Within five years of the Continuing Board Certification: Vision for the Future Commission (Vision Commission) sharing its recommendations[PDF], all 24 American Board of Medical Specialties (ABMS) Member Boards have implemented formative assessments for continuing certification.
The Vision Commission’s report, which was released in February 2019, called for the Member Boards to create formative processes that offer opportunities for learning and improvement, and an alternative to the secure, point-in-time examinations of knowledge. The formative assessments offered by the boards are designed to support physicians in keeping their skills sharp and knowledge current while identifying knowledge gaps for improvement. At the same time, board certification by an ABMS Member Board is a credential on which the public can rely as a marker of professionalism and commitment to lifelong learning.
Seventeen of the Member Boards have implemented longitudinal assessments that offer:
- Shorter assessments of specific content related to a physician’s or medical specialist’s needs and interests.
- Recurring assessments over a period of time to reinforce concepts and promote learning and retention.
- Ongoing performance feedback to identify areas in which additional learning is desirable.
- Follow-up assessments to gauge a physician’s or medical specialist’s proficiency.
Questions used in longitudinal assessment may address core specialty and/or practice-specific content. Due to its administration in real time, assessments also can address emerging medical knowledge and urgent public health topics, drawing content from new practice guidelines, peer-reviewed articles, key advances in a specialty, and critical public health information, among other sources. Because longitudinal assessments are accessible on a desktop and tablet, physicians can choose when, where, and how they answer questions. This approach may reduce or eliminate the need for study courses or travel to exam centers, both of which take time away from clinical practice. This ease and convenience are a welcome bonus.
Longitudinal assessment has been shown to result in better long-term retention than repeatedly studying the same material. When this type of assessment occurs over a period of weeks to months, it significantly improves learning compared to repeated study. Furthermore, ABMS Member Boards are required to make summative decisions about a physician’s or medical specialist’s certification status based on longitudinal assessments taken over several years. This aligns the learning with the important decision-making by a Member Board that an individual remains certified by demonstrating his or her knowledge and judgment over time. While introducing formative assessment to support physician learning represents an important advance in ABMS continuing certification, it is also essential for providing an assessment result that ensures the public that standards for specialty knowledge have been met.
Seven of the 17 Member Boards use CertLink®, the technology platform that supports the development of longitudinal assessments created by ABMS. To date, board certified physicians and medical specialists have answered more than four million questions across the seven Member Boards.
Four of the Member Boards have implemented point-in-time knowledge assessments. Point-in-time assessments are offered at less frequent intervals, ranging from a semi-annual basis to every three years.
Three of the Member Boards have implemented a customized to practice, either question- or article-based assessment. Customized to practice means that physicians can select from among topic areas based on practice setting and/or patient mix. Many of the Member Boards that offer longitudinal assessments allow physicians to customize their assessments, as well. Question-based assessments involve the use of multiple-choice questions, whereas article-based assessments involve reviewing articles with which physicians should be familiar and demonstrating mastery of the material by responding to questions related to the articles.
Eight of the Member Boards no longer even offer a traditional, secure examination. Three boards use it for re-entry only. Some boards have elected to keep an exam option based on feedback from physicians and medical specialists.
Formative Assessments Offered by ABMS Member Boards
|Anesthesiology||Allergy and Immunology||Obstetrics and Gynecology|
|Colon and Rectal Surgery||Emergency Medicine||Psychiatry and Neurology|
|Dermatology||Neurological Surgery||Thoracic Surgery|
|Medical Genetics and Genomics|
|Otolaryngology-Head and Neck Surgery|
|Physical Medicine and Rehabilitation|
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