Connecting Purpose and Performance: Rethinking the Purpose of Maintenance of Certification

Abstract

American Boards of Medical Specialties have emphasized single point in time testing for summative assessment of cognitive expertise necessary for board certification. In 2016, the American Board of Anesthesiology introduced Maintenance of Certification in Anesthesiology (MOCA), a longitudinal assessment platform that provides diplomates formative feedback with continuous questions over time and adapts questions to areas of knowledge weaknesses over time. This paper describes the rationale, history, and early results of the American Board of Anesthesiology MOCA platform. (J Am Board Fam Med 2020;33:S15-S20.

Longitudinal Assessment to Evaluate Continued Certification and Lifelong Learning in Healthcare Professionals: A Scoping Review

“…Implementation Process. Use of LA for maintenance of certification (MOC) has been recently reported in anesthesia (Harman et al, 2020), pediatric emergency medicine (Iyer et al, 2021), and radiology (Wallner et al, 2020). The intent of LA programs for MOC are not only to assess knowledge (summative), but also clinical judgement and critical medical skills.…”

“…Eight of the 12 articles were based in the United States (U.S.) (Albanese & Case, 2016; Harman et al, 2020; Horber et al, 2020; Iyer et al, 2021; Newton et al, 2020; Sun et al, 2016; Wallner et al, 2020); one article was based in the U.S and Canada (Robinson et al, 2020); two articles were based in Canada (Dion et al, 2022; Hatala et al, 2019); one article was based in the United Kingdom (Ali et al, 2018); and two articles were based in the Netherlands (Favier et al, 2017) (Table 1).…”

“…Of the remaining eight studies, six studies described the use of LA amongst the American Board of Medical Specialties (ABMS) to include the following specialties: 1) the American Board of Anesthesiology (Harman et al, 2020; Sun et al, 2016); 2) the American Board of Pediatrics (Iyer et al, 2021; Turner et al, 2019); 3) the American Board of Radiology (Wallner et al, 2020); and 4) the American Board of Family Medicine (Newton et al, 2020). Finally, the remaining two studies described the use of LA in osteopathic specialty boards (Horber et al, 2020) and the American Board of Physical Medicine and Rehabilitation (Robinson et al, 2020) (Table 1).…”

“…Key aspects of the implementation process include stakeholder participation in determining the process (certificants, certifying board, pilot participants) (Harman et al, 2020; Iyer et al, 2021; Wallner et al, 2020), phased rollout of the process (Harman et al, 2020; Wallner et al, 2020), and a publicly available content outline or learning objectives (Iyer et al, 2021). In addition, factors associated with LA include: 1) spaced assessment (Harman et al, 2020; Iyer et al, 2021; Wallner et al, 2020); 2) technology driven (computer, tablet, smartphone) in a location and time of choice (i.e.…”

“…Key aspects of the implementation process include stakeholder participation in determining the process (certificants, certifying board, pilot participants) (Harman et al, 2020; Iyer et al, 2021; Wallner et al, 2020), phased rollout of the process (Harman et al, 2020; Wallner et al, 2020), and a publicly available content outline or learning objectives (Iyer et al, 2021). In addition, factors associated with LA include: 1) spaced assessment (Harman et al, 2020; Iyer et al, 2021; Wallner et al, 2020); 2) technology driven (computer, tablet, smartphone) in a location and time of choice (i.e. asynchronous) (Harman et al, 2020; Iyer et al, 2021; Wallner et al, 2020); 3) timed questions (60 seconds-5 minutes [Harman et al, 2020; Iyer et al, 2021]); 4) immediate feedback to enhance learning and retention (Harman et al, 2020; Iyer et al, 2021; Wallner et al, 2020): 5) the inclusion of supporting references (Harman et al, 2020; Iyer et al, 2021; Wallner et al, 2020), and 6) use of resources to complete the questions (Iyer et al, 2021).…”