Case Based Required Materials

There are 3 types of Case-Based RSS series: Case Conferences, Morbidity & Mortality (M&Ms), and Tumor Boards. These are discussion based activities during which anyone in the audience may contribute content/information to the discussion of a case. At the end of the Case-Based series, the Activity Administrator must compile all of the materials that have been collected for each session and submit a final packet to the CME office. In order to receive CME credit for a Case Based series, the follow forms and templates must be used and turned in with the final packet submission. Please be sure to review the latest disclosure policy update HERE and utilize the forms below to make sure that your series is planned and documented with all the required forms.

Packet Submission Forms:

RSS Case-Based Packet Checklist

RSS Case-Based Session List Template

RSS Case-Based Participant List Template

RSS Course Director Evaluation Form

Individual Session Materials:

RSS Case-Based Planning Form

RSS Disclosure Form

RSS Resolution of Conflict of Interest Form (If applicable)

RSS Promotion Checklist

RSS Promotion Template

RSS Case-Based Sign-in Sheet Template

RSS Evaluation

Additional Resources:

RSS Risk Management-Opioid-End of Life Verification Form

Tips for Writing Objectives

RSS Disclosure Guidelines

Here is some information on each of the items listed above:

Packet Submission Forms:

RSS Case-Based Packet Checklist

The RSS checklist lists all material that needs to be submitted. Please return this form with the packets and be sure to mark all the materials that are included. It is especially important to complete the section regarding Disclosure.

RSS Case-Based Session List Template

Please use this template to submit your session list. The information submitted must include the title of the session, the date, the number of credits, the number of risk management credits (if applicable), and a list of people in a position to control content for that session. For Case-Based series, this list should include the case presenters/speakers, Course Directors, Planning Committee members and anyone else who planned in advance to contribute to the educational content of a session.

RSS Case-Based Participant List Template

Please use this template to submit your participant list. This list should include the full name, degree and number of hours attended during the series for each participant. Please also note that the participants’ names AND degrees will appear on the certificate exactly how they appear on this list. The certificates will be returned to the activity administrator (previously known as course coordinator) who is responsible for delivering the certificates directly to the participants. If your series is often attended by persons who are not members of your department, please consider obtaining mailing information so you can send all participants their certificates.

RSS Course Director Evaluation Form

Grand Rounds Course Directors are required to assess whether the overall objectives and goal that were detailed in the Case-Based Application were met. This form ensures that Course Directors look back at the series that just concluded to see what changes to practice and behavior resulted from the education. It can also be used as a tool to help plan the next series.

Individual Session Materials:

RSS Case-Based Planning Form

Before each Case-based session the course director or case presenter should complete the Case-Based Planning form. This form is tool for you to use during your planning process to help improve the education behind your activities. We understand the difficulty of having this form completed for each session, but ask that course directors and activity administrators try to have this form completed for as many sessions as possible. If you are unable to complete the form, any form of planning documentation is appreciated. These can include:

Memos detailing why/how cases were chosen for discussion

Evaluation data from past session that resulted in the case selection

Department/hospital data that supports the need for the case discussion

Please also use Tips for Writing Objectives to help you write better objectives.

Many Case-Based sessions including all Morbidity & Mortality sessions qualify for Risk Management Credit. In order to receive this, the Risk Management Verification form [link] must be completed and turned in with the Case-Based Planning form.

RSS Disclosure Form

Please be sure to review our RSS Disclosure Guidelines in the Additional Resources section. Disclosure forms must be completed, collected, reviewed, and shared with participants PRIOR to the start of each session by all those who plan in advance to be in a position to control the content of the Case-Based series. This includes all case presenters, course directors, members of the planning committee and anyone else who planned in advance to contribute to the educational content. Please contact our office if you have any questions regarding who should complete this form. Please follow the RSS Disclosure Guidelines to be sure that you are following the correct disclosure procedure. If the course director has a conflict of interest for a particular session, please contact our office.

RSS Resolution of Conflict of Interest Form

If the Course Director identifies a conflict of interest after reviewing the completed RSS Disclosure Forms, he or she must complete the RSS Resolution of Conflict of Interests Form. This form provides different ways to resolve conflicts of interests. Please note that at least one method must be completed BEFORE the start of the activity.

RSS Promotion Checklist / RSS Promotion Template

Any email, flyer or poster that announces your Cased-Based Series must include several required items. The RSS Promotion Checklist lists these items. We also have an RSS Promotion Template that you can tailor and use to promote your sessions. (This includes emails, web postings and flyers.) If you do not announce your RSS to your audience, you must have some other mechanism of notifying the audience of the educational objectives and the accreditation statement before the activity. We suggest that you add this information to the top of the sign-in sheet or to the evaluation page.

RSS Case-Based Sign-in Sheet Template

All RSSs (Including Grand Rounds, Case Conferences, M&Ms, and Tumor Boards) must provide a mechanism for attendees to prove their attendance. We recommend that you use a sign in sheet and we require that all original sign-in sheets be turned in with each packet. Each series and session should have their own separate Sign-in Sheets. You can use our RSS Case-Based Sign-in Template and tailor it to each of your sessions. This template meets all of the CME requirements and requires that participants indicate if they have completed a disclosure form. If you have your own sign-in sheet, please be sure that in addition to signatures, it includes:

  • Date, Title, and Session Speaker
  • Objectives
  • Accreditation Statement

If you have another method to verify attendance, please contact our office to receive approval.

RSS Evaluation

All RSSs must evaluate their activities. Please use our RSS Evaluation template to evaluate each session of the RSS. You may change the order of the questions or add questions, but we ask that this template be used as a guide as to what questions to ask. If you have your own evaluation method in place, please contact our office to receive approval. We require that participants fill out evaluations at the end of each session. We also ask that you review these evaluations to ensure that each session was not commercially biased and to get suggestions for future topics.

Additional Resources:

RSS Risk Management-Opioid-End of Life Verification Form

In Massachusetts, all physicians need to get 100 credits every two year to maintain their license. Of those 100 credits:

  • 10 must be designated as Risk Management credit.
  • 3 must be designated as Opioid Prescribing Education Credit.
  • 2 must be designated as End of Life Counseling credit.

During the planning of a session, a Grand Round’s Course Director can decide if the session meets the criteria for risk management, opioid prescribing education credit and End of Life counseling credit. To determine this, the course director should reference the “RSS Risk Management-Opioid-End of Life Verification Form” and check off the applicable topics. This form should then be included in the final packet you submit for credits.

Risk Management Eligible Topics:

  • Medical ethics
  • Medical-legal issues
  • Utilization review that directly relates to quality assurance
  • Patient relations
  • Non-economic aspects of practice management

Opioid Prescribing Education Eligible Topics:

  • Training in how to identify patients at high risk for substance abuse
  • Training in how to counsel patients on the side effects, addictive nature and proper storage and disposal of prescription medicines

End Of Life Counseling Eligible Topics:

  • Medical and ethical issues surrounding the end of a patient’s life
  • The type and extent of medical care, services, treatments, medications and other options that may be available to the patient
Tips for Writing Objectives

Each Grand Round Session must have specific objectives that reflect the desired result of the individual session. The Tips for Writing Objectives sheet can help both speakers and course directors create learner-centered objectives that reflect the desired result of specific sessions. Speakers can create objectives specific to their presentation by filling out the Grand Rounds Planning form.

RSS Disclosure Guidelines

The Accreditation Council for Continuing Medical Education (ACCME) has issued new guidelines that ask all individuals who are in a position to control the content of the CME activity to disclose all of their commercial relationships. These new guidelines also ask that any conflict of interest that an individual may have be resolved before the activity takes place. The RSS Disclosure policy explains the process that needs to be followed to be compliant with these guidelines.