Disclosure forms must be completed by all planning committee members and submitted with accreditation/certification applications to UBC CPD for review of potential Conflicts of Interest (COI). It is the responsibility of the planning committee to also collect and review presenter disclosures for potential COI and ensure appropriate COI Management of presenters as required. All disclosures should be summarized and made available to all participants for transparency.
Presenters please complete the fillable pdf version and return to your planning committee Chair.
Disclosure Form (fillable pdf)
Save the form and fill it out with Adobe Reader (free http://get.adobe.com/reader) or Acrobat.
Mac users must install Adobe Acrobat/Reader. Mac Preview will not work with fillable PDF forms. Steps: Install the most recent version of Adobe Reader (http://get.adobe.com/reader). Save the form to your local drive on your own computer and note the location of the saved file. (ex. Documents). Open the Adobe Acrobat Pro/Reader application 4. On the Acrobat Reader menu, go to File->Open. Open the file from the location in which you saved it. The form will not work if you simply double-click it, unless Acrobat/Reader is already your default PDF viewer.
Disclosure Slides (pdf view)
Each presenter should also outline verbally their disclosure information to the audience with a slide at the beginning of their presentation. If a disclosure slide has not been included in a presentation, it will be inserted by the program organizer.
Management of potential bias. Examples:
• Material presented is unrelated to financial relationship with commercial entity
• Other ways that bias perception can be managed
The planning committee reviews the disclosures completed by the presenters and ensures appropriate conflict of interest management in any of the following ways:
• In many cases, ensuring that the conflict is fully disclosed to program participants, with description of management, will be adequate
• The presenter is asked to present on a different subject
• The presenter alters their financial relationship
• The presenter relinquishes control of content of the presentation
• Independent expert content review is obtained
• On rare occasions, a speaker or planning committee member may need to be replaced
The UBC CPD Conflict of Interest Policy requires that planners and presenters of a CPD Activity complete the UBC CPD Disclosure Form, and that disclosures are made available to the participants to ensure transparency of the nature of any industry relationships. Disclose all industry financial relationships for the two year period prior to a CPD Activity, not just those relevant to the subject being discussed. Relationships with government agencies, regulatory bodies, and not-for-profit agencies as well as any commercial affiliation that your spouse or close family members have with respect to information being presented at a CPD Activity should also be disclosed.
If you are unsure what to disclose, try out our award-winning UBC CPD Relationship with Industry Module to help you decide, and receive credits at the same time.