As part of the American Board of Family Medicine’s (ABFM) efforts to continually improve the activities provided to Diplomates, residents and candidates for certification, we have focused over the past year on a major upgrade of the popular Knowledge Self-Assessment (KSA) activities that are utilized by an average of 40,000 family physicians annually. As part of this KSA upgrade, all items are being converted to single-best answer questions (eliminating the multiple True/False choices); the evidence, including critiques and references, is being updated; the passing standard of 80% now applies to the KSA as a whole, rather than being a requirement for every individual content category; and, the KSA platform has been substantially improved for a better user experience.

I saw this as an opportunity to help physicians continue to grow as the best clinicians they could be. I was impressed with ABFM’s commitment to ensuring a high-quality learning experience in Asthma that was both relevant and up-to-date.

—Kurt Elward, MD, MPH

In addition to feedback provided by Diplomates on KSA questions and the overall process, ABFM has utilized family physician experts in specific topic areas to inform the revision process more directly. Dr. Kurt Elward, a family physician in Charlottesville, Virginia, has been in practice for over 30 years and has facilitated group SAM/KSA sessions for over 15 years. He has had the opportunity to listen to the comments of hundreds of Diplomates about the content and process of the KSAs and has also had extensive experience with evidence-based asthma care guidelines, having led several statewide collaboratives focused on asthma care and how to implement optimal care into practice. He was selected to represent the American Academy of Family Physicians (AAFP) on the National Asthma Education and Prevention Program Coordinating Committee in 2004 and most recently served on the National Asthma Education and Prevention Program Expert Panel, which produced the 2020 Focused Update to the asthma guidelines that was published in December 2020.

Because of this extensive experience, ABFM reached out to Dr. Elward to ask if he would be willing to assist in the development of the update under way for the Asthma KSA. “So, when I had the opportunity to pair my knowledge of the asthma guidelines with the opportunity to enhance the ABFM KSA for asthma, I was thrilled,” said Elward. “I thought it was a good opportunity to serve the Board and my colleagues and help convey the critical teaching and clinical points of the new guidelines for family physicians.”

“I appreciated the Board inviting me to be a part of this,” said Elward. “They were actively looking for content experts and people with experience in ways to optimize the KSAs. I was fortunate to have the awareness of what was developing in the new national guidelines and received permission from the NIH to help introduce elements of the six key recommendations that were going to be addressed” as part of this KSA revision. “ABFM was very open to my designing questions or looking at current items that pertained to the 2020 guideline update and develop them in a way that would convey the key learning points. We tried to make the items focused on facets of the new recommendations that were important for practicing family physicians and to make the critiques both very practical and relevant to how they could implement changes in their practice. One of the things that enthuses me about the KSAs, is that we've shown that they actually can help improve the quality of care. That's why I believe in using the KSA process to provide key elements of the guidelines to family physicians and strengthen their practice in meaningful ways."

ABFM’s new Asthma KSA will be available in Spring 2021. We welcome additional feedback from all KSA utilizers on individual questions through the commenting process, which is regularly monitored and used to inform interim updates, which occur even between annual, evidence-based updates. Similarly, those with experience on national guideline panels are encouraged to let us know if they have an interest in being involved in future KSA topic updates or development of new KSAs.