David A Cook1, Eric S Holmboe2, Kristi J Sorensen3, Richard A Berger4, John M Wilkinson5. 1. Knowledge Delivery Center, Mayo Clinic, Rochester, Minnesota2Mayo Clinic Online Learning, Mayo Clinic College of Medicine, Rochester, Minnesota3Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. 2. Accreditation Council for Graduate Medical Education, Chicago, Illinois. 3. Knowledge Delivery Center, Mayo Clinic, Rochester, Minnesota. 4. Mayo Clinic Online Learning, Mayo Clinic College of Medicine, Rochester, Minnesota5School of Continuous Professional Development, Mayo Clinic College of Medicine, Rochester, Minnesota6Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Roch. 5. Department of Family Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.
Abstract
IMPORTANCE: Despite general support for the goals of maintenance of certification (MOC), concerns have been raised about its effectiveness, relevance, and value. OBJECTIVE: To identify barriers and enabling features associated with MOC and how MOC can be changed to better accomplish its intended purposes. DESIGN, SETTING, AND PARTICIPANTS: Grounded theory focus group study of 50 board-certified primary care and subspecialist internal medicine and family medicine physicians in an academic medical center and outlying community sites. EXPOSURES: Eleven focus groups. MAIN OUTCOMES AND MEASURES: Constant comparative method to analyze transcripts and identify themes related to MOC perceptions and purposes and to construct a model to guide improvement. RESULTS: Participants identified misalignments between the espoused purposes of MOC (eg, to promote high-quality care, commitment to the profession, lifelong learning, and the science of quality improvement) and MOC as currently implemented. At present, MOC is perceived by physicians as an inefficient and logistically difficult activity for learning or assessment, often irrelevant to practice, and of little benefit to physicians, patients, or society. To resolve these misalignments, we propose a model that invites increased support from organizations, effectiveness and relevance of learning activities, value to physicians, integration with clinical practice, and coherence across MOC tasks. CONCLUSIONS AND RELEVANCE: Physicians view MOC as an unnecessarily complex process that is misaligned with its purposes. Acknowledging and correcting these misalignments will help MOC meet physicians' needs and improve patient care.
IMPORTANCE: Despite general support for the goals of maintenance of certification (MOC), concerns have been raised about its effectiveness, relevance, and value. OBJECTIVE: To identify barriers and enabling features associated with MOC and how MOC can be changed to better accomplish its intended purposes. DESIGN, SETTING, AND PARTICIPANTS: Grounded theory focus group study of 50 board-certified primary care and subspecialist internal medicine and family medicine physicians in an academic medical center and outlying community sites. EXPOSURES: Eleven focus groups. MAIN OUTCOMES AND MEASURES: Constant comparative method to analyze transcripts and identify themes related to MOC perceptions and purposes and to construct a model to guide improvement. RESULTS:Participants identified misalignments between the espoused purposes of MOC (eg, to promote high-quality care, commitment to the profession, lifelong learning, and the science of quality improvement) and MOC as currently implemented. At present, MOC is perceived by physicians as an inefficient and logistically difficult activity for learning or assessment, often irrelevant to practice, and of little benefit to physicians, patients, or society. To resolve these misalignments, we propose a model that invites increased support from organizations, effectiveness and relevance of learning activities, value to physicians, integration with clinical practice, and coherence across MOC tasks. CONCLUSIONS AND RELEVANCE: Physicians view MOC as an unnecessarily complex process that is misaligned with its purposes. Acknowledging and correcting these misalignments will help MOC meet physicians' needs and improve patient care.
Authors: Furman S McDonald; Lauren M Duhigg; Gerald K Arnold; Ruth M Hafer; Rebecca S Lipner Journal: J Gen Intern Med Date: 2018-03-07 Impact factor: 5.128
Authors: Anthony Jerant; Richard L Kravitz; Daniel Tancredi; Debora A Paterniti; Lynda White; Lynn Baker-Nauman; Dionne Evans-Dean; Chloe Villarreal; Lori Ried; Andrew Hudnut; Peter Franks Journal: J Gen Intern Med Date: 2016-03-08 Impact factor: 5.128
Authors: Jason C Pradarelli; Gregory A Jaffe; Christy Harris Lemak; Michael W Mulholland; Justin B Dimick Journal: Surgery Date: 2016-04-29 Impact factor: 3.982
Authors: David A Cook; Christopher M Wittich; Wendlyn L Daniels; Colin P West; Ann M Harris; Timothy J Beebe Journal: J Med Internet Res Date: 2016-09-16 Impact factor: 5.428
Authors: Eric J Keller; Megan Crowley-Matoka; Jeremy D Collins; Howard B Chrisman; Magdy P Milad; Robert L Vogelzang Journal: PLoS One Date: 2017-02-24 Impact factor: 3.240
Authors: Eric J Keller; Robert L Vogelzang; Benjamin H Freed; James C Carr; Jeremy D Collins Journal: J Cardiovasc Magn Reson Date: 2016-08-26 Impact factor: 5.364
Authors: Christopher R Stephenson; Christopher M Wittich; Joel E Pacyna; Matthew K Wynia; Omar Hasan; Jon C Tilburt Journal: Med Educ Online Date: 2018-12