In medical specialties, as in many professions, continually learning and demonstrating retention are central to maintaining certification. At the American Board of Anesthesiology, professionals saw a new avenue for strengthening the ties among contemporary knowledge acquisition, practice, and, ultimately, patient care and safety.

ABA’s vision began taking shape in 2014 and 2015, through the development of a web-and-mobile-powered longitudinal-assessment tool called the MOCA Minute. The tool regularly fed questions to physicians scheduled to take the Maintenance of Certification in Anesthesiology exam to test their knowledge. Equally important, the MOCA Minute gave physicians immediate feedback, a rationale for the answer to each question, and links to learning resources.

The ABA initiative has had a significant positive impact on participant scores and on other medical specialties. The effort exemplifies association contributions to public safety, education, and workforce knowledge that are subjects of the ASAE Research Foundation study “Impact of Associations on Society: Evidence for Future Influence and Action,” conducted in connection with ASAE’s 2020 centennial year.

Assessment by the Minute

Historically, once anesthesiologists achieved board certification, they took a cognitive exam every 10 years to maintain their certification. In 2014 and 2015, ABA piloted the MOCA Minute to test longitudinal assessment.

At the American Board of Anesthesiology, professionals saw a new avenue for strengthening the ties among contemporary knowledge acquisition, practice, and, ultimately, patient care and safety.

The board began with 1,500 volunteer diplomates scheduled to take the cognitive exam and expanded to all participants in 2016 following promising initial results. At each phase, ABA expanded testing topics, beginning with 16 and extending to 22. In 2018, ABA transitioned the MOCA Minute from a pilot to a permanent component, replacing the traditional cognitive exam, for all participants in continuing certification.

The MOCA Minute design embodies these principles:

• Continual learning and assessment. Users refine and demonstrate professional knowledge over time rather than episodically.
• Customization. The mix of questions fed to anesthesiologists is based on the proportion of time they spend in each practice area.
• Flexibility. The tool allows ABA to push out questions and resource links in real time that relate to current challenges—for example, COVID-19.

The Results

Those who actively participated in the MOCA Minute in pilot years 2014 and 2015 scored 9.9 and 9.3 points higher, respectively, than those who did not. Anesthesiologists also expressed satisfaction, noting that they got more out of the longitudinal-assessment experience than the exam. In 2017, 77 percent of participants surveyed reported that the MOCA Minute “was serving them somewhat or very well as an assessment tool.”

Moreover, the ABA initiative has transcended anesthesiology, inspiring other medical specialty certifying bodies to make similar use of advanced technology and learning science. Today, all 24 medical specialty certifying boards use, or are in the process of implementing, longitudinal assessments in their certification programs.