The Role of Specialty Certification in Career-Long Competence.


Journal

Academic medicine : journal of the Association of American Medical Colleges
ISSN: 1938-808X
Titre abrégé: Acad Med
Pays: United States
ID NLM: 8904605

Informations de publication

Date de publication:
01 10 2023
Historique:
medline: 28 9 2023
pubmed: 5 7 2023
entrez: 5 7 2023
Statut: ppublish

Résumé

Across the medical profession there is broad acceptance of the critical role of continuing medical education (CME) in enabling physicians to adapt to both new information and evolving expectations within the profession. In the presence of widespread participation in CME, some have attempted to question, discredit, or marginalize the role of ongoing lifelong assessment of physician knowledge and skills through specialty continuing certification, advocating instead for a participatory standard based only on engagement with CME. This essay outlines the limitations of physician self-evaluation and clarifies the need for external assessments. Certification boards' role is to set specialty-specific standards for competence, assess to those standards, and assure the public that certified physicians are adequately maintaining their skills and abilities; doing so credibly necessarily requires, in part, independent assessments of physician competence. In these contexts, the specialty boards are taking approaches to identify performance gaps and leverage intrinsic motivation to facilitate physician engagement in targeted learning. Specialty board continuing certification plays a unique role, distinct from and complementary to the CME enterprise. Calls to eliminate continuing certification requirements beyond self-directed CME are contradictory to the evidence and fail the profession and the public.

Identifiants

pubmed: 37406286
doi: 10.1097/ACM.0000000000005314
pii: 00001888-990000000-00493
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1104-1106

Informations de copyright

Copyright © 2023 by the Association of American Medical Colleges.

Références

Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: The relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142:260–273.
Accreditation Council for Continuing Medical Education. Onward and Upward: Thriving Together in Accredited Continuing Education—2021. https://www.accme.org/highlights/accme-data-report-2021 . Published October 5, 2022. Accessed June 22, 2023.
Kempen PM. MOC must go: One physician’s viewpoint. A critic of Maintenance of Certification explains why the costly program burdens physicians. Med Econ. 2014;91:49–50.
Ibrahim T. Maintenance of certification, self-regulation, and the decline of physician autonomy. Am J Kidney Dis. 2018;72:711–713.
Kenney v. Am. Bd. of Internal Med., No. 20-1007, 847 F Appendix 137, 144 (3d Cir 2021.
Ass’n of Am. Physicians & Surgeons, Inc. v. Am. Bd. Of Med. Specialties. 15 F4th 831, 832 (7th Cir 2021.
Siva v. Am. Bd. Of Radiology. 38 F4th 569, 572-573 (7th Cir 2022.
American Society of Plastic Surgeons. Attacks on MOC reemerge. https://www.plasticsurgery.org/for-medical-professionals/advocacy/advocacy-news/attacks-on-moc-reemerge . Published March 24, 2021. Accessed June 22, 2023.
American Board of Medical Specialties. The American Board of Medical Specialties Response to the National Board of Physicians and Surgeons’ Assertion of Certifying Body Equivalency. https://www.abms.org/newsroom/abms-response-to-nbpas-assertion-of-certifying-body-equivalency . Published July 29, 2022. Accessed June 22, 2023.
Norman GR, Eva KW. Does clinical experience make up for failure to keep up to date? ACP J Club. 2005;142:A8–A9.
Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: A systematic review. JAMA. 2006;296:1094–1102.
Violato C, Lockyer J. Self and peer assessment of pediatricians, psychiatrists and medicine specialists: Implications for self-directed learning. Adv Health Sci Educ Theory Pract. 2006;11:235–244.
Hodges B, Regehr G, Martin D. Difficulties in recognizing one’s own incompetence: Novice physicians who are unskilled and unaware of it. Acad Med. 2001;76(10 suppl):S87–S89.
Atir S, Rosenzweig E, Dunning D. When knowledge knows no bounds: Self-perceived expertise predicts claims of impossible knowledge. Psychol Sci. 2015;26:1295–1303.
Zell E, Krizan Z. Do People Have Insight Into Their Abilities? A Metasynthesis. Perspect Psychol Sci. 2014;9:111–125.
Kruger J, Dunning D. Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77:1121–1134.
Barnsley L, Lyon PM, Ralston SJ, et al. Clinical skills in junior medical officers: A comparison of self-reported confidence and observed competence. Med Educ. 2004;38:358–367.
Greiner AC, Knebel E, eds. Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press; 2003.
Gonçalves-Sá J. In the fight against the new coronavirus outbreak, we must also struggle with human bias. Nat Med. 2020;26:305.
Shanafelt TD, West CP, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life integration in physicians during the first 2 years of the COVID-19 pandemic. Mayo Clin Proc. 2022;97:2248–2258.
O’Brien Pott M, Blanshan AS, Huneke KM, Baasch Thomas BL, Cook DA. What influences choice of continuing medical education modalities and providers? A national survey of U.S. physicians, nurse practitioners, and physician assistants. Acad Med. 2021;96:93–100.
Marco CA, Wahl RP, House HR, et al. Physician age and performance on the American Board of Emergency Medicine ConCert examination. Acad Emerg Med. 2018;25:891–900.
McMahon GT, Newton WP. Continuing board certification: Seeing our way forward. J Am Board Fam Med. 2020;33(suppl):S10–S14.
Lyness JM, Lurie SJ, Ward DS, Mooney CJ, Lambert DR. Engaging students and faculty: Implications of self-determination theory for teachers and leaders in academic medicine. BMC Med Educ. 2013;13:151.
ten Cate TJ, Kusurkar RA, Williams GC. How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide no. 59. Med Teach. 2011;33:961–973.
Chappell KB, Howard MS, Lundmark V, Ivory C. Credentialing and certification: Overview, science, and impact on policy, regulation, and practice. Int Nurs Rev. 2021;68:551–556.
Shaw RC Jr, Vines DL, Mirza SH, Eltorai AS, Benavente JL. Evaluating a potential National Board for Respiratory Care credential for pulmonary disease educators. Chest. 2023;164:190–198.
Colenda CC, Scanlon WJ, Hawkins RE. Vision for the future of continuing board certification. JAMA. 2019;321:2279–2280.
Hawkins RE, Ogrinc G, Ramin SM. American Board of Medical Specialties and new standards for continuing certification. JAMA. 2022;327:1645–1646.
Kinney CL. Positive professionalism. J Am Board Fam Med. 2020;33(suppl):S65–S68.
American Board of Medical Specialties. All ABMS member boards now offer formative assessments. ABMS Insights. https://www.abms.org/newsroom/all-abms-member-boards-now-offer-formative-assessments . Published 2023. Accessed June 22, 2023.
Macario A, Harman AE, Hosansky T, Post ME, Sun H, McMahon GT. Evolving board certification—Glimpses of success. N Engl J Med. 2019;380:115–118.

Auteurs

Jeffrey M Lyness (JM)

J.M. Lyness is president and chief executive officer, American Board of Psychiatry and Neurology, Deerfield, Illinois.

Graham T McMahon (GT)

G.T. McMahon is president and chief executive officer, Accreditation Council for Continuing Medical Education, Chicago, Illinois.

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