1 / 74

TRUST ME, I’M A (CERTIFIED) DOCTOR

Learn about the recent changes in MOC, including lifelong learning, cognitive expertise, and improvement in practice. Discover why MOC is important and how it aims to make the process less burdensome and more meaningful.

munford
Download Presentation

TRUST ME, I’M A (CERTIFIED) DOCTOR

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TRUST ME, I’M A (CERTIFIED) DOCTOR INNOVATIONS AND IMPROVEMENTS IN MAINTENANCE OF CERTIFICATION MARSHALL L. LAND, JR., MD R.J. MCKAY, JR., MD GREEN & GOLD PROFESSOR OF PEDIATRICS UNIVERSITY OF VERMONT COLLEGE OF MEDICINE AMERICAN BOARD OF PEDIATRICS, ADVISOR FOR DIPLOMATE OUTREACH AND STRATEGIC PLANNING May 3, 2019

  2. Disclosures I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in this CME activity. I do not intend to discuss an unapproved/investigative use of a commercial product/device in my presentation.

  3. Objectives Brief history of “Why” MOC Overview of recent changes in MOC • Part 2: Lifelong Learning and Self Assessment • Part 3: Cognitive Expertise • Part 4: Improvement In Practice • Fees Listen for your ideas!

  4. Why do I have to do MOC?

  5. The ABP Mission Began 1933 Mission to the public To certify pediatricians based on standards of excellence that lead to high quality care. The ABP certification provides assurance to the public that a pediatrician fulfills the continuous evaluation requirements that encompass the six core competencies.

  6. The Evolution of Board Certification 1934 Permanent certification

  7. The Evolution of Board Certification Re-test every 7 years Point system, test every 10 years 1934 1988 2003 2010 2019 4 part program, test every 10 years MOCA-Peds Permanent certification

  8. Why these changes?

  9. Explosion of knowledge PEDIATRICS 1000 MORE ARTICLES PER YEAR BEING SUBMITTED THAN 7 YEARS AGO

  10. Explosion of knowledge: weekly/daily

  11. Recognition of Medical Errors IOM: “To Err is Human” & “Crossing the Quality Chasm” Medical errors 100,000 deaths per year (now est. 400,000) Hospitalized children medical error rate 1.81–2.96/100 discharges 25% incidence of medication errors

  12. Improvements and innovations Continuing to try to make this process better LESS BURDENSOME LESS TIME CONSUMING MORE MEANINGFUL MORE RELEVANT

  13. Evolution of Board Certification Single test of knowledge  Periodic test of knowledge  More continuous measurement of knowledge acquisition and quality improvement

  14. Evolution of Board Certification MOC is about “staying current”, but it is also about attempting to improve the care we are giving, even if that care is at a high level

  15. 4 Part MOC Professional Standing (Part 1) Lifelong Learning and Self Assessment (Part 2) Cognitive Expertise (Part 3) Improvement In Practice (Part 4)

  16. Part 2 Lifelong Learning and Self Assessment “I already keep up…… Why can’t CME count for Part 2?” WHAT’S NEW?

  17. Part 2 Changes MOC points for CME! ACCME Collaboration AAP Chapter meetings, NCE, Grand Rounds, etc As of 12/11/18: Total number MOC Part 2 activities registered: 4,153 2018 number of MOC points awarded: 123,944.25

  18. Part 2 Changes New Self Assessments: • Professionalism in Global Health • Care of a Transgender Child • Immigration Health Care • Updating Patient Safety • A Journey of Improvement: The Basics of QI Question of the Week Enhancements

  19. Question of the Week Painless and Fun How good is the power of suggestion to manage a child with functional abdominal pain?

  20. Question of the Week Painless and Fun To use or not to use ibuprofen post tonsillectomy: That is the question

  21. Question of the Week Painless and Fun What’s the best way to fight off a recurrent case of the “runs” after a bout of c. diff.?

  22. Part 3 Cognitive expertise “That exam every 10 years is not a learning experience…… I hate the Testing Center” WHAT’S NEW?

  23. Maintenance of Certification Assessment for Pediatrics Assessment FOR Learning

  24. MOCA-Peds Overview • Continuousassessment tool • Questions sent quarterly; flexibility in answering • Delivered via web or mobile device at home or office • Focuses on assessmentandlearning • Fulfill the MOC Part 3 requirement/ also Part 2 points

  25. Question Overview Application offundamental knowledge of everyday pediatrics Short clinical vignettes,mimic real world situations Multiple-choice, single-best answer 5minutes per question, may use resources (eg, books, internet) Instant feedback, clinical rationale, and references

  26. General Phase-in Plan Enter MOCA-Peds at start of the 5-year MOC cycle during which next exam due • Pilot 2017 and 2018 • With changes guided by diplomate input – clinical practice guidelines • Now live 2019! • Subspecialties will phase in over time (2019-2022)

  27. Pediatric Subspecialties

  28. Pilot Participation 2017: 5,081 of 6,814 (74.6%) 2018: 6,025 of 7,562 (79.7%) Subspecialists: 81.1% registered

  29. Participant Experience: Using The Platform Sample Size: Quarter 1 = 4,181, Quarter 2 = 3,772; Quarter 3 = 3,761; Quarter 4 = 4,016

  30. Overall Acceptability: General Pediatrics

  31. Overall Acceptability: Subspecialists

  32. Overall Satisfaction

  33. Overall Satisfaction Comments “THANK YOU for listening to pediatricians…” “The MOCA-Peds pilot is a great improvement over the secure exam! Thank you so much for creating this new form of evaluation for pediatricians…so much less stressful, I am learning a lot while I take the exam and find the exam useful for my daily pediatric practice.”

  34. Overall Satisfaction

  35. Overall Satisfaction What one enhancement would you recommend that the ABP make to improve MOCA-Peds? “Would eliminate the 5 minute limit per question or lengthen significantly” “A continuous exam lasting for 4 out of 5 years is excessive” ______ New knowledge: articles and guidelines

  36. Participant Experience: Time Spent < 2 minutes/question 38 mins for 20 questions

  37. Participant Experience: Resource Use • Most common resources: • UpToDate: 57.1% • Government websites (eg, CDC, NIH, NICHD): 33.7% • Search engines (eg Google, Yahoo): 58.6% • Professional sites (eg, AAP) 26.7% • Textbook:18.8% • PREP: 8.3%

  38. Participant Experience: Resource Use • Most common resources: • UpToDate: 57.1% • Government websites (eg, CDC, NIH, NICHD): 33.7% • Search engines (eg Google, Yahoo): 58.6% • Professional sites (eg, AAP) 26.7% • Textbook:18.8% • PREP: 8.3%

  39. Did learning occur? Most significant practice changes you made as a result of participation in the 2017 pilot? “More diligent with antibiotic mgx in otitis media. In general am practicing more evidence based medical care with confidence.” Learn, refresh, or enhance medical knowledge based on using MOCA-Peds in the 2017 pilot? Yes 97.6% “Started to pay more attention to features of autism.” Able to apply any of what you learned to your clinical practice? “I identified a Kawasaki patient based on review; ..that is just one instance “ “Follow up on High BP” “Became aware of my deficiency in acute drug intoxication”

  40. Comments “I'm a neonatologist with a follow up clinic for babies discharged from the NICU. In many areas I realized that some of my practice in the clinic might have been dated. Inow have far more frequent discussions with both my general and subspecialty peds colleagues regarding the outpatient care of my former patients seen in their clinics. Having to go read up on the topics I got wrong in my answers was also enlightening. I became more facile in this process as the year went by and in fact found myself reading far more general pediatrics than I had anticipated at the beginning of the year. I truly believe that this should be the way of the future to ensure practitioners keep up to date.”

  41. “It is AMAZING. I love it. Honestly, I am learning a lot by doing it, and it’s very easy to make time to learn from it. This is a far better learning tool than a proctored exam.” “I have really enjoyed this, something I would never have thought I would say about the certification exam. I am both learning and meeting my requirement for certification, which is reflective of real practice!” “It is a great way for a subspecialist to keep up to date on general pediatrics. I would do it again. I think I will retain the general pediatrics information and actually be able to improve the clinical care I provide my subspecialty patients better…”

  42. MOCA-Peds2019 CORE KNOWLEDGE • 45 learning objectives • 1 question per learning objective • 45 total questions NEW KNOWLEDGE • Up to 4 articles/guidelines • Up to 2 questions per article • Questions appear after Q2 begins + 15 repeat questions Based on confidence/relevance ratings and questions missed Up to 4 “time-sensitive” questions Quickly developed and delivered questions based on current events

  43. Learning objectives 2019 • Diagnose and manage a neonate with an abnormal head size or shape. • Diagnose and manage neonatal abstinence syndrome. • Evaluate a child with hemoptysis. • Evaluate a hypotonic infant. • Evaluate a patient with leukocoria. • Evaluate an adolescent with a testicular mass. • Evaluate and manage a child at risk for type 2 diabetes. • Evaluate and manage a child with gross hematuria. • Evaluate and manage a prepubertal girl with vaginal discharge. • Evaluate and manage back pain in children. • Evaluate and manage neonatal jaundice. • Evaluate suicide risk in an adolescent.

  44. Learning objectives 2019 • Diagnose and manage a neonate with an abnormal head size or shape. • Diagnose and manage neonatal abstinence syndrome. • Evaluate a child with hemoptysis. • Evaluate a hypotonic infant. • Evaluate a patient with leukocoria. • Evaluate an adolescent with a testicular mass. • Evaluate and manage a child at risk for type 2 diabetes. • Evaluate and manage a child with gross hematuria. • Evaluate and manage a prepubertal girl with vaginal discharge. • Evaluate and manage back pain in children. • Evaluate and manage neonatal jaundice. • Evaluate suicide risk in an adolescent.

  45. Learning objectives 2019 • Diagnose and manage a neonate with an abnormal head size or shape. • Diagnose and manage neonatal abstinence syndrome. • Evaluate a child with hemoptysis. • Evaluate a hypotonic infant. • Evaluate a patient with leukocoria. • Evaluate an adolescent with a testicular mass. • Evaluate and manage a child at risk for type 2 diabetes. • Evaluate and manage a child with gross hematuria. • Evaluate and manage a prepubertal girl with vaginal discharge. • Evaluate and manage back pain in children. • Evaluate and manage neonatal jaundice. • Evaluate suicide risk in an adolescent.

More Related