2011 Annual Educational Conference

Pittsburgh | Sept. 8-10, 2011

2011 Conference Session Handouts

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Thursday, September 8
8:00 - 11:00 a.m.

The Need for Competent Practitioners – What Research and Experience Show
This pre-conference workshop brings together speakers from different sectors of the regulatory community around the world. Ensuring the competence of practitioners is a global priority and key responsibility of all regulators. This workshop will be divided into two distinct parts - the first sharing results of research done in jurisdictions that have already implemented continuing competency programs. Speakers will share the rationale, methods, and results of research, thus engaging participants in an active discussion about such programs and whether they make a difference in the services or care practitioners provide and to the public who are recipients of those services. After the break, different speakers will share approaches to implementing a continuing competency program in their own jurisdiction - engaging participants in discussion through the sharing of the challenges encountered, barriers along the way, opportunities presented, successes achieved, and most importantly, lessons learned!
Learning objectives:
Learn about the various models of continuing competency programs that have existed for some time and those that are in the process of being developed; Learn about research conducted to-date respecting the impact and value of continuing competency programs, and what the results show; Learn how continuous professional development (CPD) directly impacts the continuing competence of professionals, and other factors that contribute to or detract from competence; Learn about the challenges associated with implementation of a continuing competency program with respect to national harmonization, burdens and barriers, and alternate multifaceted approaches for continuing competence.

Coordinators: Deanna Williams, President/Director, Dundee Consulting Group Limited; Christopher Butcher, Principal, Heuristic Solutions
Moderator: Deanna Williams
Speakers: *Part I – What the Research Shows…
Alison MacDonald
, Associate Registrar, Alberta College of Social Workers
Marc Seale
, Chief Executive and Registrar, United Kingdom Health Professions Council
Anthony Marini
, Martek Assessments Ltd.
Part II – Different Approaches to Assuring Continuing Competence    
Kate Nosbisch
, Executive Director, Board for Architects, Professional Engineers, Land Surveyors, Certified Interior Designers and Landscape Architects (APELSCIDLA), Virginia Department of Professional and Occupational Regulation
Ambrose McLoughlin
, Registrar, Pharmaceutical Society of Ireland
Leanne Worsfold
, Director of Quality Programs/QA Consultant, iComp Consulting Inc., Ontario
Christopher Butcher
, Principal, Heuristic Solutions
Presentation  |  Handout      

11:00 a.m. - noon

Getting the Most Out of CLEAR  
This session provides the opportunity for all annual conference attendees to learn more about the structure, function, mission, and products of the Council on Licensure, Enforcement and Regulation. How can CLEAR assist you? Bring your questions and get the answers. Current CLEAR members will be available to share with you and help you get the most out of your CLEAR membership.

Speaker: Mary Romelfanger, President, Dear Watch Inc.
Followed by table discussion led by current CLEAR members
Presentation  |  Handout

1:00 – 2:00 p.m.     Opening Session

“Extreme Government Makeover: Increasing Government’s Capacity to Do More Good"
Welcome: Faye Lemon, CLEAR President, Director of Enforcement, Virginia Department of Health Professions
Opening Address: Ken Miller, author and founder, Change & Innovation Agency

Government is under incredible pressure right now. The economic crisis has hit us with a double whammy: exponential increases in demand and dramatically reduced resources. Government simply doesn’t have the capacity to do all the good we want to do in this world. How have we responded to these new pressures? By trotting out the old ideas. More blue ribbon panels, travel moratoriums, and calls for accountability. We cut back on paper clips and cut out the training. We outsource, upgrade, and rightsize. Meanwhile droves of new customers are stuck on our porch waiting to knock on our door and ask for help. The house of government doesn’t need another layer of paint or some new carpet; it needs an extreme makeover. And it needs it done fast! Our house is full of “moldy ideas” that are making everyone sick, and our pipes are bursting from the ever-increasing demands. We can stand around arguing whether the house is too big or costs too much, or we can grab some tools and fix it up. This presentation makes obvious the real problems plaguing government, shows you how you can join the crew, and gives you the tools to complete the makeover.

2:30 – 3:30 p.m.     Concurrent Sessions

Fairness – Legal and Measurement Concerns in Regulatory Testing  
Fairness in testing remains one of the most pervasive and persistent issues in testing programs of all kinds. One factor that contributes to the longstanding concern is that there are many definitions of “fairness,” ranging from social to legal to statistical points of view. What makes a test fair or unfair? This session will explore legal and psychometric concepts and recent developments addressing test fairness, including implications for regulatory testing. The session will include a summary and discussion of test fairness-related statutes, regulations, and recent case law affecting test use. Psychometric approaches to analyzing fairness will be reviewed, along with best practices for optimizing fairness and ensuring that assessment instruments are defensible in the event of a legal challenge.
Learning objectives:
General understanding of laws and recent court cases pertaining to test fairness, and implications for regulators; Legal guideline requirements with respect to ensuring fairness; Psychometric approaches to evaluating test fairness and ensuring legal defensibility; Research and controversies in test fairness; The five things that every testing program administrator should know about test fairness.

Coordinator: John Weiner, Chief Science Officer, PSI Services LLC
Moderator: George Gray, Director, workforce Test Development, ACT, Inc.
Speakers: John Weiner
Keith M. Pyburn
, Fisher & Phillips LLP
Presentation  |  Handout

Why Plan Strategically?   
In an environment in which regulatory agencies are continually asked to do more with less, leaders find themselves reacting to problems instead of planning and accomplishing goals. This session will help you to define, plan, execute, and measure strategic and operational goals for your agency. Agency leaders will also learn simple steps to align key processes, activities, departments, employees, and other groups with the agency’s vision.  Finally, you will learn the steps to connect plans to everyday tasks and operations.
Learning objectives:
The importance of (and ramifications of not) defining goals; Performing exercise(s) emphasizing individual and organizational mission, vision, and values; Strategic process; Execution of plans and operations; Identification, measurement, and analysis of key performance indicators.

Coordinator: Brian Bennett, Marketing Specialist, GL Solutions
Moderator: Brian Bennett
Speaker: Bill Moseley, President and CEO, GL Solutions
Presentation  |  Handout

Forewarned Is Forearmed: Understanding Data Bank Requirements   
Differing jurisdictions vary in what they report and don't report to the US National Practitioner Data Bank and Healthcare Integrity and Protection Data Bank. While some jurisdictions report all public action, others don't. In this session, we will discuss the reporting requirements of the NPDB & HIPDB and the newly merged NPDB, sanctions that can be imposed for failure to report, and steps being taken to encourage reporting. Participants will also learn how to use the data banks for profiling and practitioner compliance.
Learning objectives:
The scope of Section 1921, what is reportable within what time frame, and the sanctions for failure to report; The use of the NPDB as part of a comprehensive risk management strategy.

Coordinator: Sarah Monickam, Program Analyst, Health Resources and Services Administration, US Department of Health and Human Services
Moderator: Lori Long, Manager, Complaints/Investigations/Hearings, Royal College of Dental Surgeons of Ontario
Speakers: Cynthia Grubbs, Director, Division of Practitioner Data Banks, Bureau of Health Professions, Health Resources and Services Administration, US Department of Health and Human Services
Richard Morales
, Health Services Director, Colorado Division of Registrations, Department of Regulatory Agencies
Presentation  |  Handout

Investigator Issues Discussion Group 
One of the most challenging aspects facing investigations in today’s environment is dealing with increasing workloads and limited funding for investigations. Therefore, “desk investigations” are becoming the norm. How to effectively perform a “desk investigation” will be one of the many topics to be discussed. Other topics to be included are multi-jurisdictional investigations and information sharing, anonymous complaints, and effective report writing. Bring your questions and ask the experts from the CLEAR National Certified Investigator/Inspector Training (NCIT) Committee.

Coordinator: Donna Mooney, Manager of Disciplinary Proceedings, North Carolina Board of Nursing
Table Leaders: Ernie Atkins, Investigator, Compliance & Investigation Division, Virginia Department of Professional and Occupational Regulation
Steve Hart
, Inspections and Investigations Coordinator, Kentucky Board of Pharmacy
Donna Kline
, Director of Regulatory Affairs, Institute of Chartered Accountants of Alberta
Nancy McLennan
, Director of Standards Enforcement, Institute of Chartered Accountants of Alberta
Jon Pellett, Attorney, Barr Murman & Tonelli, P.A.

4:00 – 5:00 p.m.     Concurrent Sessions

Regulators’ Role in Establishing Defensible Credentialing Programs
The purpose of this session is to provide essential information about various aspects of job analysis procedures for specialized situations. Case studies will include examples of meeting regulatory mandates by 1) ensuring that a national examination reflects state/provincial practice and that reciprocity is appropriate across jurisdictions and 2) maintaining the currency of examinations in times of limited resources and developing practices. Regulators may use the information from this session to ensure their responsibilities are being met for verification of evidence in support of the validity of examination results.
Learning objectives:
Identify the steps needed to complete a job analysis; Describe how to use the results of a job analysis to create examination specifications; Identify the challenges of using national results for creating jurisdiction-specific examinations; Describe methods to achieve a balance to create national examinations appropriate to the jurisdiction.

Coordinators: Steve Nettles, Senior Vice President, Psychometrics, Applied Measurement Professionals, Inc.; Lawrence J. Fabrey, Senior Vice President, Psychometrics, Applied Measurement Professionals, Inc.
Moderator: Sandra Greenberg, Vice President for Advisory Services, Professional Examination Service
Speakers: Steve Nettles
Lawrence J. Fabrey

Presentation  |  Handout

Good Governance: Process and People  
How effective is your board? Can you articulate the distinction between policy and administration? Is it clear who does what and how decisions are made in your organization? Good governance is one of the key aspects of effective regulation. This session will clearly define results, roles, and rules for the foundation of best practices in board governance. This complex subject requires clearly developed and articulated processes and is accompanied by a need to understand professional relationships and human interaction. Are you leading by example? Do your staff understand their role and how to manage conflict? Articulating who does what and when can streamline your work in the development of strategic plans, policy analysis, and bylaws and standards of practice. This interactive session will engage the audience through real life examples and case scenarios encouraging discussion and interaction.
Learning objectives:
Define desired results, roles, and rules for good governance; Use real life examples to work through difficult issues; Discuss best practices for implementation of good governance policies.

Coordinator: Caroline MacIsaac, Vice President, Regulation Dynamics
Moderator: >Darrel Crimmins, Deputy Director, Pennsylvania Bureau of Enforcement and Investigation
Speakers: Caroline MacIsaac
Cathi Mietkiewicz
, Associate, Fasken Martineau DuMoulin LLP, Barristers & Solicitors, Patent & Trade-mark Agents
Presentation  |  Handout

Violations of Ethical Behavior: Can They Be Predicted, Measured and Rehabilitated?  
Today licensing agencies must cope with heightened challenges to professional behavior. Advances in technology, unfavorable economic conditions, and blending of the generations (i.e. new graduates working with experienced practitioners who are delaying retirement) result in a clash of value systems. Licensure agencies focus on violations of the standards of practice, including violation of professional ethics. In this session, videos will depict ethical situations encountered by the licensing boards, such as violations of sexual boundaries, gift giving, confidentiality, and workplace socialization. Attendees will identify potential violators of ethical behaviors, assess unethical behavior, and propose effective rehabilitation plans for ethical violators.
Learning objectives:
Identify trends in disciplinary actions across the United States; Discuss and apply models of ethical decision making; Understand and identify the impact of social media on the ability to maintain professional boundaries, privacy, and confidentiality; Discuss ethical violations and board actions from the regulatory or licensing board’s perspective, investigator’s perspective, and licensee’s perspective; Analyze cases of ethical violations using “Boundary Violation Video Series for Physical Therapists;” Apply assessment and prevention tools for ethical behavior violators; Discuss availability and objective of remediation programs for violators of ethical standards.

Coordinator: Z. Annette Iglarsh, Associate Dean, School of Nursing and Health Sciences Chair and Professor, Department of Physical Therapy, Simmons College
Moderator: Susan Layton, Chief Operating Officer, Federation of State Boards of Physical Therapy
Speaker: Z. Annette Iglarsh
Presentation  |  Handout

Investigator Issues Discussion Group cont’d  
This roundtable will allow for continued discussion of the topics introduced during the earlier session.

Friday, September 9
7:15 – 8:15 a.m.     Early-Bird Session  

Executive Leadership Program for Regulators  
CLEAR’s Executive Leadership Program for Regulators is unlike any other leadership training you’ll experience and is not one to miss! The program provides information that immediately and directly enhances any regulator’s management techniques. Instructors employ a variety of delivery styles and tailor the curriculum to address issues of significance to each participant. Program topics include Characteristics of Regulatory Leadership, Leadership Styles, Organizational Dynamics, The Art of Negotiation, Media and Public Relations, and much more. Benefit from a preview session specially designed to offer a sample of the training experience. Attending this session will provide a better understanding of the overall program and will allow you to experience its relevance to your work. Come join us, then consider enrolling yourself and your management staff in scheduled future program offerings or bringing the training to your jurisdiction!

Speaker: Kate Nosbisch, Executive Director, Board for Architects, Professional Engineers, Land Surveyors, Certified Interior Designers and Landscape Architects (APELSCIDLA), Virginia Department of Professional and Occupational Regulation
Presentation  |  Handout                   


8:30 – 10:00 a.m.   Concurrent Sessions

Testing Accommodations: Balancing Competing Demands  
Regulatory excellence demands that testing entities operate fiscally responsible programs that are fair to all examinees and produce results that are, insofar as possible, valid and reliable. Regulatory excellence also demands that testing entities act in compliance with the law and attempt to eliminate or mitigate the extraneous influence of an examinee’s disabling condition on the measurement. In addressing a request for accommodations from a qualified individual with a disability, testing entities need to be mindful of trying to meet both sets of demands. Using hypothetical cases, panelists will address the goal of providing testing accommodations, the interests of the involved examinee, and the potential impact and implications for a testing program of providing certain accommodations.
Learning objectives:
The panelists will help the audience to come away with a practical understanding of some of the fiscal, measurement, and test administration challenges associated with requested accommodations and to appreciate the value of sensitivity, creativity, and communication in addressing such challenges.

Coordinator: Marlene Dunham, Program Director, Professional Examination Service
Moderator: Elizabeth Azari, Vice President, ESS, National Board of Medical Examiners
Speakers:Janet D. Carson, Legal Consultant to Testing & Certifying Entities
John A. Pugsley
, Registrar/Treasurer, The Pharmacy Examining Board of Canada
Marlene Dunham
Ruth C. Loew
, Assistant Director, Office of Disability Policy, Educational Testing Service
Presentation  |  Handout

Public Involvement in Scope of Practice Legislation and Rulemaking  
Outdated scope of practice (SOP) restrictions often prevent health care professionals other than physicians from practicing to the full extent of their training and skills, adversely impacting the public by limiting choice and access. “Competing” professions are well represented when SOP laws are considered by state legislatures and when regulations are being drafted by state licensing boards. It is the voice of the public that is missing. At this session, two organizations will discuss opportunities for and barriers to increasing public participation in order to achieve a regulatory process that reflects the broader public interest.   Learning objectives: Attendees at this session will take away a heightened appreciation for the extent of SOP debates in their jurisdictions and their implications for the efficient and effective use of the health workforce. This is all the more significant because of workforce shortages in several health professions at a time when there is a growing demand for access to health care due to federal health care reform laws and the aging of baby-boomers. Attendees will learn about successful techniques to educate consumers and their organizations on the issues and encourage their participation in the regulatory process.

Coordinator: David A. Swankin, President and CEO, Citizen Advocacy Center
Moderator: David A. Swankin
Speakers: David A. Swankin
Lisa Summers
, Senior Policy Fellow, Department of Nursing Practice and Policy, American Nurses Association
Presentation  |  Handout

Substance Abuse: Two Regulatory Approaches that Protect the Public  
This session, through case studies, is designed to compare and contrast the goals and outcomes of regulatory discipline and alternative-to-discipline monitoring programs. The speakers will discuss an actual case of a multi-state substance abuse investigation and the subsequent discipline and also provide an analysis of a successful board-directed alternative-to-discipline monitoring program. The presentation will offer opportunities for different professions to dialogue about specific issues related to impaired professionals. The combined efforts of regulatory decision makers and recovery specialists can promote a safe environment in which professionals can practice their area of expertise while being monitored.
Learning objectives:
 Recognize chemical dependency as a disease; Describe physical and psychosocial characteristics of impaired professionals; Discuss regulatory responsibilities for chemically dependent professionals; Analyze through case studies the outcomes of regulatory discipline and alternative-to-discipline monitoring programs of professionals.

Coordinator: Michael R. Bloyd, Case Manager, Compliance Section, Consumer Protection Branch, Kentucky Board of Nursing
Moderator: Nancy McLennan, Director of Standards Enforcement, Institute of Chartered Accountants of Alberta
Speakers: Michael R. Bloyd>
Ann Tino
, Certified Nurse Investigator, Consumer Protection Branch, Kentucky Board of Nursing
Presentation  |  Handout

Regulatory Agency Administration Discussion Group  
This roundtable session will include several topics for discussion, such as the impacts of social media on the regulatory process, new initiatives in paperless processing, the cost and economic impacts of regulation, and dealing with cross-border practice. This highly-interactive session is a chance to share your ideas and expertise and to have your questions addressed.

Coordinator: Cathy Giblin, Registrar/Director, Registration Services, College & Association of Registered Nurses of Alberta
Table Facilitators: Cathy Giblin
Alison MacDonald
, Associate Registrar, Alberta College of Social Workers
Elizabeth Miller
, Director, Division of Health Related Boards, Tennessee Department of Health
Charlie Morrison
, Manager, Policy & Research, Ontario College of Teachers                                              

10:30 – 11:30 a.m. Concurrent Sessions

Automated Scoring of Performance Tasks  
Computers are used to replace/predict human scores on performance assessment tasks, such as essays scored for writing and short answer content-based sentences in accountancy licensure, and complex computer-based simulations in medical licensure. A brief introduction to the different assessment item types will be provided with an emphasis on the scoring engines used - many of which employ natural language processing - and the methods employed to evaluate the accuracy and consistency with human scorers. Constraints and limitations of the different methodologies will be described, and a framework for implementation and use of automated scoring technologies will be presented.
Learning objectives:
Understand how computers can be used to score complex performance tasks such as essays, short answer constructed-response questions, and simulations; Learn how these scoring engines mimic human scorers through the use of natural language processing technologies; Become aware of the limitations of each of these scoring engine systems; Discover the bases for their accuracy claims as they approximate human scoring of essays, short constructed responses, and complex simulation job samples.

Coordinator: F. Jay Breyer, Principal Project Research Manager, Measurement Group, Applied Research & Development, Educational Testing Service
Moderator: Dongyang Li, Psychometrician, Prometric
Speakers: Richard DeVore, Senior Research and Development Scientist, American Institute of Certified Public Accountants
Ronald J. Nungester
, Senior Vice President, Professional Services, National Board of Medical Examiners
Chaitanya Ramineni
, Associate research scientist, CRS & NLP, Educational Testing Service
F. Jay Breyer

Presentation  |  Handout                                

Implementing Scope Changes: Lessons Learned 
In 2006, dental hygienists in Alberta, Canada became the first among the global dental hygiene community to receive prescribing authority for all drugs used in dental hygiene practice. A curriculum designed to prepare practicing dental hygienists to assume prescribing status was developed using a team of educational and content experts, psychometricians, and pharmacists. This presentation will review program evaluation and performance outcomes of this innovative training and certification program, reviewing two years of data associated with the first certified dental hygienist prescribers who work in a variety of settings. This credentialing program serves as a model for future use by other disciplines.
Learning objectives:
Using the College of Registered Dental Hygienists of Alberta dental hygienist prescriber credentialing program as a model, the participant will be able to: Understand how to work within existing legislative framework to extend the scope of practice; Utilize regulatory guidelines in the formation of an innovative credentialing program, including curriculum development, certification and licensure, and continued competence; Learn how to identify and define the necessary competencies that define safe prescribing behavior and risk assessment/management; Formulate a curriculum model that facilitates self-study and independent learning; Discuss various forms of evaluation used to measure related outcomes, including process, product, and program evaluation; Appreciate the importance of developing a data collection plan at the onset of the project to ensure ongoing program evaluation to modify the curriculum as needed, process evaluation to improve program management, and product evaluation to assess the impact of this service on the community.

Coordinator: Stacy Mackie, Deputy Registrar, College of Registered Dental Hygienists of Alberta
Moderator: Deanna Williams, President/Director, Dundee Consulting Group Limited
Speakers: Stacy Mackie
Ann Eshenaur Spolarich
, Clinical Associate Professor, University of Southern California School of Dentistry; Adjunct Associate Professor Arizona School of Dentistry and Oral Health; Clinical Instructor on the Dean's faculty, University of Maryland Dental School
Presentation  |  Handout

Direct Discipline: Cutting Costs, Enforcing Priorities  
Sixteen years ago Pennsylvania’s Citation Program created a streamlined disciplinary process that provides licensees immediate notification of violations, which in turn significantly shortens the disciplinary process while retaining all due process rights. This program allows prosecutors to focus on more severe cases involving standards of care and practice because clear-cut violations are immediately cited through field staff and legal support staff. This session will explore the intricacies of the program, as well as its birth, success, difficulties, and significant expansion over the years. In an age when resources are becoming more and more limited, this session offers a potential method to cut costs and make effective use of those resources.
Learning objectives:
Understand the framework of the citation program; Identify key considerations for simplified processing; Evaluate processing methods and tools.

Coordinator: Caroline MacIsaac, Vice President, Regulation Dynamics
Moderator: Caroline MacIsaac
Speaker: Darrel Crimmins, Deputy Director, Pennsylvania Bureau of Enforcement and Investigation
Presentation  |  Handout  |  Additional handout

Entry to Practice Discussion Group  
This roundtable discussion will provide an opportunity for those involved in the initial licensing / registration / credentialing process to discuss the issues they face in playing the "gatekeeper" role that is fundamental to professional regulation. Issues for discussion may include defining competencies within a scope of practice, setting standards of qualification (education, training, experience), establishing equivalencies, assessing practical experience, accrediting education providers, artificial barriers to practice, labor mobility (national and international), appeals processes when registration is denied, when should the bar be raised or lowered, etc.

Facilitator: Bruce Matthews, Deputy Registrar, Regulatory Compliance, Real Estate Council of Ontario
Presentation  |  Handout                          


Noon - 2:00 p.m.    2011 CLEAR Awards Presentation, Luncheon and General Session
Awards Committee Chair, Darrel Crimmins, presents the CLEAR Regulatory Excellence Award.

Keynote address: “Current Trends in Professional Regulation”
Catherine Dower
, Associate Director – Research, Center for the Health Professions, University of California, San Francisco
Jan Robinson
, Registrar and CEO, College of Physiotherapists of Ontario
Interviewer: Faye Lemon, CLEAR President

Join us as we delve into some of the current trends in professional and occupational regulation. A brief presentation will identify and provide examples of current trends.  Then, led by an interviewer, our two commentators will suggest drivers of these trends and explore ways in which regulators might affect trends rather than being forced always to react. Looking ahead, the commentators will suggest future trends (what will the field look like five years from now?) and provide attendees with suggestions about how this knowledge can be applied in their own regulatory setting.

2:30 - 4:00 p.m.     Concurrent Sessions

Risks and Rewards of International Expansion  
As the world shrinks and populations become more mobile, there has never been a greater need for ensuring the quality of the professional workforce. This session will present the challenges and opportunities afforded by expanding your certification into international markets. Representatives from the National Commission on Certification of Physicians Assistants and the American Society of Clinical Pathology will present initiatives their organizations have undertaken to identify potential international partners and build relationships. Through examination of a real-life case study, you will learn more about beginning a dialogue with other stakeholders within and outside your organization, determining both common ground and key differences in international markets, repurposing and/or licensing your content for use in other countries, and creating long-term strategic goals for international programs.
Learning objectives:
Learn how two organizations have studied and continued to learn about the risks and rewards of international expansion; Utilize the information presented to identify areas of focus for your own program; Use the information outlined to kick-start your own research and efforts in exploring global opportunities.

Coordinator: Anthony Zara, Vice President, Global Credentialing, Pearson VUE
Moderator: Cathy Giblin, Registrar/Director, Registration Services, College & Association of Registered Nurses of Alberta
Speakers: Scott Arbet, Vice President of Research & Test Development, National Commission on Certification of Physicians
Jennifer Young
, Senior Manager, International Certification, American Society of Clinical Pathology Board of Certification
Anthony Zara
Presentation (Zara)  |  Handout (Zara)

Regulatory Models of the Future   
This session will open with a brief look at current regulatory models used in the UK, the US, and Canada, including a review of common language used in each jurisdiction. With an eye to the future of regulation and given the rapidly changing landscape, the three panelists will consider what a new regulatory framework could look like. National regulation, industry participation, consumer choice, and other options will be explored and discussed. Using examples from successful global systems, business, and industry where multiple stakeholders manage projects across continents and time zones to achieve a common goal, alternatives and non-traditional thinking will be the key focus for this session. As we gaze into the future, how will technology, the global marketplace, and the need for effective communication shape regulation?
Learning objectives:
Review the existing legislative framework and language across the UK, the US, and Canada; Discuss and consider alternative regulatory models; Analyze best practices from global industry for possible implementation.

Coordinator: Caroline MacIsaac, Vice President, Regulation Dynamics
Moderator: Barb Worth, Registrar, College of Occupational Therapists of Ontario
Speakers: Jonathan Bracken, Chief Legal Counsel, United Kingdom Health Professions Council
Richard Morales, Health Services Director, Colorado Division of Registrations, Department of Regulatory Agencies
Caroline MacIsaac
Presentation  |  Handout

Fakes and Frauds: How to Address the Evolving Problem of Illegal Practice  
This session will discuss new problems arising from illegal practice, both in terms of people holding themselves out as licensed professionals and inappropriate collaborations between illegal practitioners and licensed professionals. These collaborations include members of one profession posing as members of another or licensed professionals allowing unlicensed providers to use their names and registration numbers. These activities spawn a number of other problems, including false billings, forged documents, insurance fraud, and the active recruitment of clients in fraudulent schemes. Using real case examples, this presentation will look at the challenges in investigating these matters and options for dealing with the illegal practitioners and the licensed professionals involved. It will also examine how the issues and methodologies for dealing with them have evolved over the last ten years. 
Learning objectives
: Raise awareness of the issues of illegal practice and how it is evolving; Provide practical solutions for investigating these matters and dealing with the challenges related to evidence gathering and the lack of cooperation often faced in these cases; Important practical tips for investigators in dealing with fraud matters in general. Case studies will raise awareness of various schemes that are commonly practiced so as to give investigators an understanding of what to look for in the cases they may be assigned.

Coordinator: Mary Lou Gignac, Registrar and Executive Director, College of Dietitians of Ontario
Moderator: Mary Lou Gignac
Speakers: Dean Benard, President, Benard + Associates
Sarah Marceau
, Investigator, Benard + Associates
Presentation  |  Handout

Health Issues Discussion Group   
This roundtable session provides an opportunity for open discussion and the exchange of information and ideas on a variety of topics related to ongoing and emerging healthcare trends. Topics will include the public’s right to know versus the licensee’s right to privacy, the duty to report, the use of non-public orders in discipline matters, and licensee mobility. Feel free to bring your own questions and let the group help you solve your problems and dilemmas.

Coordinator: Donna Mooney, Manager of Disciplinary Proceedings, North Carolina Board of Nursing

Saturday, September 10
7:15 – 8:15 a.m.     Early-Bird Sessions

Is There a Science to Regulation? 
Regulatory agencies are increasingly seeking to set policy and rule making based on evidence and evaluation. As a data rich community in which the actual impact of regulatory programs on public protection is an ever-present question, how do we seek to share our learnings to continually improve our own operations? A CLEAR task force has been examining opportunities to increase knowledge exchange on evaluation and outcomes of regulatory initiatives. As we build this conversation, come share your thoughts. Learn about the task force’s early recommendations and influence the answer to the question, is there a science to regulation?
Learning objectives:
An opportunity to consider the concept of evidence-informed policy making; An opportunity to offer ideas to build a community conversation on regulatory initiatives and related learnings; An opportunity to shape a "CLEAR" solution to the regular cross profession sharing of regulatory research and evaluation outcomes.

Facilitator: Jan Robinson, Registrar and CEO, College of Physiotherapists of Ontario                      

Birth of a New Profession: Developing Written and Performance-based Examinations  
The Pharmacy Examining Board of Canada (PEBC) is developing examinations for the regulation of pharmacy technicians (PhTs) in Canada. Once registered, PhTs will become accountable for compounding, dispensing, and distributing medications and for appropriately referring clients to a pharmacist or other health professional. PEBC experienced several “birthing” challenges: pharmacists and PhTs had not fully embraced the expanded scope of practice; many trained on-the-job, and bridging programs were lacking; and regulatory standards had yet to be developed. Participants will share experiences and insights and learn from PEBC’s experiences in surmounting the challenges to develop certification examinations for an emerging profession.
Learning objectives:
Increase awareness of challenges in developing certification examinations for regulation of a new profession with an expanded scope of practice; Exchange ideas and experiences in meeting such challenges; Illustrate the processes and outcomes of PEBC’s efforts to develop a certification examination for regulated PhTs in Canada.

Coordinator: Carol O’Byrne, Associate Registrar, Pharmacy Examining Board of Canada
Moderator: Deanna Williams, President/Director, Dundee Consulting Group Limited
Speakers: Carol O’Byrne
John Pugsley
, Registrar/Treasurer, Pharmacy Examining Board of Canada
Presentation  |  Handout

8:30 – 10:00 a.m.   Concurrent Sessions

Who Gets to Pass? Setting Defensible Passing Scores to Protect the Public  
Every credentialing testing program must determine its criteria for establishing the passing standard (cut score). Yet, what is a fair and equitable method for establishing a cut score? Testing professionals have developed several unique procedures; however, different procedures may lead to different results. In this session, participants will have a hands-on experience evaluating a sample test developed for the workshop. Participants will apply three commonly used procedures: (1) Modified Angoff, (2) Bookmark, and (3) Hofstee. Critical issues related to each procedure will be explored as participants gain first-hand knowledge regarding the establishment of a cut score.  
Learning objectives:
Achieve an awareness of the Passing Score Study as a critical component of validation in credentialing programs; Describe the concept of the minimally qualified candidate; Name three issues that frequently cause confusion for subject matter experts in passing score studies; Describe the Modified Angoff procedure, the Bookmark procedure, and the Hofstee procedure; Explain how each of these three procedures evaluates the items and total test from a different perspective; Explain how the passing score is determined using each of the three procedures.

Coordinator: Thomas E. Langenfeld, Program Manager, WorkForce Development Division, ACT, Inc.
Moderator: Jeffrey Kenney, Executive Director, National Council for Interior Design Qualification
Speakers: Thomas E. Langenfeld
Grady Colson Barnhill
, Director of Recertification and Professional Assessment, Commission on Dietetic Registration
Jeffrey Kenney
Presentation  |  Handout

Trends in Regulatory Oversight I: Four Approaches  
In four Canadian provinces, commissioners are engaged with self-regulated professions to make sure they have fair and transparent licensing. Each collaborates with regulators while, at the same time, challenging them to provide sensible alternatives to complex, costly, and time-consuming registration practices. In this session you will hear the three commissioners from Ontario, Manitoba, and Quebec and a review officer from Nova Scotia discuss their mandates and approaches, share successes, and explore improvements that need to be made in their jurisdictions. For US participants, the workshop will provide new perspectives on regulatory issues.
Learning objectives:
Session participants will learn the different approaches of four Canadian provinces in promoting regulatory excellence, how the four provinces share information, and further recommendations for action in each jurisdiction. For US session participants, the workshop will provide new information on regulatory issues from Canadian perspectives.

Coordinator: Larry Colle, Education and Outreach Officer, Office of the Fairness Commissioner
Moderator: Nuzhat Jafri, Executive Director, Office of the Fairness Commissioner
Speakers: Hon. Jean Augustine, Fairness Commissioner, Province of Ontario
Ximena Munoz
, Manitoba Fairness Commissioner, Province of Manitoba
André Gariépy
, Commissioner for Complaints Concerning Recognition of Professional Competence, Province of Quebec
Diane Gordon
, Review Officer, Province of Nova Scotia
Presentation  |  Handout

LinkedIn to Facebook: Social Networking and Regulatory Practice  
Cyber Crimes – How social networks have affected investigations. The internet may be your friend. Social network sites are not private, and there is information that exists that may affect your investigation. How do you access the information? Is using this information “fair game”? How can this information help you as an investigator or agency administrator?

Coordinator: Donna Mooney, Manager of Disciplinary Proceedings, North Carolina Board of Nursing
Moderator: Donna Mooney
Speaker: James A. Wilson, Attorney, Durham, North Carolina
Presentation  |  Handout

International Relations Discussion Group  
The International Relations Discussion Group will allow participants to share information on a wide variety of table topics that may include decreasing the cost of regulation, National Council of State Boards of Nursing work on defining core competencies, increasing US federal government involvement with regulation, re-entry to practice standards (with a view to the verification of foreign credentials), Agreement on Internal Trade, fair registration practices – preventing legal challenges, expanding scopes of practice, getting rid of regulators, and common international competencies. Bring your issues and questions to this lively session as we explore regulatory topics from an international perspective.

Coordinators: Deanna Williams, President/Director, Dundee Consulting Group Limited; Mary Lou Gignac, Registrar and Executive Director, College of Dietitians of Ontario

10:30 a.m.  – noon  Concurrent Sessions

What Else Do You Want to Know about Credentialing: Ask the Experts  
Have you ever been apprehensive about responding to a question about testing with your board or in a public forum?  The 2011 CLEAR conference has highlighted some testing issues for the regulatory community. This is your turn to participate in an interactive session to ask testing experts practical questions. Should a Board invalidate a candidate suspected of cheating? What does the Board say to a candidate who “fails” the test by one point?  Inside the conference registration packet is a list of potential topics of interest. Participants are encouraged to indicate what topics are of most interest, add topics for discussion, and bring more questions to the session.

Coordinator: Chuck Friedman, Examination Program Manager, Association of Social Work Boards
Moderator: Chuck Friedman
Panelists: Elizabeth Witt, Senior Statistician, American Board of Emergency Medicine
Ronald Rodgers
, Director of Measurement Services, Continental Testing Services; President, Employment Research Institute
Presentation  |  Handout

Trends in Regulatory Oversight II: The Regulators' Perspective
This session will focus on the trend toward increased regulatory oversight by government. Recently, governments in the US, the UK, and Canada have introduced processes and controls that hold regulators more accountable through increased regulatory oversight. What lies at the core of this trend, which is sweeping across the globe? Speakers will provide insight into what is happening (and why) in their respective jurisdictions and how these issues are being approached and addressed.
Learning objectives:
 Understand the trend toward increased regulatory oversight in other jurisdictions; Learn how regulators and governments have arrived at this point and what regulators can do in response.

Coordinators: Deanna Williams, President/Director, Dundee Consulting Group Limited; Leanne Matthes, Policy Consultant, College of Registered Nurses of Manitoba
Moderator: Jim Dunsdon, Principal, Dundee Consulting Group Limited
Speakers: Richard Morales, Health Services Director, Colorado Division of Registrations, Department of Regulatory Agencies
Marc Seale
, Chief Executive and Registrar, United Kingdom Health Professions Council
Deanna Williams
Presentation (Morales/Williams)  |  Handout (Morales/Williams)

Making Disciplinary Decisions – Common Post-Hearing Issues  
Decisions in disciplinary cases are often influenced by more than just the testimony, exhibits, and submissions of counsel presented during the proceedings. Factual, legal, policy, and practical considerations, which are not part of the official record, can play a role. This session will explore how decisions may be affected by factors such as consistency with prior decisions, consideration of individual circumstances, issues of credibility, risk of appeal, availability of remedial measures, practical enforcement problems, and outside influence. Using case examples, our focus will be on reconciling these often contradictory demands in making decisions that will serve the public interest.
Learning objectives:
Increase participants’ awareness of how variations in the facts of a case, perceptions about the parties and the witnesses, policy concerns, and practical considerations which are not part of the evidentiary record can affect their decision-making; Provide participants with an opportunity to exchange ideas or approaches which they have found helpful in making disciplinary decisions which are effective, practical, and legally defensible; Encourage participants to think creatively and carefully when determining what sanctions to impose in disciplinary cases where outright exclusion from professional practice may not be warranted or desirable.

Coordinator: , Director of Healthcare Compliance Services, Affiliated Monitors, Inc.
Moderator: Ernie Atkins, Investigator, Compliance and Investigation Division, Virginia Department of Professional and Occupational Regulation
Speakers: Jim Anliot
Bruce Matthews
, Deputy Registrar, Regulatory Compliance, Real Estate Council of Ontario
Presentation  |  Handout

Legal Issues Discussion Group  
Topics for this discussion group will include the following questions: is paying for disciplinary cases the responsibility of the regulated professional and can you go too far, does increased regulation and the use of single strike provisions really protect the public, whose job is the investigation and regulation of unlicensed activity, and what happens if you don't complete the investigation in the time set by the regulations - should the licensee go free?

Coordinator/Moderator:  Jon Pellet, Attorney, Barr Murman & Tonelli, P.A.
Table Facilitators: Jon Pellett
Linda Shorting
, Vice Chair, Competence Committee, College of Registered Nurses of Alberta

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