Surgical coaching to achieve the ABMS vision for the future of continuing board certification

Abstract

In February 2019, the American Board of Medical Specialties (ABMS) released the final report of the Continuing Board Certification: Vision for the Future initiative, issuing strong recommendations to replace ineffective, traditional mechanisms for physicians' maintenance of certification with meaningful strategies that strengthen professional self-regulation and simultaneously engender public trust. The Vision report charges ABMS Member Boards, including the American Board of Surgery (ABS), to develop and implement a more formative, less summative approach to continuing certification. To realize the ABMS's Vision in surgery, new programs must support the assessment of surgeons' performance in practice, identification of individualized performance gaps, tailored goals to address those gaps, and execution of personalized action plans with accountability and longitudinal support. Peer surgical coaching, especially when paired with video-based assessment, provides a structured approach that can meet this need. Surgical coaching was one of the approaches to continuing professional development that was discussed at an ABS-sponsored retreat in January 2020; this commentary review provides an overview of that discussion. The professional surgical societies, in partnership with the ABS, are uniquely positioned to implement surgical coaching programs to support the continuing certification of their membership. In this article, we provide historical context for board certification in surgery, interpret how the ABMS's Vision applies to surgical performance, and highlight recent developments in video-based assessment and peer surgical coaching. We propose surgical coaching as a foundational strategy for accomplishing the ABMS's Vision for continuing board certification in surgery.

Outcomes of the First Virtual General Surgery Certifying Exam of the American Board of Surgery

“…Although it is not possible to conclusively predict what format future examinations will take, it is clear that virtual testing has several advantages and is supported by a growing body of technological advances and platforms 10,11 . It is conceivable that a hybrid model for certification will take place, with the written examination remaining computer-based at testing centers and the oral examination transitioning to a virtual platform.…”

“…Although it is not possible to conclusively predict what format future examinations will take, it is clear that virtual testing has several advantages and is supported by a growing body of technological advances and platforms. 10,11 It is conceivable that a hybrid model for certification will take place, with the written examination remaining computer-based at testing centers and the oral examination transitioning to a virtual platform. Although there are some disadvantages for both examiners and test-takers, the benefits seem to be more prominent at this point, and as such, perfecting the technology, set up, environment, and exam delivery may be advisable for candidates, faculty, and Board organizations to master this new skill and improve exam delivery and performance.…”

OLJ December 2021 25(4)

“…A recent development in several fields, including sports and, more recently, medicine, is video-based coaching (Knight et al, 2012). In medicine, video-based review helps doctors improve their practice in such areas as surgery and trauma resuscitation (Hu et al, 2012;Pradarelli et al, 2021;Scherer et al, 2003). Hu and colleagues reported that surgeons of varying levels of experience found video coaching helpful to reflect on and improve their practice, and that video coaching was much more aligned with a continuous improvement model than traditional forms of professional development in medicine.…”

Put me in coach

“…Pradarelli and colleagues in this issue of the American Journal of Surgery, propose that video-based assessment combined with peer surgical coaching is one avenue to meet the ABMS Vision commission recommendation that continuous certification pathways assess and identify skills gaps to help physicians stay current with standards of practice. 2 The use of video-based assessment to improve patient care, surgical quality, and individual surgical performance has been demonstrated now in numerous studies. 3,4 One of the earliest studies demonstrating the improvement of surgical quality and patient outcomes following a peer-based video assessment program is from the Michigan Bariatric Surgery Collaborative.…”