Visiting Scholars, Continuing Certification

ABMS Visiting Scholar Develops ‘Fun’ Part II MOC Activities

ABMS Visiting Scholar Develops ‘Fun’ Part II MOC Activities

ABMS Visiting Scholar Daniel J. Schumacher, MD, MEd., envisions Part II Maintenance of Certification (MOC) activities that are educational, interactive, and even a little fun. Yes, fun.

To that end, the Assistant Professor at Cincinnati Children’s Hospital is working with staff at the American Board of Pediatrics (ABP), of which he is a diplomate, to develop nine interactive MOC activities as part of his research project for the ABMS Visiting Scholars Program. The one-year, part-time program is intended to help scholars familiarize themselves with health policy and the external environment in which continuous certification occurs; develop their research skills and scholarship by engaging in a research project related to Board Certification and MOC/Continuous Certification; and contribute to the scholarship about innovations/best practices of continuous professional development, assessment, quality improvement (QI), and health policy.

A handful of learning theories are behind the content of the Lifelong Learning and Self-Assessment modules, but Dr. Schumacher is hoping that nobody will notice because of the fun manner in which it is presented. As an example, the modules embrace a social learning theory suggesting that people learn best when they are in their actual working environment interacting with others, he explained. The other theory, which has been well documented in the medical educational literature, is that physicians are not good at unguided self-assessment. However, external assessments from peers, colleagues, and tests have been shown to inform the accuracy of self-assessment. Thus, obtaining external information and feedback is critical to learning and filling gaps in knowledge.

Daniel Schumacher.jpgThat is why some of the modules use dyads of physicians working together as “coach and learner,” each playing the opposite role for the other, Dr. Schumacher said. “It’s pretty clear that physicians need others to help calibrate, keep us accountable, and point out things we might not be seeing,” he said. “That’s where the coaching comes in.”

The modules also incorporate QI principles.Physicians must have a good understanding of QI because the modules will springboard them into doing a small QI effort in the form of a guided self-directed Improvement in Medical Practice (Part IV) activity, Dr. Schumacher noted. “In order to do that, they must have all the skills necessary to engage in a QI project when they have completed the Part II modules.”

All of this educational content is delivered via discussion between “animated” ABP diplomates, one of whom is becoming director of the practice. Following the animated general pediatrician’s story, the physician pairs and team members learn the principles of guided self-assessment, gap filling, self-monitoring, and external assessment. They learn how to identify a gap in knowledge, use educational principles to address the gap, and create an intervention to fill the gap. The modules guide participants through QI steps such as gathering baseline data, developing an aim statement, and conducting plan-do-study-act, commonly referred to as PDSA, cycles.In addition to dyads who continue to mentor and coach one another through this activity, interprofessional teams collaborate to improve practice gaps. “We believe that illuminating, integrating, and applying these principles through an interweaving of learning theory and QI will help participants be more effective in their lifelong learning efforts through MOC,” Dr. Schumacher said.

“Rather than present a lot of text, which is what many modules do, these modules deliver short theory bursts and then get participants to act on the information,” noted ABP’s Vice President of Competency-based Assessment Carol L. Carraccio, MD, MA, who is Dr. Schumacher’s mentor for this project. They use a fun approach to explain QI science, which frankly can be a dry subject, she said. “We’re engaging physicians in learning how to create a QI project so it’s meaningful to their practice.” Upon completing the modules, the team will have the substrate and background knowledge/skills to conduct a meaningful QI project within the practice. Although the physician depicted in the module is a general pediatrician working in a multi-physician practice, as are most ABP diplomates, these modules are applicable to pediatricians in ambulatory settings and hospital settings alike, Dr. Schumacher added. They could be adapted for other specialties, as well.

While the script and content for the modules are nearly final, the technology/delivery platform is still being developed. The goal is to have web-based modules that can be used on a mobile device and accessible via an app. “We want diplomates to be able to work on these modules, for example, in between seeing patients or over a quick cup of coffee with a colleague,” Dr. Carraccio said. “We want them to feel like QI is part of their practice.”

Moreover, five minutes is all it should take to complete each module, which ABP anticipates rolling out in spring 2016. That means physicians will be able to complete all nine modules during the course of a couple weeks in their down time, rather than blocking out hours to work through them at home, Dr. Schumacher said, adding, “I consider them bite size QI."

These modules just might turn out to be fun, after all.