CRITERIA AND GUIDELINES FOR SERVICE PROVIDERS FEBRUARY 2010

CRITERIA AND GUIDELINES FOR SERVICE PROVIDERS FEBRUARY 2010

GLOSSARY Accreditr: A grup r institutin appinted by a Prfessinal Bard t review and apprve applicatins fr the prvisin f CPD activities (within its prfessin s ambit) by rganizatins and individuals withut accredited service prvider status; t mnitr these activities; and t revise cntinuing educatin units (CEUs) allcated where the prvider failed t cmply with the rules and regulatins f the CPD guidelines. Prfessinal Bards may delegate their respnsibility fr accrediting service prviders t Accreditrs with the mutual agreement f the Accreditr. The criteria and prcesses t be fllwed as well as the prcedures fr recrd keeping are cntained in the Criteria and Guidelines fr Accreditrs dcument. Accredited Service Prviders are the prfessin specific higher educatin institutins and departments, prfessinal assciatins r frmally cnstituted prfessinal interest grups wh meet the specified criteria and have been accredited by the Bard/ r its designated Accreditr t present learning activities fr Cntinuing Prfessinal Develpment. Attendance register is the recrd f attendees at the learning activity reflecting the names, the HPCSA registratin numbers f thse present and their signatures n cmpletin f the activity. This register must be held by the presenting rganisatin r institutin fr three years fllwing the activity; the riginal register may be audited in a cmpliance check. Cntinuing Educatin Units (CEUs) indicate the value attached t a learning activity fr Cntinuing Prfessinal Develpment. Cntinuing Prfessinal Develpment In terms f Sectin 26 f the Health Prfessins Act, 1974 (Act N. 56 f 1974) the HPCSA may frm time t time make rules which prescribe (a) (b) (c) cnditins relating t cntinuing educatin and training t be undergne by persns registered in terms f this Act in rder t retain such registratin; the nature and extent f cntinuing educatin and training t be undergne by persns registered in terms f this Act; and the criteria fr recgnitin by the HPCSA f cntinuing educatin and training curses and educatin institutins ffering such curses. CPD Sectin f the CPD, Registratins and Recrds Department at the HPCSA administers and mnitrs the CPD prcess. Criteria and Guidelines fr Service Prviders details the criteria fr and requirements f Service Prviders; the nature f the learning activities and the CEUs at each level f the hierarchy; the prcess t be fllwed t publicise, present and recrd the activities. Ethics, Human Rights and Medical Law is an understanding f the biethical principles that determine hw health prfessinals perfrm research and interact with patients/clients and sciety and is als described in Chapter I and II f the Cnstitutin. Health care is a cnstantly advancing field and with these advances cnflicts ften arise within the arenas f plitics, law, religin, philsphy and ecnmics. An understanding f biethics helps us t recgnise, admit and smetimes reslve these cnflicts. HPCSA CPD Cmmittee (accuntable t Cuncil) cmprises representatives frm each Prfessinal Bard. Tgether with the Prfessinal Bards, the Cmmittee develps plicy prpsals fr Cntinuing Prfessinal Develpment.

2 Learning activity/ies are the CPD activities fr which Cntinuing Educatin Units are earned. There are three levels f activities: thse with nn-measurable utcmes; thse with measurable utcmes (including educatin, training, research and publicatins); and thse assciated with frmally structured learning prgrammes. Learning Prtfli (Level 3 Activity) is the recrd f a health care prfessinal s learning and self develpment ver time, reflecting the individual s grwth and imprved practice. Natinal Accreditrs Frum is the bdy which has representatives frm amng the Accreditrs, and which meets at least twice a year t deliberate n plicy and issues f cmmn cncern. Feedback is prvided t the HPCSA CPD Cmmittee. Practice Audit invlves a health care prfessinal undertaking a systematic review f aspects f patient care and cmparing these against explicit criteria. Recgnitin f CEUs refers t the fact that if a CPD activity has been accredited by an Accreditr fr a specific Prfessinal Bard, all health care prfessinals may attend that activity if it is relevant t their specific scpe f practice. Health care prfessinals will therefre nt need t apply fr that activity t be re-accredited by their wn Prfessinal Bard in rder t claim the CEUs accrued fr attending that activity. Service Prviders are individuals/institutins/rganisatins/scieties wh are required t submit each f their learning activities t an accreditr fr review and accreditatin prir t presenting the CPD activity.

3 PREAMBLE Ethical practice f the health prfessins requires cnsistent and nging cmmitment frm all cncerned t lifelng learning t update and develp the knwledge, skills and ethical attitudes that underpin cmpetent practice. This perspective prtects the public interest and prmtes the health f all members f the Suth African sciety. Guided by the principle f beneficence, health care prfessinals aspire t standards f excellence in health care prvisin and delivery. The Health Prfessins Act, 1974 (Act N. 56 f 1974) (as amended) endrses Cntinuing Prfessinal Develpment (CPD) as the means fr maintaining and updating prfessinal cmpetence, t ensure that the public interest will always be prmted and prtected, as well as ensuring the best pssible service t the cmmunity. CPD learning activities shuld address the emerging health needs and be relevant t the health pririties f the cuntry. In this spirit f dedicatin t best practice and a desire t act and serve wisely and well, Guidelines fr Service Prviders f cntinuing prfessinal develpment educatin activities were develped CPD prviders are encuraged t ffer learning activities in line with adult educatin principles and greater learner invlvement, with the gal f nt nly acquiring new r updating knwledge, but als f imprving cmpetence and ultimately the perfrmance f the health care prfessinal with an end benefit t the patient/client. The purpse f this dcument is t set ut and describe the qualificatin criteria, rles, respnsibilities and the applicatin prcess fr Service Prviders. Service Prviders There are tw brad categries f service prviders viz. (1) Accredited Service Prviders and (2) Service Prviders. Bth grups f Service prviders ffer CPD learning activities t health care prfessinals. While there are different criteria and applicatin prcesses fr each, there are similar rles and respnsibilities. Accredited Service Prviders are: any ne f the fllwing Tertiary training institutins Prfessinal assciatins Frmally cnstituted prfessinal interest grups that have a prfessinal identity and are aligned with a training institutin, a prfessinal assciatin r an internatinal institutin. Service Prviders are: any ne f the fllwing Organisatins and assciatins as under accredited service prvides, but wh chse nt t apply fr accredited prvider status Individuals Organizatins/Institutins/Scieties such as: public and private hspitals; private nn-prfit grups; cmmercial enterprises r cmpanies that supprt health care prfessinals thrugh prducts r services; schls; nn-gvernment rganisatins Sme f the essential differences between the tw categries relate t: 1. Accreditatin f CPD learning activities Accredited Service Prviders Accredited by the Bard r its designated Accreditr t present an annual prgramme f CPD learning activities. Service Prviders Required t submit each learning activity t an accreditr (appinted by the relevant Prfessinal Bard) fr review and accreditatin prir t presenting the CPD activity

4 2. Accreditatin perid Accredited Service Prviders Accredited Service Prvider status is valid fr ne year Service Prviders Each activity is valid fr the perid indicated by the Accreditr 3. Level f CPD activity ffered Accredited Service Prviders May ffer CPD activities at any ne f the three levels as described in the HPCSA CPD Dcument. Service Prviders: May ffer CPD activities at Levels 1 and/r 2 as described in the HPCSA CPD Dcument Rles and respnsibilities Befre the CPD learning activity: Prir t ffering an activity, an Accredited Service Prvider/ Service Prvider shall cmpile the fllwing infrmatin/dcuments fr each CPD activity that will be presented Name and number f the accredited Service Prvider that will present the activity; The tpic f the activity; The level f the activity; The number f CEUs that have been allcated fr the activity; The dates (cmmencement and cmpletin) f the activity; The prtcl fr attendees t frmally evaluate the learning frm the CPD event and the ptential influence n their perfrmance. Evaluatin shuld fcus beynd the aesthetics, cmfrt, cnvenience r ambience f the venue, with mre emphasis n imprving quality f care and patient utcmes. A template f the attendance certificate t be issued t attendees n cmpletin f the activity An attendance recrd that reflects the names and HPCSA registratin numbers f all f the attendees (frm cmmencement t cmpletin f the activity); Where relevant, the prgramme f the activity/applicatin fr mentring and supervisin (fr quality cntrl purpses by a Prfessinal Bard). Accredited Service Prviders and Service Prviders are required t publicise the prpsed activity tgether with its CEUs. At the time f the CPD activity: The activity shuld take place as advertised. Attendees shall be prvided with the pprtunity t frmally evaluate the learning frm the CPD event and the ptential influence n their perfrmance. Please see abve regarding requirement/nature f evaluatin.

5 The Accredited Service Prvider/Service Prvider shall issue an attendance certificate t all health care prfessinals wh attended the CPD activity /r n cmpletin f a series f events. If these are nt available n the day/n cmpletin f the event the certificate/s shuld be sent t attendees within ne mnth. The attendance certificate shall cntain the fllwing infrmatin: The accreditatin and activity number (a bard specific identificatin) (eg. MDB001/12/09/2008); The tpic f the activity (ethics, human rights and medical law must be specified separately); The level f the activity; The number f CEUs fr that activity; The attendance/cmpletin date; and The name and HPCSA registratin number f the attendee. The Accredited Service Prvider/Service Prvider shall keep a recrd that reflects attendance at the entire event / cmpletin f activity and shuld retain these fr a perid f three years after the activity as these may be required in a cmpliance audit. After the CPD learning activity: The Accredited Service Prvider/Service Prvider shall develp and maintain a recrd keeping system such that all the CPD recrds will be held fr a perid f three years after the activity has been presented/ cmpleted. Accredited Service Prviders shall submit, n a mnthly basis, a list f apprved CPD activities t the CPD Department at the HPCSA. Accredited Service Prviders shall submit annually, t the Prfessinal Bard r its designated Accreditr, the fllwing infrmatin with regard t the CPD activities presented in the previus year. A list f all activities presented/cmpleted; An indicatin f ethics activities presented; An indicatin f the ptential fr the learning activity t enhance prfessinal perfrmance. Extensin f accredited prvider status will nt be cnsidered in the absence f this reprt. The Applicatin Prcess Accredited Service Prviders and Service Prviders must cmplete an applicatin frm, and submit the required dcumentatin and fees when requesting accreditatin. The applicatin prcess is described and cmpared where necessary t facilitate clarity:

6 Accredited Service Prviders Service Prviders Applicatin frm Submit an applicatin n Frm CPD 2 (A list f Accreditrs are available n the website) Submit an applicatin n Frm CPD 2A (A list f Accreditrs are available n the website) Applicatin frm requirements The name f the Department/s, Discipline/s, Unit/s, Divisin/s r Branch/es within the rganisatin that will ffer CPD; The name and prfessinal qualificatin/s f the Manager r Chairpersn f that Department, Discipline, Unit, Divisin, r Branch; The cntact telephne number r e-mail address f this persn Nte: Individuals wh wish t ffer CPD activities and are nt part f an institutin r rganizatin d nt need t submit this infrmatin Dcumentatin that must accmpany applicatin All CPD prviders must prvide supprting evidence f/fr 1. Administrative supprt Dedicated, cntactable administrative supprt and name and cntact details f this persn; A CPD c-rdinatr, cntactable by telephne, fax, email. Facilities fr presentatin f CPD 2. Presentatin facilities lecture, seminar, breakaway rms; cmputers, internet access, e-mail; data and verhead prjectrs; cpier 3. CPD learning prgramme Nte: nt required f individuals wh ffer nce ff activities A brad utline f the prgramme fr the frthcming year The names and qualificatins f the presenters f CPD activities and the tpics, are t be submitted n finalisatin/cmpletin f the prgramme

7 4. Prfessinal capacity t ffer CPD learning activities Accredited Service Prviders Training institutins (including thse in the health and educatin public sectr) must prvide evidence f: Department/s, Discipline/s r Unit/s capacity t deliver CPD thrugh full-time r part-time members f staff Prfessinal Assciatins must prvide evidence f: Natinal, branch/es r cmmittee/s that has/have the capacity t deliver CPD thrugh members wh have prven knwledge and skills in the relevant field and are in gd standing in the assciatin; Service Prviders Organizatins must prvide evidence f: Access t health care prfessinals wh have prven knwledge and skills t prvide activities in the relevant area f CPD A reference frm a training institutin/ prfessinal assciatin in supprt f the applicatin (this shuld reflect the relevance f the activities that will be prvided, an indicatin f the cde f cnduct that guides and infrms the rganisatin s business practices, the prfessinal and ethical reputatin f the rganisatin and its principles) Individuals must prvide: A certified cpy f their HPCSA registratin certificate (r ther relevant statutry cuncil eg. Nursing, Scial Wrk, Pharmacy); A certified cpy f their qualificatins; An indicatin that they are currently in practice related t the health services (clinical, teaching, research r management) and have been active in these cntexts fr at least three cnsecutive years; An indicatin f attendance at a minimum f three natinal r lcal prfessinal activities r events f direct relevance t the field f interest during the previus tw years Frmally cnstituted Prfessinal Interest Grup must prvide evidence f: Affiliatin with a prfessinally recgnised institute, rganisatin and/r assciatin; Branch/es r cmmittee/s that has/have the capacity t deliver CPD thrugh members wh have prven knwledge and skills in the relevant field and are in gd standing in the grup. 5. Attendance dcuments Template fr the certificates f attendance that will be prvided n cmpletin f the activity (Frm CPD 3) A cpy f the attendance register that will be used t recrd attendance;

8 Mechanism/Facility fr the maintenance f paper r electrnic attendance recrds. 6. Fees that will be charged fr the CPD activity The scale f fees that will be levied fr CPD activities in Levels 1 and 2 Fees that must accmpany the applicatin The applicatin fee fr Accredited Service Prvider status (A list f these fees is available n the website) The applicatin fee fr accreditatin f an activity - (A list f these fees is available n the website) Applicatin submitted t: Relevant Prfessinal Bard r its designated Accreditr (A list f accreditrs is available n the website under the relevant prfessinal bard) An Accreditr designated by the relevant Prfessinal Bard - (A list f accreditrs is available n the website under the relevant prfessinal bard) Frequency f Applicatin Annual submissin fr re-accreditatin Each new activity is submitted Outcme f the Accreditatin Prcess Accredited Service Prviders will be allcated a Service Prvider specific identificatin number linked t the relevant prfessin. The Service Prvider will be allcated a Bard specific activity number, which shuld appear n the dcumentatin fr the particular activity. 7. Evaluatin f CPD activity An indicatin f the methd fr the frmal evaluatin f all CPD activities, in which attendees are given the pprtunity t frmally evaluate the learning frm the CPD activity. Evaluatin shuld fcus beynd the aesthetics, cmfrt, cnvenience r ambience f the venue with mre emphasis n imprving quality f care and patient utcmes. GUIDELINES FOR ACCREDITED SERVICE PROVIDERS FOR THE ALLOCATION OF CEUs The fllwing guidelines are fr Accredited Service Prviders wh will gather and review the required dcumentary evidence and allcate CEUs fr the CPD learning activities that they will ffer. Nte: Service prviders must apply t a prfessin specific Bard designated Accreditr wh will review the prpsed activity and allcate CEUs. There are three levels f activities, thse with nn-measurable utcmes, thse with measurable utcmes that d nt necessarily cnstitute a full year f earned CEUs and thse assciated with frmally structured learning prgrammes.

9 Level 1 These are activities that d nt have a clearly measurable utcme and are presented as a nce ff nn-cntinuus basis. CEUs are allcated accrding t time, 1 CEU per hur t a maximum f 8 CEUs per day. Presenters/c-presenters can nly claim nce fr CEUs if the same learning activity is presented mre than nce. These activities include: (a) (b) (c) (d) (e) (f) (g) (h) Breakfast meetings r presentatins; Frmally arranged hspital r inter-departmental meetings r updates; Case study discussins; Frmally rganised special purpse teaching/learning ward runds (nt including rutine service ward runds); Frmally rganised special purpse lectures that are nt part f a business meeting; Mentring/supervisin and activities that are specific t certain prfessins; Cnferences, sympsia, refresher curses, shrt curses withut a measurable utcme, internatinal cnferences (must be apprved by a Suth African Accreditr if nt accredited/ recgnised fr CEU equivalent in the cuntry where it was held). Interest grups meeting less than six times per year. Presenters f such activities can be allcated duble CEUs, eg. if attendee receives ne CEU, presenters can get tw CEUs excluding presenters at large grup activities wh wuld be allcated CEUs frm level 2. Level 2 This level includes activities that have an utcme but d nt cnstitute a full year f earned CEUs. It includes educatin, training, research and publicatins. (Teaching and examinatin f undergraduate and pstgraduate students will nt be accredited if these activities fall within a registered health care prfessinal s jb descriptin). It als included CEUs fr Ethics, Human Rights and Medical Law. Accredited Service prviders shuld nte the fllwing when accrediting CEUs fr Ethics, Human Rights and Medical Law: The allcatin f specific CEU s t ethics, human rights and medical law is an acknwledgement f hw imprtant these issues are t ur practice. Practitiners are further encuraged t btain these units with the allcatin f duble units as cmpared t CPD in ther fields. It is imprtant hwever that CPD activities n these tpics fcus n issues f patient care. Ethics talks, fr instance, can cver a wide range f tpics but accreditatin is generally awarded t talks cncerning the principles f autnmy, beneficence, nn-maleficence, justice and human dignity. Medical law activities shuld fcus n the respnsibilities f prfessinals and the rights f patients. Fr further guidance the HPCSA ffers a range f guidelines n these tpics and they are available n the website at -www.hpcsa.c.za

10 CPD Activity a Principal authr f a peer reviewed publicatin r chapter in a bk 15 b C-authr/editr f a peer reviewed publicatin r chapter in a bk 5 c Review f an article/chapter in a bk/jurnal 3 d e Principal presenter/authr f a paper/pster at a cngress/sympsium/refresher curse. C-presenters/c-authrs f a paper/pster at a cngress/sympsium/curse/refresher curse f Presenters f accredited shrt curses 10 g C-presenters f accredited shrt curses 5 h Interactive skills wrkshp with an evaluatin f the utcme 5 i All learning material (which culd include DVD, CD, internet r email activities) with MCQs fr evaluatin with a pass rate f 70%. CEUs 10 5 3 per questinnaire j Guest/ccasinal lecturer at an accredited institutin 3 per lecture k Health persnnel wh supervise undergraduates/interns/pstgraduates in clinical/technical training in cllabratin with an accredited training institutin n a regular basis during the academic year (if nt in the jb descriptin) 2 per student (max 16 CEUs per calendar year) l External examiner f Masters and Dctral thesis 5 per thesis m Wrkshps, lectures, seminars n ethics (nt including general presentatins with a s-called cmpnent f ethics) n Level 3 Single mdules f Masters degrees with part-time enrlment fr study fr nn-degree purpses Prfessinal Interest Grups (this culd include Jurnal Clubs if cmpliant with the criteria) that are frmally cnstituted and present a regularly recurring prgramme that extends fr ne year with a minimum f 6 meetings per year. These activities shuld be nging r have a measurable utcme that is assessed accrding t criteria determined by the grup, which may be interdisciplinary. 2 per hur 5 n cmpletin f mdule 3 per meeting This level cmprises structured learning, i.e. a frmal prgramme that is planned and ffered by an accredited training institutin, is evaluated by an accredited assessr and has a measurable utcme. Successful cmpletin f an activity at this level will earn 30 CEUs. Activities include: (a) Pstgraduate degrees and diplmas that are recgnised as additinal qualificatins by the relevant Prfessinal Bard. At the end f each year f study (nt exceeding the nrmal duratin f the degree), 30 CEUs may be claimed upn submitting an academic reprt n prgress. An additinal 30 CEUs may be claimed n successful cmpletin f the qualificatin;

11 (b) Shrt curses with a minimum f 25 hurs with additinal clinical hands-n training, plus a frmal assessment f the utcme. Other Activities (c) (d) Learning prtflis; Practice audit. Guidelines fr the latter tw activities are available n the HPCSA website. Health care prfessinals will need t submit dcumentatin/prtflis t an Accreditr t btain the 30 CEUs fr these activities. ACTIVITIES THAT DO NOT QUALIFY FOR CEUs The fllwing activities d nt qualify fr CEUs: time spent in planning, rganising r facilitating any activity; published cngress prceedings; nn-referenced letters t the Editr f accredited jurnals; daily ward runds; written assignments; cmpilatin f student training manuals fr internal use; staff and/r administrative meetings; turs and/r viewing f exhibits and technlgical demnstratins; membership f prfessinal bdies, Prfessinal Bards r assciatins; hlding a prtfli n the prfessinal bdy s executive r cuncil structure; and presentatins and publicatins t the public. Meetings arranged by pharmaceutical cmpanies and manufacturers r imprters f prducts and technical devices (including assistive device technlgy) r their representatives purely fr the purpse f marketing and/r prmting their prducts are nt eligible fr accreditatin. Activities fr the purpse f training in the use f cmpany prducts r technlgical devices may be presented by arrangement with an Accreditr r Accredited Service Prvider. QUALITY CONTROL BY ACCREDITORS/ PROFESSIONAL BOARD / HPCSA CPD COMMITTEE A Prfessinal Bard r its designated Accreditr will be respnsible fr mnitring the quality f the CPD learning activities ffered t health care prfessinals by the Accredited Service Prviders /Service Prviders. Accredited Service Prviders may be audited at any time by the accreditr, Bard member r a member f the HPCSA CPD Cmmittee. The accreditatin status f an Accredited Service Prvider may be reviewed and/r revked in light f the utcme f an audit r upn any critical incident being brught t the attentin f the HPCSA CPD Cmmittee, an Accreditr r the relevant Bard. Quality measures will include review f the list f all activities prvided fr the year; cmpliance with the guidelines in the allcatin f CEUs fr the learning activities; maintenance f all necessary dcumentatin; cmpliance with annual reprting requirements; all learning activities specifically relating t ethics; relevance f activities prvided t the field f practice; any prblems experienced/ reprted.

12 Frm CPD 2 APPLICATION BY TRAINING INSTITUTIONS/PROFESSIONAL ASSOCIATIONS/PROFESSIONAL INTEREST GROUPS FOR ACCREDITED SERVICE PROVIDER STATUS Cmplete and submit nline r in hard cpy t the Prfessinal Bard r the delegated Accreditr registered with the relevant Prfessinal Bard Name f prviding rganisatin and/r f Prvider Name f respnsible persn Name f CPD c-rdinatr r administrative persn Pstal Address Cntact Telephne (including area cde) Cntact Fax N (including area cde) E-mail address The fllwing infrmatin must be submitted in supprt f yur applicatin A brad utline f the prgramme fr the frthcming year State the facilities available fr the presentatin f CPD activities (lecture rms, etc). State the methd fr recrding attendance. State the fees t be levied fr CPD activities in Level 1 r 2 Attach a cpy f the prpsed attendance register. Attach a cpy f the attendance certificate that will be prvided n cmpletin f the activity State the methd t be used fr btaining feedback r evaluatin f the event. Specify the intended mechanism fr mnitring attendance (per hur r per sessin) fr the duratin f the activity State yur r yur institutin/rganisatin s invlvement r experience in health care educatin. State yur prpsed target audience, e.g., ptmetrists Has an applicatin already been submitted t anther Accreditr requesting apprval? YES NO If YES, t whm and what was the utcme? In rder t be awarded accredited service prvider status, yu agree t: exercise integrity and ethical behaviur in the allcatin f CEUs fr learning activities; recrd the name, prfessinal registratin number and the CEUs awarded t every participant at each CPD activity; validate participant attendance fr the entire event; prvide participants with attendance certificate /evidence f cmpletin; submit an annual reprt n activities presented; safeguard the recrds fr at least three years, be subjected t quality assurance checks as may be deemed necessary by the HPCSA frm time t time. SIGNED DATE

13 Frm CPD 2A APPLICATION FOR APPROVAL OF CONTINUING PROFESSIONAL DEVELOPMENT (CPD) ACTIVITIES Please cmplete and submit this applicatin t a Prfessin-specific Accreditr NOTE: The Prgramme fr the Activity and the Presenter s CV must be submitted with this applicatin Name f Prviding Organisatin and/r Name Of Prvider/Name f Individual (Including Registratin Number) Pstal Address f Prviding Organisatin and/r Prvider and/r Individual Target Audience Cntact Persn (Organisatin/Prvider/Individual) Telephne Number (Including Area Cde) (Organisatin/Prvider/Individual) Fax Number (Including Area Cde) (Organisatin/Prvider/Individual) e-mail Address (Organisatin/Prvider/Individual) Activity Title Date(s) f Activity/Prgramme Venue (Full Address) f Activity (If Applicable) Pstal cde Level f Prpsed CPD Activity Registratin Fee invlved fr participants Duratin f the learning activity (hurs) Suggested CEU s (General) Level 1 Level 2 Level 3 Suggested CEU s in Medical Ethics, Human Rights and Legal Issues pertaining t health sciences Level 1 Level 2 Level 3 Suggested number f CEU s (Indicate Maximum CEUs in each Level) Level 1 Level 2 Level 3 Specify intended methd f evaluatin (e.g. Questinnaire

14 Specify the intended mechanism fr mnitring attendance (per hur r per sessin) fr the duratin f the activity Have yu applied t anther accreditr t have this activity apprved. If yes, t whm and what was the utcme Name f Accreditr: Organisatins/Prviders: With the submissin f this applicatin, I herewith undertake t mnitr the attendance fr the duratin f the activity, evaluate the presentatins as specified and t infrm the accreditrs accrdingly. I recgnize the authrity f the Bard/Accreditrs t cancel the accreditatin in the event f nn-cmpliance with the criteria. Signature: ORGANISATION/PROVIDER/INDIVIDUAL Designatin: Date: FOR THE OFFICIAL USE OF THE ACCREDITOR This is t certify that.(name f Accreditr) - has agreed t the prpsed CPD pints as fllws: Level 1 Level 2 Level 3 Ethics/Human Rights/Legal Matters Specify ethical/human rights/legal matters relating t health sciences TOTAL: Specify the reasns why the abve-named Accreditr has nt accredited the learning activity:. SIGNATURE ON BEHALF OF DESIGNATED CPD ACCREDITOR DATE: NAME AND DESIGNATION:

15 FORM CPD 3 CERTIFICATE OF CPD ATTENDANCE ACCREDITATION NUMBER (frm Accreditr/ Bard) TOPIC OF THE ACTIVITY LEVEL OF THE ACTIVITY NAME AND REGISTRATION NUMBER OF PRACTITIONER DATE OF ACTIVITY NUMBER OF CEU S IN LEVEL(S) Level 1 Level 2 Level 3 Ethics, Human Rights and Medical Law PROVIDER SIGNATURE DATE SIGNED 15

16 ANNUAL REPORT: ACCREDITED SERVICE PROVIDER Frm CPD 6 ACCREDITED SERVICE PROVIDER Name f accredited service prvider Name f CPD crdinatr r administrative persn Pstal Address Cntact Telephne Cntact Fax N Cell N E-mail address 16

17 ACTIVITIES APPROVED BY ACCREDITED SERVICE PROVIDER Accreditatin N Activity Level CEUs Date f Activity Ethics, Human Rights r Medical Law Start Finish CEUs Tpic Indicate the ptential f the activity t enhance prfessinal perfrmance 17

18 PROBLEMS/CHALLENGES EXPERIENCED OTHER COMMENTS DETAIL OF PERSON COMPLETING THE FORM Name and Surname Designatin Date Signature 18