ACEP: How long do you believe it would be before changes to MOC would take effect?

BH: It would be difficult to estimate timelines until and unless specific changes are approved. Before ABEM changes from the current ConCert Examination format, we need to carefully study the alternatives. In short, we need to be certain that innovation doesn’t outpace rigor.

The ABEM MOC Program already has a significant learning dimension. For the LLSA, 92 percent of physicians report that the activity leads to changes in practice to at least some degree. In a report by Marco et al, more than 90 percent of test takers reported a learning benefit to preparing for and taking the exam.¹

Before ABEM considers any transition from the ConCert, which is a highly successful, psychometrically proven physician-assessment format, we need to study the alternatives. There are potential upsides to these new processes, but there are aspects that could be better understood.

ACEP: The American Board of Anesthesiology (ABA) has been allowed to pilot an alternative to a continuous certification exam every 10 years. Do you think this is a viable alternative? Why or why not?

BH: It’s too early to definitively determine if the ABA approach is the best course for emergency medicine. ABEM is carefully monitoring the ABA program as well as a similar one developed by ABMS called CertLink. Both formats use frequently transmitted questions for physicians to answer that can be delivered via a mobile platform. Before ABEM would adopt CertLink, we would need to be sure that the learning and assessment advantage is better than the current combination of LLSA tests and the ConCert Exam. ConCert is carefully designed to assess complex cognitive skills, such as diagnostic processing, rather than fact recall. Cognitive psychology research demonstrates that tests designed like this have a huge learning dimension. Though physicians don’t prefer learning through testing or appreciate the considerable learning impact, learning is a proven and powerful aspect of the ConCert Exam.

What makes certification different from simple CME [continuing medical education] testing is that it includes a summative assessment against an external objective national standard. In ABEM’s case, that assessment is accomplished via an examination. In the absence of a physician demonstrating cognitive competencies against a national standard, ABEM would become little more than a CME clearinghouse, and becoming certified, little more than a glorified CME certificate.

ACEP: Is ABEM considering changes to its MOC process, including moving away from the ConCert exam every 10 years? If so, when would such changes occur?