Life Science Compliance Update

May 06, 2016

ABIM MOC Survey Results Announced

We have previously written about the way the American Board of Internal Medicine (ABIM) is seeking physician input on Maintenance of Certification (MOC) assessments. recently, ABIM announced the findings from that recent survey. All ABIM Board Certified physicians were invited to participate in the survey, and over 9,200 responded, a 4.7% response rate.

ABIM presented the results from the survey ("Improving the MOC Assessment Experience") at a recent ABIM meeting, in front of more than seventy leaders of medical societies. Following the presentation, the ABIM Board of Directors and Council continued discussions, considering physician-guided recommendations about options for updating the MOC assessment process. Through those discussions, ABIM will also create a timetable to seek feedback from physicians, launch a pilot, evaluate the pilot, and eventually implement changes.

ABIM made inferences about the full population of ABIM Board Certified physicians from a representative sample of 1,225 physicians. The random representative sample had a 29.4% response rate; and, in an attempt to correct non-response bias, ABIM "weighted sample responses and performed multiple imputations."

Key Survey Findings from the Representative Sample

Of the representative sample, 86% responded positively to the idea of taking an assessment at home or in their office, instead of the typical testing center, and were comfortable with potential tasks necessary to facilitate secure, remote assessment. 79% of the representative sample liked the idea of taking shorter knowledge assessments, skipping the full-length MOC exam. 76% responded positively to the idea of using online resources during an assessment, and another 76% responded that they would like maintaining their board certification to signify that they are staying current in the knowledge they need to practice. 56% of respondents positively responded to the idea of shorter, more frequent knowledge assessments, though opinions regarding the preferred length and frequency of assessments varied widely.

The survey also highlighted the fact that many physicians are dissatisfied with the current MOC program (69.6%), but 38.5% are satisfied with ABIM's recent efforts to address those needs and concerns of the internal medicine community.

ABIM Responds

According to Richard J. Baron, M.D., President and CEO of ABIM,

In our efforts to deliver a meaningful, performance-based credential that signifies something important about physicians, the survey results provide invaluable guidance as to what physicians favor in the assessment process. These insights will empower our decision making for the future by giving us direct insight into what physicians value as future components of our evolving MOC assessment.

Richard G. Battaglia, M.D., Chief Medical Officer of ABIM, believes that the

opinions from physicians gleaned through the survey will be used to frame future discussions and refine details about potential assessment ideas. Results indicate that physicians are interested in exploring all of the ideas presented in the survey. ABIM will continue to engage physicians and societies to explore assessment models that are reflective of practice today.

Future Surveys

As mentioned by both Dr. Baron and Dr. Battaglia, ABIM will continue to analyze the surveys and continue to solicit feedback from the community on different aspects of MOC assessment models. Dr. Baron stated that ABIM will evaluate the results from a research study, for which hundreds of physicians have already signed up, to understand how an "open book" portion of MOC would impact both the assessment experience, and performance.

Prior to launching any future pilots, ABIM plans to ask for feedback from the community on more detailed aspects of the piloted MOC assessment models. The current assessment will remain in place as the community continues to explore alternatives.

April 04, 2016

ABIM Considers Open Book Testing

We have previously written about the 2020 Task Force organized by the American Board of Internal Medicine (ABIM) on Maintenance of Certification (MOC) assessments. ABIM is using the task force in an attempt to continue perfecting their MOC program and setting a new process for internists and subspecialists.

Most recently, ABIM announced that they are looking at permitting access to online resources for a portion of the maintenance of certification assessments. In a blog post written by President and CEO of ABIM, Richard J. Baron, M.D., MACP, he announced that the idea to "make at least a portion of ABIM's assessment 'open-book" was repeatedly suggested from both medical society leadership, and in broad community dialogue. Many who suggested the idea believe that permitting such "open book assessments" may result in test scores that are "truer to a physician's every day experiences."

In response to those suggestions, ABIM has launched a study to examine the ways ABIM diplomats might have access to online resources during a portion of the MOC assessment. For the study, ABIM is seeking physicians who have either passed the Internal Medicine Certification exam or have taken the Internal Medicine MOC exam within the past five years to participate.

While ABIM has no definite answers as to when the open book option or any other alternatives to the current MOC assessment might be implemented, they have made significant progress, and look forward to being able to shed more light on the future in the coming months.

Possibly permitting open-book test taking is not the only thing ABIM is looking at doing to update their MOC testing. Other ideas include:

  • Developing new approaches to assessment; getting physician input about new approaches through society meetings, focus groups, design sessions, and online surveys
  • Surveying all ABIM Board Certified physicians about the MOC experience and alternate assessment ideas they have. ABIM has received thousands of responses and once they have an opportunity to compile the responses, will share the results
  • Inviting all diplomates within a specialty to participate in blueprint review, a key building block to future assessment discussions
  • Inviting more physicians to participate in the standard setting process

What's Next?

In April, the ABIM Board of Directors and Council will be meeting jointly to consider physician recommendations about what the best options are for updating the MOC assessment process. The two groups together will refine a timetable to pilot, test, and implement changes to the assessment process.

It is expected that alternative assessments will require analysis and piloting to ensure that the approach is impartial, fair, and respectful. ABIM recognizes the importance of physician and society input, and as such, will continue to update and engage them.

Dr. Baron emphasizes that he and the Board of Directors are grateful to the individuals and societies who have joined ABIM in trying to make the process better, and also to those who are urging the process to move faster. ABIM has committed to issuing quarterly progress reports so that everyone knows what the expect, and when to expect it, in the process.

If you have ideas about MOC, Dr. Baron encourages you to reach out to him at rbaronmd@abim.org.

March 03, 2016

New ABIM MOC Process: Asking for Physician Input

The American Board of Internal Medicine (ABIM) is setting a new process for internists and subspecialists on various aspects of Maintenance of Certification (MOC) assessments. These changes come in connection with the Assessment 2020 Task Force report, and will align with ABIM's continuous improvement efforts.

As the MOC program continues to evolve, the goal is to ensure that the clinical content is relevant to a broad cross-section of physicians. As such, ABIM board certified physicians can provide input on what topics are most important and most often seen in practice, and some physicians will even be able to participate in the process to set MOC exam minimum passing scores.

In 2015, physicians across the full range of internal medicine practice reviewed the Internal Medicine MOC exam blueprint and rated exam topic areas by relative frequency and importance in practice. The input from those physicians, taken together with data from national databases, helped create updates to the Fall 2015 blueprint aimed at enhancing the assessment's effectiveness at evaluating whether a certified general internist has maintained competence and currency in the knowledge and judgment required for practice.

Now, ABIM is expanding the blueprint review process to subspecialists, by allowing ABIM Board Certified physicians in several subspecialties to provide feedback on their MOC exam blueprints about relative frequency and importance in practice. Their input will be used to update the content of future MOC exams in the same way internal medicine input was used last year.

Richard J. Baron, MD, President and CEO of ABIM, said,

Internists and subspecialists will have a hand in shaping the content of MOC assessments so they better reflect what physicians need to know to provide the best care for their patients. Moving forward, ABIM will continue to invite physicians to review assessment content, and, through their timely and representative responses, we will be able to create an even more meaningful credential that is a source of price for those staying current in medical knowledge and practice.

As mentioned previously, ABIM invited a group of ABIM Board Certified internists from various geographic regions, practice settings, and age ranges, who spend at least half of their work time in direct patient care, to participate in ABIM's process for establishing the ABIM Fall 2015 Internal Medicine MOC examination minimum passing score. The internists worked with ABIM Internal Medicine Exam Committee members to set a new standard for the exam, which reflects the level of performance required to pass the exam. ABIM still does not set pass rates, instead, they rely on a evidence-based, peer-defined approach to set the exam's minimum passing score.

Nick Fitterman, MD, Chair of the ABIM Internal Medicine Exam Committee, is thrilled with the outcome,

It was incredibly valuable to hear perspectives from physicians who participated in the standard setting process for the Fall 2015 Internal Medicine MOC exam. This enhanced process is quite reliable and representative, and we heard from several participants that they appreciated the opportunity to learn more about the exam. More physicians will be invited to participate in standard setting as other subspecialty MOC assessments are updated.

ABIM also collaborated with physicians to create Score Reports that feature a more user-friendly design with detailed descriptions of exam performance, so physicians taking the exam better understand their score. These new Score Reports are sent electronically to physicians.

ABIM plans to continue collaborating with physicians to update its approach to knowledge assessments and is continuing to look for ways to adapt assessments to embrace advances in medical practice and technology. You can learn more about ABIM's ongoing conversations with the internal medicine community and opportunities to provide input by visiting the Transforming ABIM blog.

Additionally, if you are a physician who is interested in participating in the blueprint review, you can get more information here. The estimated time to rate each blueprint section varies, and ranges from approximately fifteen minutes to approximately one hour. You can choose to review just one section of the blueprint, multiple blueprint sections, or the entire blueprint. You are free to submit your review responses at any point, and can save your work and return to it later. The following subspecialties are currently open: Cardiovascular Disease; Endocrinology, Diabetes, & Metabolism; Medical Oncology; Nephrology; and Rheumatology. More subspecialties are slated to open in Spring 2016 and Fall 2016.

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