American Board of Clinical Neuropsychology (ABCN)

Maintenance of Certification (MOC):A Review of Process and Procedures

Nathaniel W. Nelson, Ph.D., ABPP1,2

1University of St. Thomas, Minneapolis, MN2Private Practice, Minneapolis, MN

Presented at the Annual Meeting of the American Academy of Clinical Neuropsychology (AACN)

San Francisco, CA, June 18-19, 2015

Special Thanks To Key MOC Consultants

ABPP Board of Trustees Liaison Deb Attix, Ph.D., ABPP

ABCN MOC SubcommitteeMarsha Gragert, Ph.D., ABPPWilliam MacAllister, Ph.D., ABPPMike Schoenberg, Ph.D., ABPPRobert Seegmiller, Ph.D., ABPP

ABCNTony Stringer Ph.D., ABPPJohn Lucas, Ph.D., ABPPIda Sue Baron, Ph.D., ABPP

ABPPDiane ButcherDavid Cox Ph.D., ABPPMichael Tansy, Ph.D., ABPP

Objectives

1. Summarize the rationale and benefits of ABCN Maintenance of Certification (MOC).

1. Provide a general overview of MOC process and procedures, including who is expected to participate and when.

1. Illustrate how MOC application is completed through review of a sample submission (“mock” MOC application).

Outline

1. MOC: Why, What, Who, and When?

2. MOC Basics: Review of Process & Procedure

3. MOC Application Exercise (“Mock MOC” Application)

Why Was MOC Developed?

• As summarized by ABPP (www.abpp.org), maintenance of certification (MOC) was developed “as a result of converging forces within psychology and the broader healthcare community, including public advocacy groups that insist upon competent practice throughout the career of a psychologist”.

• In light of the “limited half life” of psychology competencies, the ABPP Board of Trustees concluded that “regular demonstration of competence is necessary for the ABPP certificate to continue to be a viable and credible credential.”

• MOC was developed as a periodic process of self-review that would assure quality care and the protection of the public consistent with the highest professional standards.

What is MOC?

First, what MOC is NOT

What MOC is NOT

To be absolutely clear, the ABCN MOC process does NOT entail:

Re-Submission of One’s Credentials

Re-Submission of Work Samples

Re-Examination of any kind (written, oral, or otherwise)

Fee or payment of any kind (it is free!)

MOC in Medicine: Not Without Controversy

What is MOC?

Adapted from Lucas, J. (2014). The American Board of Clinical Neuropsychology and American Academy of Clinical Neuropsychology: Updated milestones 2005-2014. The Clinical Neuropsychologist, 28, 889-906.

2015. MOC Pilot Phase initiated by AACN/ABCN Boards of Directors (Pilot initiated in March and is ongoing).

“Early in its history, ABCN recognized that the knowledge base and skill sets required of specialists at the time of board certification were dynamic in nature and would change with advances in the field” (p. 898). However, limited resources precluded development of a process that formally evaluates continued competence.

2006. ABCN membership reaches 500; ABCN reconsiders MOC; ABPP was also exploring recertification process for all Specialty Boards. Determination: MOC would involve documentation of activities that exemplified functional and foundational competencies required of respective specialties.

2010. ABCN endorses general MOC principles proposed by ABPP. Specialty competence is established at the time of initial board certification, “and could be continuously updated through routine engagement in a wide variety of ongoing professional activities” (p. 898).

2012-2013. Formal ABPP MOC proposal drafted; subsequently revised following feedback from ABCN and other specialties. ABCN develops procedures, materials, MOC criteria. Requirements expected across all specialties, but adapted to address competencies specific to ABCN.

2014. MOC procedures formally approved by the ABPP Standards Committee.

What is MOC?

The Bottom Line:ABPP (ABCN) MOC is a process that involves periodic documentation of routine professional activities that demonstrate Specialists’ continuing professional development and competence.

Who Will Participate in MOC?

• If Specialists are certified before 1/01/15: MOC is not required.

– However, participation in MOC is strongly encouraged. Specialists certified prior to 1/01/15 may ‘opt in’ to the MOC process at any time; after doing so, they will be required to undergo MOC every 10 years (and every 10 years thereafter).

• If Specialists are certified after 1/01/15: MOC is required every 10 years (and every 10 years thereafter).

Who Will Participate in MOC?

• MOC Pilot Participants (March 2015 – present): ABCN and AACN Boards of Directors have committed to participating in MOC pilot process, and the MOC pilot is ongoing. As of 6/01/15, 20 MOC pilot applications were successfully submitted and reviewed.

• Every ABCN Specialist, regardless of the time of original certification, is strongly encouraged to participate in MOC!

– “It is ABPP’s hope that all specialists will participate in MOC, as doing so supports ABPP in its role of setting and maintaining standards of competence and excellence, and sets a clear leadership example for future specialists. It is our sincere hope that your MOC experience is a positive, self-reflective experience” (www.abpp.org).

When Will I Complete MOC?

• MOC Timeline (Full Membership). The precise timeline for opening MOC to the full ABCN membership is uncertain, but MOC applications will likely be accepted beginning in late 2015/early 2016 pending receipt of AACN/ABCN BOD feedback and resolution of certain procedural challenges.

• Specialists certified before 1/01/15. Those who opt in will be Eligible in their initial 8th year of certification, Encouraged in their Anniversary year, and Required no later than 10 years after the initial 1/01/15 MOC inception (2024).

– Example: A Specialist certified in 2009 would be Eligible for MOC in the 8th year post-certification (2017), Encouraged to participate in Anniversary year (2019), and Required to participate in 2024.

• Specialists certified after 1/01/15. Eligible to participate in their initial 8th year of certification; Required to participate before the end of the 10th year of certification (and every 10 years thereafter).

– Example: A Specialist certified in 2017 would be Eligible for MOC in 2025 and Required in 2027.

Why Should I Participate if I am Not Required To Do So?

• As noted by ABCN (www.theabcn.org), clinical neuropsychology is a growing, evolving, complex field of practice and competencies demonstrated at the time of initial certification are not static. MOC offers an efficient, structured means of documenting the efforts that competent Specialists already pursue.

• Participation in MOC demonstrates commitment to the highest standards of practice and regard for public welfare, reasons that likely led Specialists to pursue board certification in the first place.

• MOC participation sets a clear leadership example for colleagues and neuropsychology students across all levels of training, and supports ABPP in its mission to establish and uphold standards for specialty clinical practice.

Outline

1. MOC: Why, What, Who, and When?

2. MOC Basics: Review of Process & Procedure

3. MOC Application Exercise (“Mock MOC” Application)

How Does The MOC Process Work?

• After MOC application process opens to full ABCN membership, Specialists will receive notification from ABPP that MOC applications can be submitted (those certified prior to 1/01/15 will be asked if they would like to ‘opt in’ to the process).

• At the time of MOC Eligibility (or Requirement), Specialists will complete the MOC application, documenting professional activities aggregated over the last 2 years, and submit to ABPP electronically.

• Informational documents, inclusive of MOC procedures/policies, application materials/requirements, and a sample MOC application, will be made available electronically by ABPP at the time of MOC notification of Eligibility.

How Does The MOC Process Work?

• The MOC application allows Specialists to document a wide array of professional activities that can be used in support of ongoing competence.

• Professional activities are organized under 5 categories:

(1) Collaborative Consultation(2) Teaching and Training(3) Ongoing Education(4) Research and Methodologies(5) Professional Leadership

• Activities are then translated into ‘credits’ in support of MOC Application

– 40 Credits Minimum Required for Overall MOC– 30 Credits Minimum Required for Specialty– 20 Credits Minimum Required for Subspecialty (e.g., Pediatric)

How Does The MOC Process Work?

• Professional Development Activities and Credits (EXAMPLES BELOW ARE NOT EXHAUSTIVE!!):

– Collaborative Consultation> Case consultation with a colleague (5 consultations – 1 credit).> Journal club participation or presentation (5 journal clubs = 1 credit)> Research group participation or presentation (5 group meetings = 1 credit)

– Teaching/Training> Teaching/supervising students/trainees (1 hour = 1 credit; 1 semester course = 20 credits)> Thesis/dissertation committee (Committee chair = 15 credits; Committee member = 10 credits)> Training, in-service, presentation of other professionals (1 hour = 1 credit)> Workshop presentations to professional audience (1 hour = 1 credit; Workshop– 10 credits)

How Does The MOC Process Work?

• Professional Development Activities and Credits (EXAMPLES BELOW ARE NOT EXHAUSTIVE!!):

– Ongoing Education> Attending a conference presentation for CE (1 CE hour = 1 credit)> Self-directed learning, such as journal-based CE (1 journal article = 1 credit)

– Research/Methodologies> Peer-reviewed journal publication (First author = 10 credits per publication)> Book chapter (1 chapter = 5 credits)> Grantsmanship (Primary Investigator = 20 credits)

– Professional Leadership> Management/administration of clinical services (Each year = 10 credits)> Management/administration of psychological service provider (Each year of service = 10 credits)> Leadership in professional organization or board (10 credits per office per year)> IRB member (10 credits per office per year)

How Does The MOC Process Work?

Foundational Competency Functional CompetencyScientific Knowledge & Methods Assessment (ABCN Core)Evidence Based Practice Consultation (ABCN Core)Individual and Cultural Diversity Intervention (ABCN Core)Ethical Legal Standards & Policy Research/EvaluationProfessionalism SupervisionRelationships TeachingInterdisciplinary Systems Management-AdministrationReflective Practice/Self-Assessment/Self-Care Advocacy

Professional activities are simultaneously cited as evidence of ongoing competency, specifically defined by the ABPP/ABCN Foundational and Core Functional Competencies:

How Does The MOC Process Work?

• The MOC application itself consists of 2 parts:

1. Specialty Continuing Professional Development (SCPD) Grids (5 Activity area Grids)(a) Collaborative Consultation(b) Teaching and Training(c) Ongoing Education(d) Research and Methodologies(e) Professional Leadership

2. Narrative Summary (750 words maximum; elaborate upon Grid activities/competencies)(a) Brief description of current professional neuropsychological activities(b) One-paragraph vignette from typical neuropsychological work.(c) One-paragraph describing a recent ethical or individual/cultural diversity issue(d) Means of evaluating effectiveness of professional activities.(e) Summary of additional relevant activities not described in the SCPD grid (if relevant)(f) Summary of professional activities outside specialty if neuropsychology (if relevant)

How Does The MOC Process Work?• Applications forwarded from ABPP to ABCN MOC Committee for evaluation:

– ‘Pass’> Application clearly meets ABCN criteria; recommendation that Specialist maintain

certification for another 10 years

– ‘Needs More Information’> Application is incomplete/unclear; recommendation that Specialist clarify> Applicant will have 90 days to submit requested information (after that time,

Reviewer will prepare written feedback, recommend remediation)

– ‘Fail’> Application does not clearly meet ABCN criteria; written feedback prepared;

recommendation for remediation)> Applicant will have 1 year to resubmit MOC materials

– If initial deficiencies are adequately addressed, recommendation that Specialist maintain certification for another 10 years

– If initial deficiencies are not adequately addressed, or if Specialist does not resubmit within the 1 year, recommendation that certification be revoked.

Outline

1. MOC: Why, What, Who, and When?

2. MOC Basics: Review of Process & Procedure

3. MOC Application Exercise (“Mock MOC” Application)

2 2

23

51

6

51515

1

29

20

1. Provide occasional case consultations to local neuropsychologists and general practitioners regarding patients/clients with varied cognitive and psychological disorders (approximately 5 consultations per year x 2 years).

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

✓

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

✓ ✓ ✓

4. Research group meetings, including monthly AD consensus, TBI phone conferences, and other research presentations (75 total meetings in last 2 years).

2. Multidisciplinary consultations provided to colleagues in medicine and social work (approximately 3 consultations per year x 2 years).3. Journal club meetings with neuropsychology practicum students and interns in a training clinic (1/month x 2 years).

5. Not applicable

6. Biweekly 90-minute ‘cultural interviews’ with clinical psychology colleagues (not specialty-specific).

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

1. Provide direct supervision of pre-doctoral interns and post-doctoral residents in large university-based medical center (10 hours weekly x 2 years)2. Dissertation chair for 2 projects; committee member for 3 projects.3. Not applicable4. Not applicable.5. Not applicable.6. Not applicable.7. Not applicable.

480 48060 60

540 540

20

✓ ✓ ✓ ✓ ✓ ✓

12 12

5 5

17 17

17

1. Not applicable2. Earned CE credits at AACN (2013, 2014).3. Not applicable4. Not applicable.5. Competed 5 Online CE articles through The Clinical Neuropsychologist.6. Not applicable.

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

2 2

2 2

2

1. Not applicable2. Not applicable3. Not applicable4. Not applicable.5. Not applicable.6. Not applicable.7. Completed 2 Ad Hoc Reviews of articles submitted for possible publication at The Clinical Neuropsychologist.

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

20 20

20

40 20

20

1. Section head and clinic director within neuropsychology department (10 credits x 2 years).2.. Not applicable.3. Not applicable4. Not applicable.5. Not applicable.6. Not applicable.7. Member of my Institutional review board (not specialty-specific).

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

✓ ✓ ✓ ✓ ✓ ✓

2020172

20

79

2354017

2

602

20

Stay tuned!

For latest information related to MOC process, procedures, and timeline,

please refer to:

www.abpp.orgwww.theabcn.org

Thank You!

Questions?