What: Individuals involved in the course planning and delivery must disclose their relevant financial or nonfinancial relationship(s) ( see 3.2 a)
Who: Individuals involved in course planning and delivery
When: Prior to and during course planning and prior to course delivery
How: Individuals involved in course planning and delivery complete the provider-supplied disclosure form and inform the ASHA Approved CE Provider of relationships that have developed at any time during the planning and prior to delivery of a CE course.
3.2 The Provider must have a written process [PDF] in place to (1) identify relevant conflicts of interest, (2) determine if the existence of those conflicts of interest disqualifies an individual from being involved in the course planning and delivery, and (3) disclose conflicts of interest to learners. Conflicts of interest in continuing education arise when financial and/or nonfinancial considerations, relevant to the course content, compromise or have the potential to compromise professional judgment.
3.2.a The Provider must document that each individual developing and/or delivering course content has disclosed, prior to and during course planning, all existing and relevant financial and nonfinancial relationships.
3.2.b The Provider must have a process to identify relevant financial and nonfinancial relationships that have developed after course planning and prior to course delivery.
3.2.c Any individual involved in developing and/or delivering course content who refuses to disclose relevant financial and nonfinancial relationships will be disqualified and cannot have control of, or responsibility for, the planning, management, presentation, or evaluation of the CE course.
3.2.d The Provider must have a process to determine whether relevant conflicts of interest disqualify the individual from participation in course planning and/or delivery or if the conflicts may be resolved through disclosure.
3.2.e The Provider must have a process for disclosing relevant conflicts of interest for all instructional personnel.
3.2.g The Provider must ensure that the following information is disclosed to learners:
ASHA Approved CE Providers must have a written process in place to
Providers with an existing COI process should review Required Practice (3.2) to confirm that the process is compliant with the Requirement. ASHA CE has created a sample process [PDF] that providers may use as a starting point for the organization's process or simply personalize and begin using.
Below are sample disclosure forms that ASHA Approved CE Providers may use as the basis for the development of a Provider-specific disclosure form. These forms are provided as a guidance and may be modified as desired by the ASHA Approved CE Provider.
What: Learners must be informed of the instructional personnel's relevant financial or nonfinancial relationship(s) ( see 3.2 f)
Who: ASHA Approved CE Provider
When: Prior to the course and at the start of the course
How: State in all promotional efforts and at the start of the course the following:
Example of relevant financial relationship(s) and relevant nonfinancial relationship(s) statement
Dr. Wadelmann, Cognitive Rehabilitation After Traumatic Brain Injury, employed by University of Malibu Health Science Center
Financial—Author for ABC SLP Publishers and receives royalty payments.
Nonfinancial—Board of directors: Association for Traumatic Brain Injury Specialist. Receives no compensation as member of board of directors.
View more information on disclosing in CE course promotion materials and at the start of speaker presentations.
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:
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?
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.
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
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.
What are the three things that have to be disclosed about a 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.
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.
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. See sample form [DOC] for multiple accreditors.
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