May 2002 • Volume 8 • Number 5 |
In the words of folksinger Bob Dylan, "The times, they are a-changin'." And family physicians need to change right along with them, says the American Board of Family Practice.
Witness the way FPs take the certification and recertification exams. According to Robert Avant, M. D., ABFP's executive director, it's time to make optimal use of today's computer technology.
"What we want to do is move toward a computer-administered exam," said Avant. "This is where many different types of examinations are headed."
Avant and Terrence Leigh, Ed.D., ABFP assistant executive director, presented the concept April 7 at the Residency Assistance Program Workshop for Faculty and Staff of Family Practice Residencies in Kansas City, Mo.
Such a system, Avant said, would open up possibilities well beyond the capabilities of the current testing format.
"The graphics are better; our ability to monitor how someone is doing is better," he explained. "But the most exciting thing is that we've been able to develop patient-care simulations that allow us to move from presentation of a case to doing the history, developing a treatment plan and following up over time. That's something we haven't been able to do with the current exam."
So, the $64,000 question: When should FPs preparing to sit for their boards expect to be faced with a computer screen rather than paper and pencil?
"We're hoping to begin phasing this in during the 2003 calendar year," said Avant. Meeting that timetable, however, depends on the results of a just-completed pilot project. On April 12, the board offered its certificate of added qualifications in sports medicine exam in a computerized format at eight different sites around the country. Although ABFP has conducted previous pilots, he said, this was the first time the entire exam appeared in computerized format.
Understandably, there was a certain amount of opening-night jitters involved. "It's a critical issue for us," said Avant. "If the results are perfect, we can proceed with our scheduled timetable. If there are problems, they'll have to be addressed. Our concern is that it has to be perfect the first time, because it IS the exam."
What is the Academy's reaction to the change?
"It's just terrific," said Norman Kahn, M.D., vice president for science and education. "We asked ABFP to do two things, and they did both of them. It's a clear sign of the strong working relationship the AAFP has developed with ABFP."
Members have clamored for many years to have the exams administered more than once annually, Kahn explained, and the board is doing just that. "In 2003, physicians taking the certification or recertification exam in July will have the choice of taking it on paper or on the computer," he said. "And then there will be a second exam offered later in the year that will be given only by computer."
The same arrangement will hold for 2004. After that, put down your pencils, ladies and gentlemen. It's all keystrokes and mouse clicks from there on out. Although you'll still get two chances a year.
Regarding AAFP's second request, said Kahn, "This gives us two full years to prepare the nation's family physicians. We'll be providing training at the 2002 Assembly, as well as during the 2003 board review courses and the 2003 Assembly," and most likely beyond that.
As for the logistics of how and where the exams will be administered, Avant said, "We'll need to start out by using exam centers, but the goal on down the line is to be able to offer this via home computers. Of course, there'll be some confidentiality issues that will have to be addressed when we get to that point."
The eventual objective, he said, is to use this technology for performing other types of ongoing physician assessment.
"We really want to move ahead in ways to assess physicians over a lifetime, and this is the way to go," Avant said. "But we don't have a drop-dead date for that."
FP Report is published by the
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Copyright © 2002 by
American Academy of Family Physicians.