The American Board of Pediatrics

Training Requirements for Subspecialty Certification

APPD Meeting – May 2, 2009 Forum for Fellowship Directors Presented By:

The American Board of Pediatrics

ABP Update

APPD Fall Meeting – October 2, 2013 Plenary Session

Arlington, VA

Update from the ABP

1. Mission of the ABP

2. Role of Program Directors in Certification Process “Evaluation and Tracking” 3. Examination Issues:

• Criterion-based Scoring • Scoring Changes • ITE

4. Combined Training in Pediatrics-Medical Genetics

5. Recommendations from Subspecialty Clinical Training and Certification (SCTC) Initiative

The ABP At a Glance

Established in 1933

Sole mission to the public to assure that physicians have specialized training in pediatrics & meet the standards needed to provide quality care

Includes 250 physicians who volunteer time to establish & evaluate the set of standards

Independent certifying board for

Diplomates

One of the 24 specialty boards recognized by the American Board of Medical Specialties (ABMS)

The American Board of Pediatrics:

ABP Mission

• The ABP certifies general pediatricians and pediatric

subspecialists based on standards of excellence that lead to high quality health care.

• Certification provides assurance to the public that a general pediatrician or pediatric subspecialist has successfully completed accredited training and fulfills continuous evaluation requirements that encompass the six core competencies.

Improve care of children

Standardize training and promote evidence- based care

Purpose of Certification

Provide accountability to the public that pediatrician has unique knowledge and skills to provide routine and complex care and that they maintain those skills over time (MOC)

Role of PDs in Certification Process Tracking and Evaluation

• Part of the certifying process

• PDs and faculty are key in determining who is eligible for certification based on assessment of clinical competence and professionalism

Implications of Next Accreditation System

No immediate changes in tracking and evaluation or reporting of competence to ABP

Milestones will not be used for certification decisions by ABP until further data is accumulated, but ABP will expect programs to use milestones to inform their assessment of trainees.

Future Directions for the American Board of Pediatrics

Residency and Fellowship

Milestones Assessment

Milestones Assessment

Milestones Assessment

Medical School

Milestones Assessment

Examination & Certification

Professional Development

& MOC

Outcomes: Healthy Children

Standard Setting Categories

Normative • Based on performance of

other candidates

• Certain % will fail

• Reference group defined – First-time takers

– American medical school

– Recently trained

Absolute • Based on how well you

performed

• All can pass; All can fail

• Key is determining “how much is enough”

Criterion-based Scoring • Passing score for 2012 general pediatrics exam

was established using an absolute (criterion-based) standard.

• Minimal score (% correct) required to pass exam, based on new standard.

• Performance reported on a standardized scoring scale with a range of 1-300. Passing standard is 180. Percent score will not be provided.

Criterion-based Scoring

Multiple exam forms to ensure security

over three days of testing.

Forms constructed using same blueprint with some overlap in questions.

Equating techniques adjust for form differences to ensure that scaled scores are comparable regardless of form taken.

Implication of Criterion-based Scoring on Exam Report

Most changes in score reports for

individuals and PDs are minor.

Individual score reports include standard score for each subtest in comparison with all first time takers of the exam (bar graph). Percent correct will no longer be reported.

Implication of Criterion-based Scoring on Exam Report

Report of ten-year cumulative results have changed most significantly by deleting scores prior to the 2012 exam. Percent certified will remain for all ten years. Reports for RC for Pediatrics will be generated annually to include first attempt pass rates and percentage of those eligible who are first time takers. Each year the report will provide data for the previous 5 years.

Changes to ITE

Exam for 2013 reduced in length (3 hours) and number of questions (150 MCQs)

New scoring methods and scale (1-300) used for 2013 ITE

No change in predictive accuracy of pass-fail classifications with shorter ITE.

Sample ITE Score Report

ABP will provide to all

Program Directors with ITE results to assist with

interpretation of score report.

Changes to ITE Score Reports (2013)

PD reports and candidate score reports have been modified to reflect the new 1-300 scale.

Comparison of ITE scores to Certification Exam results will be based on one administration year initially and build back to 5 years over time.

Individual ITE score reports will still include percent correct. Caveat: Exam difficulty may vary slightly from year to year

PDs will be provided with table of 2012 ITE scores (0-800) converted to new scale (1-300)

Upcoming ITE Changes

• ABP anticipates migrating the ITE to an internet-based (IBT) delivery system

• A pilot test to be conducted in 2014 to help identify any potential obstacles

• ALL programs will be asked to complete a brief survey next week and will be asked if interested in participating in the pilot (voluntary)

• Programs randomly chosen to participate in pilot will receive a $20 per resident discount on the standard fee.

ITE to IBT Pilot 2014

• Personal or institutional devices (Windows or Mac operating systems) including desktops, laptops, or iPads

• ITE must be proctored. Testing period will not change.

• Paper exam provided for back-up purposes. All residents expected to use internet-based system

• An application must be downloaded to each machine to administer exam and restrict navigation.

Combined Training in Pediatrics-Medical Genetics

• A four year combined residency training program will replace the current five year program, effective July 2014.

• Any trainee who began training before 2014 must fulfill the current five year program requirement.

• All currently approved programs and any new programs must submit an application to each Board for approval.

• The new requirements and application form are available on the ABP Web site.

• ABP appointed a Task Force in 2010 to examine the current model of pediatric fellowship training with emphasis on competency-based clinical training and to make recommendations for change if warranted.

• This process has included input and feedback from the pediatrics community

• Surveys of program directors, current fellows, and practicing subspecialists

Initiative on Subspecialty Clinical Training and Certification (SCTC)

• CoPS has served as network for communication efforts

• Final recommendations were approved by ABP Board of Directors in June 2013

• Visit ABP and CoPS websites to view recommendations (www.abp.org; www.pedsubs.org)

Initiative on Subspecialty Clinical Training and Certification (SCTC)

www.abp.org - Eligibility and training requirements for general

pediatrics and all subspecialties, PD information, ABP policies, etc.

- 2012 – 2013 Workforce Data available for viewing and downloading from ABP Web site

- Resources for Program Directors - www.abp.org - Click the Program Directors button

ABP Web Site