Edited By Charles E. Willis , MBA, FACEhp
Some of our colleagues like to “lovingly” tease me that, in 2018, I used my last article as editor-in-chief of this publication to go on a bit of a rant1. Perhaps they’re right, and we’ll come back to that, but he who laughs last, laughs loudest…
Back in May of 1847, at the inaugural meeting of the American Medical Association, there were two key items on the agenda:
- Setting standards for minimum requirements of medical education and training, and
- Establishing a code of ethics2-5.
This was a watershed moment. That 1847 AMA Code of Ethics didn’t just expand upon the principles of medicine that date to the era of Hippocrates; that was the first documented professional code of ethics for any profession. Medicine was the first profession to recognize that individuals who serve the wellbeing of others must themselves act with dignity, care, discipline and respect.
In 2004, in the journal Teaching and Learning in Medicine, Cruess, et al. proposed a definition of “professional” in the context of medical education, with the aim of “assist[ing] in the teaching of professionalism and as a base for evaluating professional behavior.”6 Within their lengthy definition, they proposed that members of a “profession” are “…governed by codes of ethics and profess a commitment to competence, integrity and morality, altruism, and the promotion of the public good within their domain.”
Which brings us back to “the rant”…
From 2016–2018, the Almanac produced a series connecting the CEhp National Learning Competencies (NLCs) to daily practice. It was a wonderful series, and I encourage you to read the archives if you missed any of them, but it met an abrupt end when we couldn’t find an author to address NLC6. No author could provide guidance on adhering “the ethical standards for CEhp professionals” because our profession didn’t have a code of ethics. We had backed ourselves into a corner, in spite of the fact that ethics have been part of our professional DNA from the start7-10.
So, in 2018, I used this very platform as a bully pulpit, calling for us to “take ourselves seriously,” “get this done,” and that in order for us to be considered “part of the healthcare enterprise” by the professions we serve, we needed first to clarify our own professional boundaries and expectations: We needed a code of ethics.
Perhaps they’re right about it being “a rant,” but as George Bernard Shaw wrote, “[t]he reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man.” And, we had progress that needed to be made.
Why Does This Matter?
In January, 2022, the ACEhp Board of Directors formally approved our profession’s own Code of Ethics [the Code]. It took Continuing Education in the Health Professions a bit longer than the AMA, but we arrived in our own time.
Like the learners that we support, our profession and the individuals devoted to it are in a constant state of improvement. That practice of tenacious renewal is inspiring and a reason that I love this community. It would also pose a challenge when attempting to codify a thing that is always changing.
Ultimately, the Alliance would take another page from the AMA by making the Code a living document, with plans to support, clarify and help CPD professionals understand and model its principles.
A Tested Model
The Code was shaped in a model reminiscent of the AMA Code and its Principles of Medical Ethics. The Code sets standards for behavior, intention, equity and applicability for our work. It’s a short document that was anything but simple to construct in a process lasting nearly two years.
Under the leadership of Charles Willis, the Alliance’s Governance Committee began by reviewing codes of ethics adopted by other representative associations. These ranged from the highly prescriptive to the alarmingly brief. Some codes were limited to the obligations of professional leaders, while others sought to be more inclusive. We owe special acknowledgement to a group of fellow professional development experts, the Society for Human Resource Management (SHRM), who had not only adopted their own code, but also developed a handbook for any organization looking to assemble a code of their own.
This process highlighted the innumerable ways that professions find their collective identities. Ultimately, in a spirit similar to that of the AMA Code of Medical Ethics, the committee focused on general principles in order to keep applicability high.
Over time, the Code will evolve. At any given time, it should reflect the collective moral compass of our profession. It should be a tool to help new members to acclimate and empower existing professionals to engage with stakeholders. In “The Leadership Challenge,” James Kouzes and Barry Z. Posner outlined five observable skills and abilities associated with leadership:
- Model the Way
- Inspire a Shared Vision
- Challenge the Process
- Enable Others to Act
- Encourage the Heart
I see all five of these principles in the Code. It’s a shared, and sharable, vision that enables others to act with personal agency in the face of our common professional challenges. The ACEhp Code of Ethics will eventually be accompanied by explanations and examples for each of the principles in order to anchor it within practice and reduce ambiguities.
For now, I encourage all of you to engage in this process. Review the Code. Consider how difficult situations that you’ve faced in your career align or diverge from it, and submit questions and cases to firstname.lastname@example.org so that case studies can be constructed from real-world situations faced by members of our community.
Jacob S. Coverstone, FACEhp
Member of the Alliance Board of Directors, 2022-2023 Treasurer
ACEhp Code of Ethics
The Alliance represents a community of continuing education professionals who share and implement best practices across healthcare settings, to validate the impact of continuous learning, enhance clinical performance and improve health outcomes.
Declaration of Values
Continuing education professionals conduct their work honestly and with integrity. We clearly and respectfully communicate with our colleagues and all members of the healthcare team. Continuing education professionals exhibit a commitment to continuous learning and change, always oriented to improving patient outcomes. We engage with any and all stakeholders in advocating for the principles that govern our work.
Declaration of Principles
- CE professionals advance health care delivery by enabling and supporting learners to apply the latest evidence in the service of better patient outcomes.
- CE professionals accomplish this by developing and supporting activities that help learners meet educational needs, including interprofessional activities designed to advance patient safety, teamwork, and quality improvement.
- CE professionals engage and support learners in their own professional development and promote collaborative practice.
- CE professionals promote the value of continuing education and through our practice, protect the integrity of the continuing education enterprise.
- CE professionals participate as essential stakeholders in the legal, regulatory and ethical framework that governs the continuing education enterprise.
- CE professionals embrace the social justice dimensions of our work, as a matter of mutual obligation, pursuing equity and fairness in all our interactions with patients, clinicians and stakeholder organizations.
Jacob S. Coverstone, FACEhp, is the managing director at Neurovations Education. He is the Alliance Board of Directors Treasurer.
Charles E. Willis, MBA, FACEhp, principal, Clinical Outcomes Improvement, served on the Alliance Board of Directors and supported the Almanac Editorial Board as board liaison.
- Coverstone, J. S. (2018, January 17). Ethics in CEHP. CE Almanac. Retrieved September 1, 2022, from https://almanac.acehp.org/Leadership/Leadership-Article/TitleLink/Ethics-in-CEhp
- Riddick FA Jr. The code of medical ethics of the American Medical Association. Ochsner J. 2003 Spring;5(2):6-10. PMID: 22826677; PMCID: PMC3399321.
- Baker, R. A. (1999). The American medical ethics revolution: how the AMA's code of ethics has transformed physicians' relationships to patients, professionals, and society. JHU Press.
- Waddington, I. (1975). The development of medical ethics-a sociological analysis. Medical History, 19(1), 36-51.
- American Medical Association. AMA principles of Medical Ethics. American Medical Association. Retrieved September 1, 2022, from https://www.ama-assn.org/about/publications-newsletters/ama-principles-medical-ethics
- Cruess, Sylvia R., Sharon Johnston, and Richard L. Cruess. ""Profession": a working definition for medical educators." Teaching and learning in Medicine16.1 (2004): 74-76.
- Wentz, D. K. (Ed.). (2011). Continuing medical education: looking back, planning ahead. UPNE.
- Institute of Medicine 2010. Redesigning Continuing Education in the Health Professions. Washington, DC: The National Academies Press. https://doi.org/10.17226/12704
- Dixon, J. (1978). Evaluation criteria in studies of continuing education in the health professions: a critical review and a suggested strategy. Evaluation & the Health Professions, 1(2), 47-65.
- Fletcher, S. W., Hager, M., & Russell, S. (2008). Continuing education in the health professions: Improving healthcare through lifelong learning. Continuing Education in the Health Professions: Improving Healthcare Through Lifelong Learning, Southhampton, Bermuda.