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ACCME Criteria Review: Designed to Change

Whether you are an accredited provider such as i3 Health or you are an educational partner working with an accredited provider, it's still important to understand the criteria that underly continuing medical education (CME) activities. This is part of a periodic series of posts looking at what each criterion means in general and what it might mean for you.

We've covered the three criteria included in the CME Mission and Program Improvement group. Today we move to the criteria about Educational Planning and Evaluation. If you are not working in an accredited program, you'll likely find these criteria to be more relevant to your work than the previous ones. Prior to the reorganization of the Accreditation Council for Continuing Medical Education (ACCME's) criteria, Educational Needs was Criterion 2 (C2). You can find a post about that criterion here.

Educational Needs is about the reason education is needed: some gap in knowledge, competence, or performance. The next step is to identify the goals of the activity. What is the activity Designed to Change (formerly Criterion 3)?

This criterion states:

The provider generates activities/educational interventions that are designed to change competence, performance, or patient outcomes as described in its mission statement.

While specific learning objectives may be written at this stage of the planning process, this criterion is a reminder of the broader scope of those objectives. Once those objectives are met, what will happen when a learner goes back to their office and patients? While there are multiple levels of outcomes that can be achieved, the ACCME requires at least one of the following three be met:

  • 1.) Competence: Does the learner have new skills and/or strategies that they can use outside of the classroom?
  • 2.) Performance: Does the learner use the skills and/or strategies they gained in the educational activity?
  • 3.) Patient Outcomes: Has the use of the skills and/or strategies taught in the activity improved patient outcomes?

It is important to remember that these are not specific objectives. You should be able to summarize the larger goal of the activity in 50 words. So while you may have a dozen objectives for a large conference, what the conference is Designed to Change summarizes the broader goal that those objectives cover.


  • 1.) Competence: Learners will have motivational interviewing skills to use with their patients
  • 2.) Performance: All patients will be screened using a new suicide prevention checklist
  • 3.) Patient Outcomes: There will be a reduction in severe complications due to delayed treatment when a patient presents in the emergency department

You can see how these examples relate back to the educational needs and practice gaps that should already have been identified. You can also see how this relates back to the mission statement. What an activity is designed to change should fit within the mission statement and it should build on the educational needs.

You now know what the problem is that needs to be addressed (Educational Needs) and what the goal of the intervention is (Designed to Change). The next thing to do is to choose the right format to create the desired changes. But that's the next criterion, so that will be the next post in this series.

Other Posts in This Series CME Mission and Program Improvement Educational Planning and Evaluation Reference

ACCME (2020). Accreditation Criteria. Available at: 

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