As with other activities sponsored by industry, in the case of educational programs – including continuing professional development (CPD) programs, sometimes also referred to in the medical context as ‘continuing medical education’ (CME) programs – there is convincing evidence that sponsorship alone often influences both the content of these programs and the effects they have on the behaviour of those who undertake them. Furthermore, because the conduct of educational activities is often a core responsibility of scientific and clinical societies, the independence of these programs is of profound importance both for the members of the societies and for the broader community.
Internationally, there has been a tendency for CPD to be delivered by for-profit companies that have strong links with the pharmaceutical industry. In Australia, it is increasingly common for meetings of purported educational intent to be organised by commercial entities for the achievement of profit, or for events of an obviously promotional kind to be referred to as an ‘educational’ activity. Industry funded CME that is designed for promotional purposes should not be disguised as education or science.
By its very nature, education cannot be subject to commercial or other sectional interests. Accordingly, in general, the use of the term ‘education’ should be restricted to contexts that are free of such interests. The activities of industry in providing information about their products, for example distributing materials that argue a specific case for a particular product with which they are associated, and conducting training programs in relation to the use of equipment supplied by them, should be distinguished from education and recognised as serving other purposes. It is important that adequate measures are taken to ensure that educational programs undertaken under the auspices of professional associations are free from the possibility of bias of any kind towards commercial sponsors and that the community can have full confidence that this is the case.
This means that for any such program:
- the group responsible for organising it should include a majority of individuals who do not have relevant conflicts of interest
- clear rules of management of dualities and conflicts of interest should be observed within the
- high standards of transparency should be maintained, with public disclosure of relevant interests of the organising committee
- the scientific, clinical and educational content should in no way be affected by the presence or nature of commercial sponsorship
- speakers should be meticulous about declaring dualities and conflicts, and steps should be taken to ensure that their presentations are balanced
- processes should be established to assess the outcomes of the programs, including provision for feedback regarding possible biases from course participants
Various mechanisms are available for ensuring that the above conditions are met. It is desirable that educational programs sponsored by a society do not involve industry support at all. However, if this is not possible, such support should be paid into a fund that is available to the society to conduct these and other activities. The process of negotiating with industry sponsors should be separated from that of designing the program. It is inappropriate for receipt of sponsorship support to be made contingent on conditions of any kind regarding choice of speakers or topics or inclusion of particular content.
The organising committee should adopt procedures to ensure that individuals with conflicts of interest may provide input into discussion, but should not participate in the actual decision-making process relevant to that issue. The committee should be able to provide a formal undertaking that the scientific, clinical and educational content are in no way affected by the presence or nature of commercial sponsorship. Alternatively, if this is not possible, the committee should provide a written statement of the way in which such sponsorship did affect the program content.
Clear guidelines and disclosure statements should be provided to prospective speakers and other teachers. When speakers have conflict of interests, their presentations may be subjected to review before delivery by a reviewer without such conflicts to ensure that it is balanced.
The policies and practices that have been adopted for a particular program should be open to public scrutiny. Independent observers, who can provide a disinterested assessment of the outcomes, should be identified.
It is the responsibility of the institution accrediting an educational activity to ensure that accreditation of a particular activity implies that the activity was free of inappropriate biases related to industry sponsorship or representation.
- The institution accrediting an educational activity should be responsible for ensuring that the activity is free of biases related to industry sponsoring or presentation.
- Clear guidelines, which include requirements for clear disclosure statements, should be provided to speakers.
- The organising group should include a majority of individuals without conflicts of interest, and conflicts should be managed within the operation of the committee.
- Measures should be adopted to ensure that the scientific, clinical and educational content is not affected by the presence or nature of commercial sponsorship.
- Processes should be established to assess the outcome of the programs, including provision for feedback regarding possible biases from course participants.