Enduring Material

Enduring material is a non-live CME activity that "endures" over time. Typically, an enduring material is a printed, recorded, and/or an online interactive educational module that may be used over time at various locations, and that in themselves constitute a structured CME activity. It is "enduring," meaning that the CME activity doesn't have a specific time or location designated for participation. Rather, the learner determines where and when to complete the activity.

Enduring materials must comply with all ACCME Essential Areas and Elements including the Standards for Commercial Support and Accreditation Policies. However, there are specific communication requirements for enduring materials because of the nature of the activities.

For CME activities, including those in which the learner participates electronically (e.g., via Internet, CDROM, satellite broadcast), all required ACCME information must be transmitted to the learner prior to the learner beginning the CME activity.

Providers that produce enduring materials must review each enduring material at least once every three years or more frequently if indicated by new scientific developments. So, while providers can review and re-release enduring material every three years (or more frequently), the enduring material cannot be certified for credit for more than three years without some review on the part of the provider to ensure that the content is still up-to-date and accurate. That review date must be included on the enduring material, along with the original release date and a termination date.

Accredited providers may not enlist the assistance of commercial interests to provide or distribute enduring materials to learners.

ACCME policy does not require 'post-tests' for enduring materials. ACCME records retention policies do, however, require participants to verify learner participation and evaluate all CME activities.

Sometimes providers will create enduring material from a live CME activity. When this occurs, ACCME considers the provider to have created two separate activities – one live activity and one enduring material activity. Both activities must comply with all ACCME requirements, and the enduring material activity must comply additionally with all ACCME policies that relate specifically to enduring materials.

In addition to the application requirements, enduring material activities must also adhere to the following requirements:

Prior to starting the educational activity, participants must be aware of the following information:

  • The principal faculty and their credentials,
  • the medium or combination of media used,
  • the method of physician participation in the learning process,
  • the estimated time to complete the educational activity (same as number of designated credit hours),
  • the dates of the original release and most recent review or update, and
  • the termination date (date after which enduring material is no longer certified for credit).

Effective July 1, 2011

In addition to providing clear instructions to the learner on how to successfully complete the activity, an enduring material must include:

  • An assessment of the learner that measures achievement of the educational purpose and/or objectives of the activity with an established minimum performance level; examples include, but are not limited to, a post-test, and/or application of new concepts in response to simulated problems.
  • Communication to the participant the minimum performance level that must be demonstrated in the assessment in order to successfully complete the activity.
  • Access to appropriate bibliographic sources to allow for further study.

Regarding Commercial Support

  • The material must not contain any product-specific advertising.
  • The program must acknowledge any commercial support, but only at the beginning of the program.
  • Acknowledgement of commercial support may include the name, mission, and areas of clinical involvement of the company or institution, and may include corporate logos and slogans, if they are not product promotional in nature.
  • No brand names or product-group messages may be used in the acknowledgement, even if they are not related to the topic of the enduring material.

Commercial interests (e.g., pharmaceutical companies and medical device manufacturers) may not provide or distribute any enduring materials.

Remember, programs must verify learner participation and evaluate any enduring material-driven CME activity.