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Self-Assessment and Lifelong Learning for Family Physicians: Maintenance of Certification and Assessment of Performance

This article discusses the components of Maintenance of Certification (MC-FP) for family physicians, including self-assessment, lifelong learning, and assessment of performance in practice. It explores the importance of professionalism, knowledge assessments, clinical simulations, practice-based learning and improvement, and patient-clinician communication. The article also highlights the extension of certification to 10 years by completing MC-FP requirements in three blocks and provides examples of self-assessment modules (SAMs) and patient-based improvement models.

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Self-Assessment and Lifelong Learning for Family Physicians: Maintenance of Certification and Assessment of Performance

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  1. Self-Assessment, Lifelong Learning, & Assessment of Performance in Practice: Maintenance of Certification for Family Physicians Parts II &IV David Price, MD Colorado Permanente Medical Group Associate Professor Family Medicine UCSHC Chair-elect, American Board of Family Medicine MedBiquitous April 2007

  2. MOC • Response of ABMS & member boards to quality concerns & gaps • Multiple stakeholders (patients, FSMB, AMA, ACCME, physicians, etc.)

  3. Components of MOC (MC-FP) • Professionalism • Periodic self-assessment (SAM*) • Knowledge assessments (KA*) • Clinical Simulations (ClinSim*) • CME • Cognitive expertise (Examination) • Practice-based learning & improvement • PPM • MIMM • Pt-Clinician Communication • Pt Safety module

  4. Extend Certification From7 to 7+3 Years • Old: 6 SAMs + 1 PPM then exam year 7 • NOW: Diplomates engaged/remaining in MC-FP process can extend certificate to 10 years by completing MC-FP requirements in 3 blocks: • 2 SAMs + 1 PPM per 3 year block x 3 blocks • with exam in 10th year.

  5. Part II (SAMs + Simulations) • 2004: DM, HTN • 2005: CAD, Asthma • 2006: Depression, Heart Failure • 2007: Well child care, Pain management • 2008: Health behavior change, Maternity care • Eventual choice from about 20 modules

  6. SAM: Diabetes Mellitus

  7. ABFM Self-Assessment Modules: Completion Time

  8. Changes Resulting from Diplomate Input • Questions printable for initial completion off line (“pre-test”) • Only incorrectly answered questions appear upon completion • On-line full text references for questions • Direct link to references from questions

  9. Needs assessment Objectives Implementation Evaluation Follow-up Plan Do Study Act CME Process vs. QI cycle Price D. Continuing medical education, quality improvement, and transfer of practice. Medical Teacher 2005;27(3): 259-268.

  10. Part IV • Patient-based, physician controlled improvement model (HTN, DM, CAD, asthma, depression, HF) • 6 or more quality indicators per condition • Practice audit 10 charts/patients • Feedback vs. peers & benchmarks • Select area(s) for improvement • Develop QI plan (from a “QI wizard”) • Re-audit (PDSA) 10 charts/patients

  11. I hope this has been an eye opening experience

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