Over the years that I have been in the field of health care continuing education, our profession has evolved. We are working to make it truly a profession. But one thing we are still working on is our language. What is a learner? What is an attendee? Is there a difference? Should there be a difference? Different programs use different terms. One program may make a distinction between terms while another program uses them synonymously. This makes studying the impact of our field difficult. If we can't agree on the right words to use, then we can't compare programs or aggregate data from multiple programs. Unfortunately, I can't tell you what the difference is between these sorts of terms, at least not yet. Volunteers at the national level are working on creating new guidelines and new glossaries, and I will share those with you as soon as they are available. But there are some common terms that are well-defined, so if you are new to the world of healthcare CE or just need a refresher, here is a primer of some terms that do have agreed-upon definitions. There's a link to a much longer glossary in the references, but these are the most relevant to the world of joint providership. (Yes, that's defined below.)

Names for Organizations and Relationships Between Organizations

Accreditor: The organization that approves other organizations for CE credit. i3 Health is accredited by the ACCME, the ANCC, and the California Board of Registered Nursing. They are our accreditors.

Accredited Provider: An organization that is approved to provide CE credit. i3 Health is an accredited provider of both CME and NCPD credits.

Co-Provided Activity: An activity created by two or more accredited providers. If you are accredited by the ACCME and/or the ANCC and wish to partner with i3 Health, the activity will be co-provided by your organization and ours.

Directly Provided Activity: An activity created by a single accredited provider without the partnership of another organization.

Jointly Provided Activity: An activity created by one accredited provider and one or more organization that is not accredited. Joint providership is most likely the relationship you will have with i3 Health as we work together to create new activities.

Terms Related to Activities

Accreditation Statement: The specific language required by an accreditor to tell learners that an organization is accredited.

Activity: A single educational offering or series of educational offerings.We avoid the word program for a single course because "program" has its own definition in our world.

AMA Credit Designation Statement: The statement of how many credits an activity has been certified for. The AMA is very strict in the language and formatting of this statement, so make sure that any of your promotional materials, handouts, websites, etc. use the statement exactly as it has been provided to you.

Course: Live in-person activities that are individual events. These are typically one-time events such as annual conferences.

Enduring Material or Internet Enduring Material: An activity that can be accessed over an extended period of time whenever a learner chooses. Many online educational activities include an enduring component because frequently live online activities are recorded and made available after the fact. If that recording is certified for credit, it becomes an enduring material.

Hours of Instruction: The number of hours of education. A long conference will include breaks and meals. Because education is not occurring during those times, they are not counted toward the number of hours of instruction. The number is determined based only on the time spent in educational sessions.

Internet Live Activity: A course, only online. Learners must attend virtually at a specific time.These are frequently recorded and turned into enduring materials.

Live Activity: An activity that must be attended at a specific time, be it in person or virtually.Courses, Regularly Scheduled Series, and Internet Live Activities are all examples of live activities.

Program: Everything an accredited provider does. This includes every activity a provider has certified. This is why we avoid using the word "program" when referring to individual activities.

Regularly Scheduled Series: A course with multiple sessions of related content, with the anticipation of the same basic audience for each session. The most common RSSs are grand rounds, tumor boards, and morbidity and mortality conferences. If the same content is being presented to multiple audiences, the activity is a course and not an RSS.

Terms Related to Funding

Advertising and Exhibits: These are promotional activities that are completely separate from any educational activity. They are a different category than commercial support.

Commercial Bias: When the content of activity promotes the products of a specific company.Commercial support does not mean that an activity has a commercial bias, and at the same time, no commercial support does not mean that there is not the potential for commercial bias.

Commercial Interest: There is a very specific definition of "commercial interest." Per the ACCME, a commercial interest is "any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients." This language is required to be included in conflict of interest disclosure forms, which is why it's important to know the exact definition. We generally think of commercial interests as pharmaceutical and medical device companies, and while they can provide grants or purchase advertising or exhibits at conferences, they are not allowed to participate in the educational content or become accredited on their own. Organizations that provide clinical services to patients, including for-profit clinics or labs, are not considered commercial interests.

Commercial Support: Grants or in-kind contributions given by a commercial interest to pay for or support an educational activity. Income received from advertisements and exhibits are not considered commercial support.

Conflict of Interest: Financial relationships that may create an incentive to commercial bias, COI for short. Not all financial relationships create a COI. The relationship needs to be relevant to the activity. Potential COI are identified using a conflict of interest disclosure form and can be resolved using a variety of methods. i3 Health resolves COI by requiring all presentations to undergo peer review and by not allowing planners to have potential COI.

Terms Related to Needs and Outcomes

Competence: Knowing how to implement what has been learned. This does not mean that what's been learned has been implemented. It simply means that learners know how to implement what they learned.

Knowledge: The information learners have. What learners need to know before they can reach competence. Learners can't implement information that they don't have.

Performance: When learners implement what they have learned. Once learners know what they need to do and know how to do what they need to do, they need to actually do it. That last step is what we mean by performance.


ACCME and AMA (2017). Accreditation Council for Continuing Medical Education (ACCME®) and American Medical Association (AMA) Glossary of Terms and Definitions. Available at: https://www.accme.org/sites/default/files/2018-04/011_20170421_Glossary_of_Terms.pdf

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