disclosed in promotional efforts about the course and prior to the beginning of the course.
For example, let's say the instructor is giving a presentation at a course about pediatric hearing screenings in the school-age population. That instructor has a voluntary position on the Board of Directors for the Educational Audiology Association (EAA) and receives no compensation for participating on the board. This would be considered a relevant nonfinancial relationship and should be disclosed. If the instructor also has a voluntary position on the Board of Directors for the American Geriatrics Society (AGS), this relationship is not relevant and, hence, would not be disclosed. If that same instructor is giving a presentation on progressive hearing loss in the geriatric population, the position on the EAA Board would not be disclosed.
What Might Disqualify Instructional Personnel
Is failure to return or provide disclosure information the same as refusal to disclose?
Yes. Planners or instructional personnel who fail to submit disclosure information cannot be involved in the planning or presentation of the course.
What if a person is asked to speak at the last minute and, on arrival, he or she refuses to disclose relationship information?
All instructional personnel must disclose relationship information to the Provider prior to being accepted to present. Even if arrangements are made within a short time period, the disclosure process must be followed. If the presenter made disclosure information available to the Provider, but then at the course refuses to disclose the necessary information, he or she should not be allowed to present.
What if the presenter works for the equipment manufacturer? Does this mean we can't have them make presentations?
Employees of companies that sell products or services can be presenters as long as they meet the requirements and follow the Provider's processes for disclosure and appropriate course content. Course content must focus on the science or practice of the professions of audiology and speech-language pathology and not on the marketing or sale of products or services.
What would disqualify an individual from course planning or delivery?
Failure to disclose disqualifies someone from being considered as a planner or presenter. Once someone discloses, the Provider determines what steps to take to qualify or disqualify the person. Disqualification might depend on the nature of the course content, the relationship the planners and instructional personnel have to the Provider organization, and the relationships they disclose on their forms. Each situation is different. For example, a Provider might disqualify someone if that individual has a strong relationship with a competitor.
Disclosing to Learners
Why do speakers have to say they have no relevant financial and no relevant nonfinancial relationships?
This helps the learner distinguish between disclosure information that is missing and circumstances where there is nothing to disclose.
Are we required to have instructional personnel disclosures printed and distributed on-site to individuals attending face-to-face courses?
No, you are not required to distribute printed instructional personnel disclosures onsite. However, it is required that all instructional personnel make a disclosure statement revealing relevant financial and relevant nonfinancial relationships, or lack thereof, at the start of a course. Even if instructional personnel have no financial or no nonfinancial relationships to disclose they must still make a disclosure statement.
The preferred way is to make the instructional personnel disclosure orally at the start of the course and accompany the statement with a slide, handout, or similar written form stating the same information.
Don't forget to check in with the presenter a month or so prior to the presentation to see if there have been any changes in his/her relevant relationships. If so, you may need to update the disclosure statement in the slide, handout, or other written document.
More information about the format for instructional personnel disclosure statements.
How does a Provider make participants aware of relationships (financial/nonfinancial) prior to the course? Printing becomes cost prohibitive if you have several speakers for an offering. Can we indicate with an asterisk that presenters have a conflict of interest? Or does the disclosure have to be specific?
All presenters must disclose whether they have relevant financial relationship(s) or not and whether they have a relevant nonfinancial relationship(s) or not. So there must be a disclosure for all instructional personnel. Disclosure information at the course can be presented verbally and on slides or handouts. Disclosure information made available to attendees prior to their attending the course should be in a format and delivery mechanism that is easy to locate and access.
The intent of the requirement to have disclosure information available prior to attendees going to the course so they can make an informed decision about their attendance. Potential attendees should not be inconvenienced and have to go several places to search for disclosure information. Ideally, it should be located in the same place with information about the course and course registration. If course promotional information is provided in a printed format, then it makes sense to make disclosure information available in the print format. If course information is available via a web-based format, then disclosure information should be available in that format.
In addition to oral disclosure at the start of a course, are we required to provide in written form content disclosure, instructional personnel disclosure, and disclosure of financial and in-kind support for the course?
No, the Required Practice doesn't mandate both written and oral disclosure at the start of the course.
Can we put our conflict of interest policy and speaker disclosure forms on our website instead of handing them out at the course?
The disclosure forms themselves are for the planners and speakers to complete and submit to the Provider. The Provider uses information on the forms to identify relevant financial and nonfinancial relationships that need to be discussed with the planner and speaker. The information on the disclosure forms serves as a basis to craft the disclosure statements about speakers that will appear in the Provider's promotional materials prior to the course and for speaker disclosure at the course. It's probably not appropriate to put copies of forms completed by the planners or instructional personnel on the Provider's public website. But posting disclosure statements of instructional personnel on the website could be appropriate if it's an easy way to communicate that information to potential attendees of the course. The organization's conflict of interest policy can be on its website or handed out on request. A copy of the speaker disclosure form template can be posted there as well for potential speakers and planners to access and complete.