This is the fourth in a series of six articles that will describe the foundation of evidence and thinking that served as catalyst for the development and evolution of the Applied Learning and Evidence Translation (ALET™) Blueprint first described in 2025 White Paper titled “The Education We Deliver Isn't Built for the Change We Expect,”¹ developed by the ALET Collaboratory. Please check out the first article, Bridging the Knowing-Doing Gap: The Applied Learning and Evidence Translation (ALET™) Blueprint for Clinical Behavior Change, the second article, What Should We Measure Now? How Collaborative Community Dialogue is Evolving a Shared Framework for What Actually Drives Clinical Behavior Change, and the third article The Applied Learning and Evidence Translation (ALET™) Blueprint: A Framework to Expand Learning Design and Impact to Sustained Practice Change.

Accredited providers invest significant time and resources in continuing medical education. Over the past two decades, the expectations for what education should achieve have evolved substantially.

In 2006, the Accreditation Council for Continuing Medical Education introduced the Updated Accreditation Criteria, replacing the Essential Areas and Elements. This change marked a shift from focusing primarily on knowledge acquisition toward resulting in desired changes in competence, performance and patient outcomes.

That shift deepened in 2016, particularly through refinements to the commendation criteria. These updates emphasized deliberate planning, documented integration of instructional design principles and clear alignment between identified needs, educational strategies and measured outcomes.

As accreditation expectations have matured, so have the demands for educational planning. Providers must now show not only that education occurred, but that it was intentionally designed to support meaningful change in practice.

This continuous evolution has increased the need for planning approaches that make instructional intent, explicit design choices and outcomes easier to articulate.

From Concept to Planning Practice

Earlier articles in this series introduced the Applied Learning and Evidence Translation (ALET™) Blueprint and its interdisciplinary foundations. This article focuses on how accredited providers can incorporate use of the ALET™ Blueprint (henceforth referred to as “ALET™”) into their planning process.

Specifically, it examines how ALET™ can help providers plan, design and document education in ways that align with current ACCME expectations, including particular commendation criteria.

Viewed through this lens, ALET™ functions less as a standalone framework and more as a planning discipline. It can assist providers in making decisions that are more explicit, particularly decisions related to instructional design, behavior change, and outcome selection.

This matters because commendation places greater emphasis on deliberate planning and documentable practices. Providers are expected to show how needs inform design, how design supports change and how outcomes reflect that intent.

ALET™ offers a structured and practical way to make those connections easier to see and explain.

Incorporating ALET™ Into Existing Planning Processes: Three Case Studies

Current State 1: Providers Already Conduct Needs-based Planning

Accredited providers routinely identify practice gaps and educational needs. This work may take different forms, including literature review, learner feedback, claims data or quality metrics.

ALET™ builds on this work rather than replacing it.

The framework encourages providers to look beyond what clinicians do not know and consider what makes change difficult in real practice. These factors often include decision complexity, workflow constraints, confidence and competing priorities.

This perspective aligns with ACCME expectations that education addresses underlying causes of gaps, not just surface-level knowledge deficits.

Current State 2: Providers Already Make Instructional Design Choices

Every educational activity reflects design decisions, whether explicit or implicit. Choices about format, faculty, interactivity and assessment all shape how learners engage and apply information.

ALET™ can help make these choices more deliberate. It prompts planners to ask whether selected methods support the type of change being sought.

For example, complex clinical decisions may benefit from case-based discussion or longitudinal engagement rather than one-time lectures. This type of alignment supports ACCME’s emphasis on intentional instructional design, particularly within the commendation criteria.

Current State 3: Providers Already Measure Outcomes

Accredited providers assess outcomes at some level. These assessments focus on competence, performance or patient outcomes, depending on the activity and context.

ALET™ encourages planners to connect outcome measures directly to the original educational intent. When outcomes are selected early and revisited throughout planning, they become tools for improvement rather than solely for reporting.

 This approach supports ACCME expectations for meaningful assessment and quality improvement.

Where ALET™ Can Add Value

ALET™ does not create new requirements. It provides a framework for integrating existing planning elements into a more coherent approach.

By making the current state explicit and connections traceable, providers can more clearly demonstrate how their education aligns with ACCME criteria and supports progress toward commendation.

Crosswalking ALET™ to Core ACCME Criteria and Selected Commendation Criteria

The following points of this article of highlights areas where the ALET™ Blueprint most clearly aligns with both core ACCME and selected commendation criteria — eight areas in total. It is not an exhaustive crosswalk. Instead, it focuses on areas where many accredited providers already operate, and where ALET™ can help make planning decisions more explicit, integrated and traceable.

Addressing Practice Gaps and Contributing Factors

ACCME criteria require providers to identify practice gaps and the educational needs that underlie them. ALET™ reinforces this requirement by encouraging planners to consider not only what learners need to know, but what enables application of that knowledge in practice.

These factors often include decision complexity, workflow constraints, confidence and practice context. By documenting these contributing factors, providers can clearly show alignment between identified needs and selected educational strategies.

Intentional Instructional Design

Both core and commendation criteria emphasize that educational design should be deliberate and aligned with intended outcomes. ALET™ prompts planners to make instructional design decisions more explicit rather than assumed.

Planners consider choices related to format, sequencing, interactivity and faculty roles in relation to the type of change being sought. When planners document these decisions, providers can clearly show intentionality and integration across activities.

Demonstrates Creativity and Innovation

Commendation criteria recognize creativity and innovation when educational approaches are thoughtfully aligned to the problem being addressed.

ALET™ supports this criterion by encouraging planners to move beyond default formats and consider which approaches best support decision-making, behavior change, or skills development. Innovation reflects purposeful design rather than novelty.

Improves Performance

Several commendation criteria focus on improving clinician performance rather than knowledge acquisition alone. ALET™ aligns directly with this expectation by emphasizing the conditions that affect whether learning translates into action.

By addressing barriers such as workflow, competing priorities and confidence, planners can design education that supports what clinicians do in practice, not just what they know. This alignment supports measurable improvements in performance.

​​​​​​​​​​​​​​Creates Individualized Learning Plans

Commendation criteria also recognize approaches that respond to variability among learners. ALET™ supports individualized learning by encouraging planners to consider differences in learner roles, settings and experience.

Providers can tailor cases, pathways or follow-up activities without creating entirely separate programs.​​​​​​​

Optimizes Technical and Procedural Skills

For education focused on technical or procedural skills, commendation criteria emphasize optimization rather than exposure.

ALET™ reinforces the importance of practice, feedback and context so that skills-based education supports competence and performance in real settings.

​​​​​​​​​​​​​​Engages Teams

Commendation criteria increasingly emphasize engagement beyond individual learners, including teams and practice environments.

ALET™ supports this by encouraging planners to consider networks, roles, and interactions within care settings. Education designed with teams in mind aligns more closely with how care is delivered.

Assessment, Outcomes and Use of Data

ACCME criteria require assessment of changes in competence, performance or patient outcomes. Commendation expectations extend this focus by emphasizing the use of data to inform planning and improvement.

ALET™ encourages planners to select outcome measures early and connect them directly to intended change. Planners then use assessment data to refine future design.

Why This Crosswalk Matters

ALET™ does not introduce new requirements. It can help providers organize and articulate work that many already do.

For many providers, the gap is not capability. It is visibility and intentional design. ALET™ can help close that gap.

A Practical Path Forward

For most accredited providers, incorporating ALET™ does not require a redesign of their educational program. It requires clearer articulation of planning decisions that are already being made.

The evolution of ACCME criteria has steadily emphasized intention, integration and outcomes. ALET™ aligns with these expectations by helping providers connect needs assessment, instructional design and measurement in a visible and coherent way.

Whether or not a provider is actively pursuing commendation, the same planning discipline applies. Education that is intentionally designed to support competence, performance and patient care is better positioned to align with expectations for accreditation and other review requirements.

ALET™ raises expectations in a useful way. It asks providers to be more explicit, more intentional and more transparent in how education is planned and evaluated. At the same time, it offers a practical framework for meeting those expectations without unnecessary complexity.

For many providers, the work is already underway. ALET™ can help make that work easier to explain, easier to evaluate and easier to sustain.

References

1. Paynter N, Pardo C, Doyle-Scharff M, et al. The Education We Deliver Isn't Built for the Change We Expect. 2025: https://aletcollaboratory.org.

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Maureen Doyle-Scharff, PhD, MBA, FACEHP, is a visionary change agent who is an expert in brokering public-private partnerships that drive changes in the global healthcare ecosystem. Recently retired from Pfizer Inc, she spent nearly 25 years leading a cross-functional team focused on enabling healthcare communities to advance science and close gaps in care through independent and collaborative grants and partnerships. In addition, she spent the last few years leading Pfizer’s Institute of Translational Equitable Medicine (ITEM), focused on the science behind health disparities and translating new data and information to improve patient outcomes globally.

 

 

Pam Beaton, CHCP, FACEHP, is a medical affairs leader with nearly 20 years of experience in continuing medical education, including leadership roles in pharmaceutical and biotechnology organizations. Her work focuses on strengthening the strategy, governance and measurement of independent medical education to better align with clinical practice gaps and patient needs. She has led the development of global frameworks, policies and tools that improve the quality, transparency and effectiveness of educational funding and program design. Beaton is particularly interested in advancing instructional design, outcomes assessment and practical approaches that support meaningful changes in clinician behavior. She is an active contributor to the Alliance for Continuing Education in the Health Professions.

 

Carol Havens, MD, is retired from her role as the director of physical education and development at The Permanente Medical Group, Inc.

Andrew Crim, MEd, CHCP, FACEHP, is the director of education and professional development at the American College of Osteopathic Obstetricians and Gynecologists (ACOOG). He has three decades of experience in adult learning, instructional design, successful grant development and outcomes assessment. Crim is a pioneer in applying emerging AI technology to CPD operations and regularly presents on its impact. He is the current vice president of the Alliance for Education in the Health Professions’ Board of Directors and serves on the Texas Medical Association’s subcommittee on accreditation. In 2024, the Texas Governor appointed him as chair of the Texas Council for Developmental Disabilities, which he has served on for 15 years. In 2023, Crim and his son, Parker, started a small business making craft ketchup and it supports organizations that enable Down syndrome inclusion, independence and employment.  

 

Beth Wilson, MBA, CHCP, is the director of continuing professional development at the American Academy of Ophthalmology. She leads the strategic vision and execution of a multimillion-dollar educational portfolio serving ophthalmologists and allied health professionals nationwide. Over 14+ years, she has scaled CPD programs that drive measurable advances in clinical practice, secured ACCME accreditation and forged cross-sector CME partnerships that expand the Academy’s reach.

Caroline O. Pardo, PhD, CHCP, FACEHP, is chief learning officer and co-founder of StitchedHealth and co-founder of Integrated Action Science. Dr. Pardo is a medical sociologist with 20 years of experience in education, research and implementation science.