Regardless of profession, the highest performers share a common trait: all are lifelong learners, continuously searching for opportunities to enhance their abilities. Since its inception, the Maintenance of Certification in Anesthesiology™ program (MOCA®) has endeavored to support our diplomates as they seek opportunities to maintain and improve their skills and clinical knowledge.
As a certifying board, we find ourselves at an interesting juncture between the Vision for the Future Commission report recommending enhancements to continuing certification programs, the American Board of Medical Specialties (ABMS) developing new program standards in 2020 and our Board forging ahead with our innovation strategies, guided by diplomate input and feedback. So, what will come next for continuing certification?
A Brief History of MOCA
In 1999, the American Board of Medical Specialties (ABMS) established the ABMS Program for Maintenance of Certification (ABMS MOC®). In doing so, ABMS spurred Member Boards to implement programs that assure the public that board-certified physicians demonstrate a commitment to quality clinical outcomes and patient safety. Following this decision by ABMS, we launched MOCA in 2004.
The Traditional MOCA program had four parts designed to help board-certified anesthesiologists demonstrate they were maintaining their certification and staying up to date on medical knowledge.
In 2016, following advancements in technology and learning science, and most importantly, feedback from our diplomates, we replaced Traditional MOCA with MOCA 2.0®; the continuing certification program that diplomates participate in today. It took five years of planning and significant diplomate input to evolve to MOCA 2.0, which provides our clinicians with a web-based, personalized approach to knowledge assessment and increased opportunities to continuously learn so they can provide high-quality patient care.
At the core of MOCA 2.0’s redesign is MOCA Minute®, our interactive, longitudinal self-assessment tool that replaced the 10-year MOCA exam. This transition to MOCA Minute represents our dedication and desire to move toward innovative, effective and relevant evaluation techniques that support continuous knowledge acquisition and retention. Development and implementation of MOCA Minute has taken considerable investment, effort and time that has paid off by providing more timely and personalized incremental learning that fits more readily into diplomates’ busy schedules. It also has resulted in greater diplomate satisfaction. While MOCA Minute has been embraced by most anesthesiologists, our work to make MOCA even better for our diplomates’ practice is never finished.
About the Physicians Users’ Group & MOCA 3.0
In the fall of 2018, we asked 17 volunteer physicians to help guide the development of the next generation of MOCA, which we’re referring to as MOCA 3.0. This group is representative of our diplomate corps and is at the center of leading us into the next iteration of MOCA by continuing our ongoing efforts to make the program more relevant, customizable and convenient.
Each of the diplomates in the Users’ Group is actively participating in MOCA 2.0. The diverse members in the group include private practitioners, academicians, subspecialists and residents preparing to take their certifying exams.
Their work started with the redesign of our web-based Physician’s Portal and the development of a new mobile application to provide our diplomates with a more personalized and seamless digital experience. These new platforms will launch in January 2020 as the first phase of MOCA 3.0 and are setting the foundation for a larger initiative to further transform the continuing certification program.
As the Board of Directors’ liaison to the Users’ Group, my role is to listen to the group’s insights and requests, share their feedback with our full Board, and prompt discussions that align the Board’s future course with their needs and our mission.
Innovation Summit and the Vision for the Future Commission’s Final Report
Shortly after the release of the Commission’s final report, we hosted a two-day Innovation Summit to aid in our strategic approach to enhancing MOCA. We brought together thought leaders in technology, education, and medicine to examine how advances at the intersection of these fields are likely to impact board certification. They emphasized the importance of informal in-person and online networks, the value of co-created content, and how artificial intelligence (AI) is revolutionizing education. Additionally, they highlighted that we must strive to engage learners on their own terms as today’s clinicians are learning in drastically different ways than previous generations.
We presented the key themes from the Summit to our Users’ Group, who affirmed what we heard and added their own insights. They said that clinicians are lifelong learners who want to improve their practice—and they need our help identifying learning opportunities and resources. The Users’ Group also said that, while MOCA Minute questions do help to surface knowledge or skill deficits, it’s often an organic part of their workday—like the release of a new drug or a conversation with a colleague—that highlights an opportunity for improvement.
“I really like the MOCA 2.0 program. I think it’s very easy to use – user-friendly. Definitely the fact that you can pull up the questions on your mobile device is easy. I like the fact that you get 30 questions every quarter and you get immediate feedback on your answers. “
– Kimberly Nichols, M.D.
Diplomate Testimonial, ASA Annual Meeting 2016
Following the Innovation Summit, the Commission’s report, and the feedback we’ve heard from our Users’ Group and diplomates at-large, we have a solid understanding of what our board-certified anesthesiologists want from a continuous learning and assessment program. Our next task is to translate these ideas into a seamless digital experience that supports approaches like micro-, adaptive- and on-the-job learning that facilitates continuous education and professional development for our diplomates.
To accomplish this, our next step is to host a Learning Theory Workshop this summer where learning theory experts will help us establish guiding principles to augment our single-best-answer assessments with tools such as adaptive models, like those described at Innovation Summit and by our Users’ Group.
Meanwhile, the group continues to help us grapple with the tough questions — How can we capture meaningful learning that anesthesiologists do each day without creating undue burden? — while also helping us evaluate existing programmatic tools like the Personal Portfolio, CME Explorer and Knowledge Assessment Report for enhancement. In September, the group will meet in Raleigh to test the redesigned portal and new app ahead of its January 2020 launch. From there, we will work with our Users’ Group and the collective diplomate community to continue evolving MOCA 3.0 into an interactive, diplomate-centered program that supports physicians’ learning and helps them demonstrate their commitment to quality outcomes and patient safety.
What improvements would you make to the Knowledge Assessment Report, the Personal Portfolio, or the CME Explorer?
What enhancements would you make to MOCA Minute? How would you modify quality improvement (Part 4) to make project completions more seamless?