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Accreditation
Policy and
Procedures
Version2.1
2010
1
Department of Medical Education
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TableofContents:
1.
Introduction ............................................................................................................. 3
2.
Purpose&Scope...................................................................................................... 4
3.
PolicyStatement...................................................................................................... 4
4.
Abbreviations .......................................................................................................... 4
5.
Definitions ................................................................................................................ 4
6.
BenefitsofCPDAccreditation............................................................................... 5
7.
CPDEventsCategory............................................................................................... 5
8.
ActivitiesnoteligiblefromCPDCreditPoints................................................... 6
9.
GuidelinesforCPDprogramapproval................................................................ 6
10. CalculationofCreditPoints................................................................................... 7
11. ApplicationforCPDAccreditation..................................................................... 10
12. CPDProviders ........................................................................................................ 11
13. Fees .......................................................................................................................... 12
14. GeneralPrinciples ................................................................................................ 13
15. Certificates.............................................................................................................. 14
16. CommercialSupport&Sponsorship ................................................................. 14
17. QualityAssurance ................................................................................................. 15
18. Violations................................................................................................................ 16
19. Complaints.............................................................................................................. 17
20. Procedures&Responsibilities ........................................................................... 18
21. Forms&Templates............................................................................................... 18
2
Department of Medical Education
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1. Introduction
Medicineundergoescontinuouschangeanddevelopmentaffectingthehealthcareprovisionas
a whole. Hence, continuing education is essential to the maintenance and provision of high
standardsofhealthcareforindividuals,familiesandcommunities.Healthcareprofessionalsare
encouragedtopursueeducationalandtrainingactivitiestailoredtotheirscopeofpractice,and
based on their professional needs and competencies. The educational and training activities
have to continue to evolve and adopt the quality standard for continuing professional
development(CPD)thatincludetheacquisitionofnewknowledge,skills,andattitudestoenable
competentpractice.Continuingprofessionaldevelopment(CPD)isaprocessoflifelonglearning;
in practice supporting staff development, and equipping the healthcare workforce with the
requiredknowledgeandskillstosafelyandeffectivelyprovidecare.
Our mission at Dubai Health Authority is to ensure that the health services provided in the
EmirateofDubaiareofaninternationalstandard.Toachievethat,CPDaccreditationbyDubai
HealthAuthority(DHA)wasdevelopedtoensurethathealthservicesandeducationalplansare
better positioned to meet the demand for better healthcare services, now and in the future.
Therefore,DHAAccreditationwasestablished[toensurethattheprogramsavailabletoDubais
healthcare providers satisfy the educational and quality standards. This will assist health care
professionals to keep abreast of the developments in their specialties and related fields and
ultimately enable them to provide the targeted level of health care to the patients and the
community.
3
Department of Medical Education
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2. Purpose&Scope
Encouragetheprovisionofhighqualitytrainingprograms.
Assureparticipantsofprogramcompliancewithstandards.
AidintheutilizationofCPDforrelicensurepurposes.
Facilitatereciprocityofcreditpointswithlocal,regional,andinternationalaccreditation
bodies.
Ensure the transparency and standardization of the DHACPD accreditation system,
includingdefiningaclearsystemforgrievancesandappeals.
Ensurethattheeducationalmaterialsarewithfreeorminimalcommercialbias.
TobecomeabenchmarkinternationalCPDaccreditationstandard.
3. PolicyStatement
This policy applies to all CPD Providers approaching DHA for the accreditation of their
educationalprograms.
This policy is applicable to both local and international CPD programs, whether live or
enduring.
MEDistheonlybodyinDHAthatisauthorizedtograntCPDaccreditation.
4. Abbreviations
CME:ContinuingMedicalEducation
CPD:ContinuingProfessionalDevelopment
DHA:DubaiHealthAuthority
MED:DepartmentofMedicalEducation
5. Definitions
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6. BenefitsofCPDAccreditation
Forhealthcareprofessionals:
o Developtheknowledgeandskillsofhealthcareprofessionalsatalllevels.
o Continuousacquisitionofnewknowledge,skills,andbehavioursneededfor
competentpractice.
o Revalidationorrecertificationofpractitioners,wherebythepractitioner
demonstratesactiveinvolvementincontinuingprofessionaldevelopment.
o Demonstratecommitmenttotheprofession.
Forinstitutions/organizations/CPDproviders:
o Createaninnovativeanddynamicculture.
o Supportstaffdevelopmentandequipthehealthcareworkforcewith
requiredknowledgeandskillstoeffectivelyandsafelyprovidecare.
o Encourageandfostercontinuedlearningandconcurrentlyensurethat
institutionsmeettheirobligationsinprotectingpublicsafety.
7. CPDEventsCategory
Category A: includes open live activities targeting participants from different
organizations. Examples include open courses, seminars, symposia, meetings,
conferences,teleconferenceCPD,etc.
Category B: includes live internal activities limited to groups within a particular
organization like practice based activities, case studies, grand rounds, journal clubs,
internalteaching,consultationwithpeersandcolleagues,etc.
CategoryC:includesselfstudyactivities(including,butnotlimitedtothefollowing):
5
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o
o
o
8. ActivitiesnoteligiblefromCPDCreditPoints
Regularmorningmeetings,endorsements,wardroundsandcaserevisions.
Departmentalormedicalsocietyinternalmeetings
Communityandpatientawarenesssessions.
PublicDirectedActivities.
Softwareskillstraining.
Inductionandorientationprograms.
BasicProductTraining&Productspecificknowledge.
Academic degree programs (e.g. postgraduate certificate, diploma, master, etc.) and
theirpreparationmodules.
9. GuidelinesforCPDprogramapproval
InorderforaCPDactivitytobeaccreditedbyDHA,itneedstomeetthefollowingrequirements:
Activitydesign:
o Developedbyqualifiedinstructionaldesignersandsubjectmatterexperts.
o Well structured and follow a logical format that promotes adult learning
principles.
AimsandObjectives:
o Have clearly defined aims and objectives and the activity must appropriately
reflecttheseobjectives.
o The overall objective should end with maintaining, improving and developing
knowledgeandskillsofhealthcareprofessionals.
Content:
o Activitytitlesshouldbereflectiveoftheactivitycontent.
o Contentshouldbecurrent,uptodateandbasedonevidence.
Qualificationsofthepresenter/speaker/instructor:
o Possess the relevant level of academic and professional qualifications, and/or
relevantteachingandworkingexperience.
6
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10.
CalculationofCreditPoints
Liveactivities(categoryA&B)
o Participants
A maximum of one credit point is assigned to every hour the speaker
spendsinteractingwiththeparticipants.
Creditpointspersessionwillbegivenasmultiplesof0.5points.
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Testingofparticipantknowledge/understandingisrequiredand
shouldbedesignedbyaqualifiedbody.
The website should assign a supervisor to facilitate
communication with participants and to handle any technical
relatedissues.
Presence of a mechanism to ensure and demonstrate actual
participationandachievementofthelearningobjectives.
The program has to be submitted for accreditation/re
accreditation each year. However, the educational product
contenthastobereevaluatedbytheproviderevery3yearsas
aminimum.
Publications:
Publishing articles are acceptable in peer reviewed journals
includedintheMEDLINEBibliographicDatabase.
A maximum of 10 points may be awarded to the lead author
and5pointsforsecondaryauthorshipforeachpublication.
Documents/eDocuments:
Every200wordsisequivalentto1minute.
Everydiagramisequivalentto5minutes
o A max of 50% of the credit points can be gained from
images/diagrams.
Amaximumof1creditpointisawardedforcompletionofeach
designateddocument/edocument.
The content should be designed by known and acceptable
academicbodyspecializedinhealth.
Testing of participant knowledge/understanding is required by
qualifiedbody
Theprogramhastobesubmittedforaccreditationeachyear.
DHApreservestherighttograntnumberofcreditsbasedonwhathasbeenapproved
bytheaccreditationcommitteeandnotnecessarilyasitisreceivedfromtheprovider.
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11.
ApplicationforCPDAccreditation
Thecompletedapplicationshouldbesubmitted,withallthenecessarysupporting
documents,4weeksbeforethestartingdateoftheeducationalProgram.
o Urgentapplicationsmaybeacceptedatanextrafee,howeverbynolessthan7
workingdaysbeforethestartingdateoftheeducationalProgram.
o Noprogramwillbeaccreditedretrospectivelyorduringtheperiodof
conductingtheprogram.
SupportingDocuments
o Correctlyfilledapplicationform(typed).
o Detailedandclearprogramagenda,includingstartandendtimesofeachpart
oftheeducationalprogram.Breaksandregistrationtimesshouldalsobe
clarifiedintheprogram.
o Anabstractdetailingthecontentsofeachofthepartsalongwithall
presentationslidesaremandatory.
o UptodatespeakersCVs/Resumes.
o Signeddeclarationform,byallthespeakers/instructorsconfirmingtheabsence
ofcommercialbias(otherwise,thatparticularpresentationwillbediscredited).
o Detailsabouttheorganizationseekingaccreditationbysubmitting:
CopyofaValidUAEtradelicense.
SignedCPDProviderdeclarationonthedisclosureform.
o Samplecertificateofattendance.
o Copyofthebrochure,flyerandinvitationifavailable.
o Copyoftheapprovalletterisrequirediftheeventisaccreditedbyanother
organizationoraccreditationbody.
Applicationsareacceptedashardcopiesorbyemail.
Theapplicantcanexpecttoreceiveananswerregardingthedecisionofthe
accreditationcommitteewithin14workingdaysofsubmittingtheapplication.
o Forurgentapplications,thedurationforareplywillbeaminimumof5working
days.
o Onrareoccasions,theprocessmaytakelonger;dependingontheassessment
ofDHAAccreditationcommittee,subcommittees,oradvisors.
DHAhastherighttorejectrequeststhatareincomplete,arebeyondthescopeofCPD,
sentafterthespecifiedperiodforsubmission,receivedduringorafterthe
establishmentofactivity,failedtomeettherequiredconditions,orincludedweak
scientificcontent.
10
Department of Medical Education
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12.
CPDProviders
CPDProvidershouldmeetthefollowingrequirementsinordertobeacceptabletoapply
forDHAAccreditation:
o Theorganizationshouldhaveahistoryofdeliveringatleast4accreditedCPD
activitiesperyearwithaminimumof10attendeesperProgram.
TheabovementionedCPDactivitiesshouldhavebeenobtainedin
associationwithanalreadyregisteredCPDProvideroranyother
recognizedaccreditedbodies.
o TheorganizationshouldbelegallyrecognizedandallowedtoworkintheUAE.
Examplesareeducationalinstitution,adistricthealthboard,
governmentalorprivatehospitals,registeredsociety,educationalunit/
committeeandtrainingcentrespecializedinhealthfields.
Accreditationrequestsfromorganizationsthatarenotspecializedin
healthfieldsorfromproprietaryhealthcarerelatedentitiessuchas
pharmaceuticalcompaniesormedicalequipmentcompanieswillnotbe
acceptable.
o SufficienteducationalexpertisetodevelopandmanageCPDactivities,andhave
adesignatedpersonresponsibleforCPDactivities.
o Theorganizationshouldbeingoodstandingi.e.doesnothavecomplaintsor
disciplinaryactionsagainstitinthelast6months.
CPDProviderresponsibilities:
o Assuretheavailabilityofproperandappropriatepremisesforadministration
anddeliveryoftheeducationalprogram.
o Declareinadvertisementmaterialsthattheprogramreceivedaccreditation
fromDHAonceawrittenapprovalhasbeenreceivedonly.
o Ensureparticipantattendanceoftheeducationalsessions,inordertobeeligible
toreceivetheassignedcredithours(asdetailedinotherpartsofthispolicy).
o Registerthenamesofattendeesandkeeprecordsoftheattendanceandthe
evaluationformsfornolessthan3year.
o TimelysubmissionoftherequiredpostactivitydocumentstoCPDAccreditation
aftertheendofeachprogram.
o Ensurethecomplianceoftheeducationalactivitieswiththerulesand
regulationsdetailedinthispolicy.
o EnsurethattheProgramiseducationalandnonpromotionalandthatthe
supportingCommercialInterestwillplaynoroleinthedesignorconductofthe
program.
o Issueacertificateofattendanceforthedelegatesandlecturers.
11
Department of Medical Education
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13.
Fees
AllapplicationssubmittedforCPDaccreditationaresubjectedtothefeeschargesas
followings:
Fee
Amount
Comments
Shortprogram(duration
oftwohoursorless)
DHS200/perprogram
Programlongerthan2
hrsduration
DHS500/perday
Urgentprocessingfees
(havetobesubmittedat
least7workingdays
beforetheprogram)
DHS2000/perapplicationPlus
feesappliedforthedurationofthe
program
Paidtoprocessand
considerthesubmitted
accreditationrequest
Paidtoprocessand
considerthesubmitted
accreditationrequest
Paidtoprocessand
considerthesubmitted
accreditationrequest
Allfeesarenonrefundableandnontransferableunderanycircumstances.
CPDProvidersareresponsibleforpaymentofallfeesandsubmissionofallrequired
documents4weeks(or7workingdaysforanurgentprocessingrequest)beforethe
effectivedateoftheprogram.Failuretodosowillresultinrejectionoftheaccreditation
request.
FeespaymentdoesnotnecessaryindicateeligibilityofreceivingtheCPDaccreditation
whichissubjectedtotheassessmentandevaluationaccordingtoDHAguideline.
PaymenthastobereceivedinCashatthefollowingaddress:
RoomC3,
ProfessionalDevelopmentCentre(TrainingCentreformerly),
DepartmentofMedicalEducation,
DubaiHealthAuthority
12
Department of Medical Education
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14.
GeneralPrinciples
Anychangesintheprogramaftergrantingaccreditationneedtobereportedforre
accreditation,withtheappropriatereaccreditationfeeandform.
o NoncompliancewiththismaysubjecttheCPDProvidertosignificantfinancial
andadministrativepenalties.ReaccreditationrequestsaretreatedbyDHA
Accreditation.
Changinginaccreditedprogramschedule,placeordateshouldbereportedatleasttwo
weeksbeforeconductingtheactivity.
AnnouncementsofCPDaccreditationbyDHA(withorwithoutthenumberofcredit
points)canonlytakeplaceafterthewrittenconfirmationofaccreditationbyDHA
Accreditation.
LateentryintotheeducationalProgram.
o Attendanceofatleast75%oftheeducationalprogramismandatorytoreceive
thecredithoursassigned.
o Formultisessionprograms,whereaccreditationisbasedonsessionbasis,this
ruleappliessessionbysession.
TheCPDProvidershouldsubmitthepostactivityreport,includingacopyofattendance
recordandevaluationsummaries,within30workingdaysoftheendoftheeducational
Program.
ApplicationsfromIndividualcoursedelivererswillnotbeacceptedunlesssubmitted
througharegisteredCPDProviderwithDHAaccreditation.
ProgramsorganizedorsponsoredbyorganizationsthatgoagainstDHAhealth
recommendationsshallnotbeaccepted(e.g.Tobaccocompanies,etc.).
Awardedcreditpointsarevalidforonecalendaryearonlyandeachprogramhastobe
submittedforreaccreditationeachyear.
CPDprovidermayutilizesamecreditpointsandaccreditationnumberforrepeated
activitiesprovidedthatDHAaccreditationhasbeeninformedandapprovalhasbeen
received.
InternationalAccreditation,fromrecognizedbodies,canbeacceptedonlyiftheevent
wasconductedphysicallyoutsidetheUAE.
o AlleventsorganizedandconductedintheUAEshouldbereviewedand
accreditedbyacceptablelocalauthorities.
DHAwillnottakeapartinthedirectionoflettersonbehalfofanyotherpartytoinvite
peopleorbringinlecturersfromoutside.
Theorganizeriscommittedtoconducttheapprovedactivityinspaceandtimeallotted
andnotreturned,delayedormakinganychangesincontentforanyreasonwithout
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notifyingDHAaccreditationatleast2weeksbeforethestartdateoftheactivityyin
advance.
DHArecommendstheuseofcertificatesdesignedandproposedonthewebsiteforthe
delegatesandlecturers.
Ifthecountrywheretheactivitytakesplacehasanationalregulatorybodythatgrants
accreditationthenthefinaldecisionconcerningaccreditationofeachactivityremains
thedecisionofthatnationalregulatorybody.
15.
Certificates
TheCPDCreditscertificateshouldincludeattendeesname,nameoftheprovider,name
oftheprogram,date,timeandlocationoftheprogram,numberofverifiableCPD
creditsprovidedbyDHAAccreditationandsignatureofcoursedirectorand/or
supervisorrepresentingthescientificorganizingcommitteeoftheprogram.
ApprovalforaccreditationdoesnotimplyauthorizationtousetheDHAlogoornamein
anyassociationwiththeactivity,includingactivitymaterialsotherthantheauthorized
creditstatementsmentionedbelow.
Accreditationstatement:
o Thefollowingstatementshouldbestatedclearlyintheprovidedcertificate:
Fortheattendees"ThisProgramisawarded(numbers)CPDCreditpoints
byDubaiHealthAuthority(DHAaccreditationNo.)"shouldbestatedclearly
intheprovidedattendancecertificate.
Forthespeakers"(numbers)CPDCredithourswereawardedDHA
accreditationNo.___Faculty).
o TheCPDProvidermayissueothercertificates(e.g.AppreciationCertificateor
AttendanceCertificate)thatdonotmentionCPDorDHAusingCommercial
Interestlogos.
16.
CommercialSupport&Sponsorship
AllCPDactivitiesmustbefreeofcommercialbiastowardsaparticularservice,
product,therapyorcompany
Allspeakers/presentersparticipatinginCPDactivityshouldhavenopotential
conflictsofinterestorsupportthatmightcauseabiasintheirpresentation.
o AllspeakersareresponsibletoconveyandresolvetoDHAaccreditationandto
theparticipants,aswell,anycompetinginterestswithrespecttoinformation
beingpresented.
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WhencommercialexhibitsareaccompanyingtheCPDProgram,arrangementsforthe
commercialexhibitionshallnotinfluenceplanning,norinterferewiththepresented
educationalmaterial.
Nopromotionalactivityormaterialshallbeheldinconcurrentorcontiguouswiththe
CPDprogramschedule.IthastobeseparatedclearlyfromthescientificprogramandIt
willnotberecognizedforcredits
Theonlyformofpromotionpermittedistheacknowledgementthatthecompanyhas
contributedtotheeducationalprogrambyprovisionofagrant.
o howeverthismustbedonewithoutspecificmentionofthecommercialspecific
servicesorproducts
Declarationofsupport/sponsorshipbytherelevantcommercialbodymaybepresented
onpreeventannouncementsandbrochures.Thismayincludeusingthelogoofthe
commercialorganization.
o However,nodrugorproductadvertisementshouldappearonorwithanyof
thewrittenmaterials(preliminaryorfinalprograms,brochures,oradvance
notifications)fortheevent.
o Commercialdisplays(likebannerswithproductsname)maynotbeplacedin
thesameroomwithorduringconductingtheeducationalactivities.
o Representativesofcommercialinterestsmustnotengageinsalesor
promotionalactivitiesduringthescientificactivity.
Genericnamesshouldbeusedratherthantradenamesinallpresentationsandwritten
educationalmaterials.Whentradenamesareemployed,itispreferabletousethetrade
namesofseveralcompaniesratherthanthatofasinglecommercialsponsor.
o Presentedmaterialsmustgiveabalancedviewofallrelevanttherapeutic
optionsavailableratherthanoneparticularoption.
Theselectionofeducationaltopics,speakers,andcoursematerialsshouldbebased
upontheeducationalneedsofhealthcareprofessionalsandmustnotbeinfluencedby
commercialsponsors.
17.
QualityAssurance
Theaccreditationformshouldbecompletedpromptlyandsubmittedalongwiththe
requireddocuments.
CPDProvidersshouldensuretheconductionofeducationalactivitiesbyqualifiedand
experiencedspeakers
AdvertisingandpromotionofCPDactivitiesmustclearlyshowtheeducational
objectivesoftheProgram;thenatureoftheaudiencethatmaybenefitfromthe
15
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Program;thecostoftheProgramtotheparticipant,theitemscoveredbythecostand
theamountofCPDcreditthatcanbeearnedincompliancewithDHAaccreditation
guideline.
Thepresentedmaterialsshouldbebasedonindependent,evidencebased,accurateand
uptodateinformation.
RandomInspections
o RepresentativeofDHAAccreditationhastherighttorandomlyinspect/attend
accreditedCPDactivitieswithoutanypriornotification,forthepurposesof
ensuringqualityandcompliancewiththeguidelines.
ProvidersofaccreditedCPDactivitiesshouldsubmitashortreportofeachProgramto
theDHAAccreditationincludingasampleoftheevaluationformused,evaluation
summaryandattendancesheet.
o Providermustkeeprecordsforatleast3yrs.
DHAAccreditationfullysupportsandrecognizestheparticipationofpractitionersin
accreditedCPDactivitiesinordertopromoteandmaintainthehigheststandardsof
healthcaretopatientsandthecommunityatlarge
18.
Violations
Aproviderwhofailstodiscloserelevantinformationregardinganysponsorshipmaybe
barredfromapplyingforaccreditationinthefuture,and/orbecomesubjecttofinancial
penaltiesandpotentiallylegalaction.
DHAAccreditationreservestherighttocancel/suspendprivilegesforcurrent/future
activitiesorganizedbyanyCPDProviderinvolvedintheplanningofactivitiesthatdonot
complywiththispolicysguidelines.
Advertisementviolation:theCPDProviderwillbeconsideredtohavecommittedan
advertisementviolationifanyoftheaboverulesregardingadvertisingforCPDactivities
hasbeenviolated.Examplesinclude,butarenotlimitedtotheunapproveduseofthe
DHAnameorlogo,ortheprovisionoffalseinformationontheadvertisement.
o UsingDHAandDubaiGovernmentnameandlogoshouldbeonlyafter
obtainingofficialpermissionfromtheInstitutionalMedia&Marketing
departmentattheDHA.
ProgramManagementviolation:theCPDProviderwillbeconsideredtohavecommitted
aprogrammanagementviolationifanyoftheaboverulesregardingprogramplanning,
designorimplementationareviolated.Examplesinclude,butarenotlimitedto
changingthedurationorcontentoftheprogram,oranynoncompliancewiththe
CommercialSupport&Sponsorshipguidelines.
16
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Failuretoprovidetherequiredpostprogramnecessarydocumentswithin30working
days.
ProvidingCPDcertificatetosomeonewhodidntattendorpartiallyattendedthe
activity.
IssuingCPDcertificateswhicharenotincompliancewithDHAaccreditationrulesabout
CPDcertificates.
IftheCPDProvidercommitsmorethanoneviolationinthesameprogram,morethan
onepenaltyfeemaybecharged.
Theproviderwillbegiventhetheopportunitytopresenthisviewsandexplanationsin
writing,within7workingdaysfromreceivingviolationletter,priortoplaceoccurred
violationintheprovidersprofile.
19.
Complaints
AllcomplaintsmustbesubmittedinwritingandsignedbytheCPDProvider.
Complaintsshouldbesupportedbydocumentswherepossible.DHAAccreditation
mayrequireadditionalmaterialanddocumentsfromtheCPDProvider,ifthey
determinethatthematerialstheyhaveareinsufficient,tojudgethecomplaints
properly.
Complaints/inquirieswillbeconsideredonlyifreceivedwithin10workingdaysof
thereceivedreplyfromtheAccreditationofficeaboutthestatusoftheProgram.
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20.
Procedures&Responsibilities
No. Description
Responsibility
1.
FillCPDProgramApplicationFormandpaytherequiredfees.
CPDProvider
2.
SubmitCPDProgramApplicationFormwiththenecessary
documentsandpaymentsslips.
CPDProvider
3.
Receivethedocumentsandforwardittotheoffice
Accreditation
Secretary
4.
Reviewthesubmittedapplicationandrelateddocuments
Accreditation
committee
members
5.
CPDProviderswithsuccessfulapplicationswillbenotified
Accreditation
aboutthestatusoftheirapplicationsandnumberofprovided Secretary
CPDcredithours.
CPDProviderswithunsuccessfulapplicationswillbeinformed
aboutthereasonforrejection.
6.
SubmitallpostCPDProgramreportanddocumentstoDHA
Accreditation.
CPDProvider
21.
Forms&Templates
CPDProgramAccreditationApplicationform
SpeakerDeclarationform
CPDProviderDeclarationonDisclosureform.
SampleCPDCertificateforattendees
SampleCPDCertificateforspeakers
SampleEvaluationForm
AttendanceSheetSpreadsheettemplate
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Department of
Medical Education
Nurses
Pharmacists
Have you applied for accreditation of your program with other entities?
Yes
No
If yes, please specify the reason and your application status:
Applicants detail:
Organization seeking accreditation:
Part of DHA:
Yes
No
If yes, was the program approved by Education Unit/Committee in your facility:
Activity Contact Person:
Telephone #:
Mobile #:
Title:
Fax:
Email:
Sponsor Name(s):
Influence of Sponsor(s) on the followings:
* Level of control on content of activity:
1
2
* Level of control over format of meeting:
1
2
* Selection and choice of speakers:
1
2
* Grade 1 No control;
Yes
No
3
3
3
Department of
Medical Education
What to include with your application:
Completedapplicationform.
Enoughsubmissiontime
Agendaoftheprogram
thecompletedapplicationshouldbesubmitted,
withallthenecessarysupportingdocuments,4
weeksbeforethestartingdateoftheeducational
program.
includestartandendtimesofeachpartofthe
educationalprogram,registration,breaks,andQ&A
times.
Presentationsabstract/Outline
anabstractoranoutlinedetailingthecontentsof
eachoftheparts/presentationsismandatory.
Biographyofthespeakers
summaryofProfessionalBiographyofspeakers
SpeakerDeclarationForm
shouldbefilledbyspeaker(s)foreachpresentation
intheprogram
Applicationfee
mustbereceivedbeforetheapplicationis
reviewed.CashpaymentshouldbeinRoomC3of
PDCcentreatDepartmentofMedicalEducation.
Chequesarenotaccepted.
200DHSforshortprogram(2hrsindurationor
less).
500DHSperdayforprogramslongerthan2hrsin
duration.
Please,submitthecompletedapplicationformwiththerequireddocumentsandpaymentto:
Mailto:
OR
Emailto:
ProfessionalDevelopmentCentre
Scanalldocuments
MedicalEducationDepartment(MED)
andsendthemto:
DubaiHealthAuthority(DHA)
Accreditation@Dha.gov.a
P.O.Box:4545
Tel:042191817
Fax:043113275
Department of
Medical Education
Accreditation Number:
Yes
No
Reviewer:
Date:
Reason if rejected:
Accreditation Number:
General Information
CPD Program Name:
Speaker Name:
Presentation Title:
Program Date:
Location:
Presentation Date:
Presentation Time:
From:
To:
E-Mail Address:
Statement
Agree Disagree
The content and/or presentation of the information with which I am involved will
promote quality & improvements in practice and will not promote a specific
proprietary business interest of a commercial interest. Content for this activity,
including any presentation of therapeutic options, will be well-balanced, evidencebased and unbiased.
I am not representing any material which interfere with copyright infringement
Or if I do so, I have requested and/or obtained permission from copyright holder(s) to
reproduce/copy, from their work, the portions of my presentation that are protected
by copyright laws. I acknowledge that DHA Accreditation will not be held legally
responsible for any misrepresentation on my part regarding copyright infringement.
I understand that DHA Accreditation may need to review my presentation and/or
content prior to the activity, and I will provide educational content and resources in
advance as requested
If I am presenting at a live event, I understand that a DHA Accreditation member
may be attending the event to ensure that my presentation is educational, and not
promotional, in nature.
If I am discussing specific products or services, I will use generic names to the extent
possible. If I need to use trade names, I will use trade names from several companies
when available, and not just trade names from any single company.
If I have been trained or utilized by a commercial entity or its agent as a speaker for
any commercial interest, the promotional aspects of that presentation will not be
included in any way with/within this activity.
If I am presenting research funded by a commercial company, the information
presented will be based on generally accepted scientific principles and methods, and
will not promote the commercial interest of the funding company.
I have carefully read and declare that I am the above mentioned speaker and I have filled this form to the best
of my ability.
Signature
Date
CPDProviderDeclarationondisclosure
As a registered CPD provider with Dubai Health Authority and in compliance with DHA accreditation
guidelines,wedeclarethat:
Allscientificprogramsofthecourseweredevelopedunderoursupervisionandresponsibility,
thatitisscientificallybalancedandwithoutbias.
Allspeakers/presentersparticipatinginouractivitieshavenopotential conflictsofinterestor
supportthatmightcauseabiasintheirpresentationandallofactivitiesarefreeofcommercial
interest.
We are Responsible for ensuring that all potential conflicts of interest relevant to the
presentation/eventaredeclaredtotheaudiencepriortotheCPDactivities.
DHAaccreditationofficeshouldbeinformedofanysourceofcommercialfundingreceivedby
CPDproviders.
All printed material related to CPD activities does bear the DHA Accreditation statement in
accordancewiththerelevantdisclaimer.
ApprovalforaccreditationdoesnotimplyourauthorizationtousetheDHAlogoornameinany
association with the activity, including activity materials other than the authorized credit
statement.
We accept responsibility for the payment of all fees to DHA accreditation office as a CPD
providerandassupervisorofdifferentCPDactivities.
The amount paid for program accreditation is nonrefundable and nontransferable,
irrespectiveofconductingtheprogram.
Declarationofsupport/sponsorshipbytherelevantcommercialbodymaybepresentedonpre
event announcements and brochures. This may include using the logo of the commercial
organization.
OnbehalfofCPDProvider,
Name:
OfficialStamp:
Position:
Organisation:
ProgramTitle:
Date:
Version2.0
Certificate of Attendance
Presented to
Participant Name
For attending the
Event Name
Organized by organizer Name
on Date
at Venue
This activity was awarded () CPD Credit Points (DHA Accreditation No.)
Signature
Name
Course director
Post/Organization
Signature
Name
Course Coordinator
Post/Organization
Signature
Name
----------------Post/Organization
Course/PresentationEvaluationForm
Course Title____________________________ Course Date _______________ Your Unit [optional] ____________
Please Tick the appropriate response:
Strongly
Agree
Strongly
Disagree
Disagree
1. Courseregistrationprocedurewascleartome
2. TheLocationwaseasilyaccessible
3. Thefacilitiesandactivityatmospherewereconvenient
5. Theprogramwaswellorganizedingeneral
Strongly
Disagree
Disagree
6. Learningobjectiveswereclearlystatedandmet
7. Contentwasinformativeanduseful
8. Contentwasrelevanttomyspecialtyarea
CourseOrganization
Agree
CourseContent
Agree
Strongly
Agree
Strongly
Agree
Strongly
Disagree
Disagree
11. ThePresentationsflowedinalogicalsequence
12. ReadingMaterialswereuseful
InstructorsandPresentations
Agree
Course/PresentationEvaluationForm
organized
14. The instructors, in general, Exhibited respect and
concern
16. Theamountofinteractionandtimeweresufficient
Strongly
Disagree
Disagree
Pre&PostKnowledgeAssessment
(ifapplicable)
Agree
Strongly
Agree
18. Theassessmentmethodswereappropriate.
19. Ireceivedadequatefeedbackonmyperformance
20.
Poor
OverallCourseEvaluation
Fair
Good
Excellent
21. AdditionalCommentsandsuggestions:
_____________________________________________________________________________________
_____________________________________________________________________________________
Thankyouforyourparticipationinthissurvey
CPDProgramSignin/SignoutSheet
Program Title:
Date:
Location:
Name of CPD Provider:
No.
Name
Profession/Organization
Signature